Insurance Code § 1369.1031

Sec. 1369.1031. CERTAIN COVERAGE REQUIRED. (a) This section applies to a health benefit plan described by Section 1369.102. (b) Notwithstanding any other law, this section applies to: (1) a standard health benefit plan issued under Chapter 1507; (2) a basic coverage plan under Chapter 1551; (3) a basic plan under Chapter 1575; (4) a primary care coverage plan under Chapter 1579; (5) a plan providing basic coverage under Chapter 1601; (6) group health coverage made available by a school district in accordance with Section 22.004, Education Code; and (7) the state Medicaid program, including the Medicaid managed care program operated under Chapters 540 and 540A, Government Code. (c) A health benefit plan that provides benefits for a prescription contraceptive drug must provide for an enrollee to obtain up to: (1) a three-month supply of the covered prescription contraceptive drug at one time the first time the enrollee obtains the drug; and (2) a 12-month supply of the covered prescription contraceptive drug at one time each subsequent time the enrollee obtains the same drug, regardless of whether the enrollee was enrolled in the health benefit plan the first time the enrollee obtained the drug. (d) An enrollee may obtain only one 12-month supply of a covered prescription contraceptive drug during each 12-month period. Added by Acts 2023, 88th Leg., R.S., Ch. 395 (H.B. 916), Sec. 2, eff. September 1, 2023. Amended by: Acts 2025, 89th Leg., R.S., Ch. 204 (H.B. 1620), Sec. 11.005, eff. September 1, 2025.