Tex.
Ins. Code Section 1369.1031
Certain Coverage Required
(a)
This section applies to a health benefit plan described by Section 1369.102 (Applicability of Subchapter).(b)
Notwithstanding any other law, this section applies to:(1)
a standard health benefit plan issued under Chapter 1507 (Consumer Choice of Benefits Plans);(2)
a basic coverage plan under Chapter 1551 (Texas Employees Group Benefits Act);(3)
a basic plan under Chapter 1575 (Texas Public School Employees Group Benefits Program);(4)
a primary care coverage plan under Chapter 1579 (Texas School Employees Uniform Group Health Coverage);(5)
a plan providing basic coverage under Chapter 1601 (Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System);(6)
group health coverage made available by a school district in accordance with Section 22.004 (Group Health Benefits for School Employees), Education Code; and(7)
the state Medicaid program, including the Medicaid managed care program operated under Chapter 533, 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.
Source:
Section 1369.1031 — Certain Coverage Required, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1369.htm#1369.1031 (accessed Jun. 5, 2024).
