The bill aims to enhance access to prescription hormone therapy for patients of all ages by mandating that health plans provide reimbursement for a 12-month supply of such therapy when obtained at one time by the enrollee. This requirement will take effect for health plans issued or renewed on or after January 1, 2026. Exceptions to this rule include cases where the enrollee requests a smaller supply, the prescribing provider specifies a smaller supply, or if the therapy is classified as a controlled substance. In the case of controlled substances, health plans must reimburse for the maximum refill allowed under state and federal law. The bill also allows health plans to impose limits on refills in the last quarter of the plan year and permits prescribing providers to temporarily limit refills to a 90-day supply during acute dispensing shortages.

Additionally, the bill reenacts and amends RCW 41.05.017 to include the new section regarding prescription hormone therapy reimbursement. It clarifies that "prescription hormone therapy" encompasses all FDA-approved drugs used to manage hormone levels, excluding glucagon-like peptide-1 and its receptor agonists. The legislation aims to ensure that patients have better access to necessary hormone therapies while maintaining appropriate clinical guidelines for prescribing and dispensing.