This Act requires individual health insurance plans, group and blanket health insurance plans, the State employee health plan, and State Medicaid insurance to cover medically necessary pre-exposure prophylaxis (“PrEP”) treatment for the prevention of human immunodeficiency virus (“HIV”) infection before possible HIV exposure and post-exposure prophylaxis (“PEP”) treatment for the prevention of HIV infection after possible HIV exposure.
The required PrEP and PEP coverage must include services related to administering the covered treatment and must be provided without any of the following:
1. Cost-sharing requirements, including deductibles, coinsurance, copayments, and out-of-pocket expenses.
2. Prior authorization or step therapy requirements.
3. Unreasonable delay in coverage determination.
This Act applies to all policies, contracts, or certificates that are renewed, modified, altered, amended, or reissued after December 31, 2026.