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Insurance Coverage for Contraception

Washington law requires health-insurance plans that cover prescription medication to provide equitable coverage for contraception.

What is required?  If a health-insurance plan provides generally comprehensive coverage of prescription medication, it must provide coverage for Food and Drug Administration-approved prescription contraception, including prescription barrier methods and emergency contraception.

To which insurance plans does the law apply?  Health-insurance plans issued or renewed on or after January 1, 2002 that provide generally comprehensive coverage of prescription medication.

Does the law provide additional protections for women?  Yes.  Insurers may not impose copayments, deductibles, waiting periods, limitations, or restrictions on prescription contraceptives that are not imposed on other covered prescription medication.

Does the law contain a refusal clause, allowing certain employers and/or insurers to refuse to provide or pay for contraceptive coverage?  No.  Although a separate regulation allows employers to refuse to provide insurance coverage for services they oppose for religious or moral reasons, the same regulation explicitly recognizes that an individual has a right to obtain a health plan that covers the full range of services regardless of an employer's religious or moral objection to a particular service.

In a recent opinion, former Washington Attorney General (now Governor) Christine Gregoire determined that, even if an employer refuses to purchase insurance coverage for contraception, an employee may not be denied contraceptive coverage and an insurer may not charge the employee an extra fee for such coverage.  Former Attorney General Gregoire further stated that nothing in the regulation requires insurers to provide services without appropriate payment or fee and that other mechanisms of recovering the cost of such coverage should be considered.  Wash. Op. Att'y Gen. No. 5 (Aug. 5, 2002).

Wash. Admin. Code § 284-43-822 (Adopted 2001).


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