Any insurer who, on or after January 1, 2019, delivers or issues a policy of accident and sickness insurance in this state under the provisions of this article shall make available as benefits to all subscribers and members coverage on an expense-incurred basis and individual and group service or indemnity type contracts issued by a nonprofit corporation shall provide coverage for long-term antibiotic therapy for a patient with Lyme disease when determined to be medically necessary and ordered by a licensed physician after making a thorough evaluation of the patient’s symptoms, diagnostic test results, or response to treatment.
Structure West Virginia Code
Article 15. Accident and Sickness Insurance
§33-15-1a. Premium Rate Increase Requests; Loss Ratio Requirement
§33-15-1b. Rates, Individual Major Medical Policies
§33-15-2. Scope and Format of Policy
§33-15-2b. Guaranteed Issue; Limitation of Coverage; Election; Denial of Coverage; Network Plans
§33-15-2c. Feasibility Study for Alternatives to Guaranteed Issue
§33-15-2d. Exceptions to Guaranteed Renewability
§33-15-2f. Certification of Creditable Coverage
§33-15-4. Required Policy Provisions
§33-15-4a. Required Policy Provisions-Mental Illness
§33-15-4b. Policies to Cover Nursing Services; Definition
§33-15-4c. Third Party Reimbursement for Mammography, Pap Smear or Human Papilloma Virus Testing
§33-15-4d. Third Party Reimbursement for Rehabilitation Services
§33-15-4e. Benefits for Mothers and Newborns
§33-15-4f. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing
§33-15-4g. Required Coverage for Reconstruction Surgery Following Mastectomies
§33-15-4h. Coverage for Patient Cost of Clinical Trials
§33-15-4i. Third-Party Reimbursement for Kidney Disease Screening
§33-15-4j. Required Coverage for Dental Anesthesia Services
§33-15-4l. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications
§33-15-4m. Eye Drop Prescription Refills
§33-15-4n. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs
§33-15-4p. Lyme Disease to Be Covered by All Health Insurance Policies
§33-15-4q. Coverage for Amino Acid-Based Formulas
§33-15-4r. Substance Use Disorder
§33-15-4s. Prior Authorization
§33-15-4t. Fairness in Cost-Sharing Calculation
§33-15-4u. Mental Health Parity
§33-15-4v. Incorporation of the Health Benefit Plan Network Access and Adequacy Act
§33-15-4w. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs
§33-15-5. Optional Policy Provisions
§33-15-6. Inapplicable or Inconsistent Provisions
§33-15-7. Order of Certain Provisions
§33-15-8. Third Party Ownership of Policy Covering Insured
§33-15-9. Requirements of Other Jurisdictions
§33-15-10. Franchise Insurance
§33-15-12. Continuum of Care Services
§33-15-14. Policies Discriminating Among Health Care Providers
§33-15-17. Child Immunization Services Coverage
§33-15-18. Equal Treatment of State Agency
§33-15-19. Coordination of Benefits With Medicaid
§33-15-20. Individual Medical Savings Accounts; Definitions; Ownership; Trustees; Regulations
§33-15-21. Coverage of Emergency Services
§33-15-22. Assignment of Certain Benefits in Dental Care Insurance Coverage