Any insurer who, on or after January 1, 2019, delivers or issues a policy of group 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 16. Group Accident and Sickness Insurance
§33-16-3. Required Policy Provisions
§33-16-3b. Home Health Care Coverage
§33-16-3bb. Coverage for Amino Acid-Based Formulas
§33-16-3cc. Substance Use Disorder
§33-16-3d. Medicare Supplement Insurance
§33-16-3dd. Prior Authorization
§33-16-3e. Policies to Cover Nursing Services
§33-16-3ee. Fairness in Cost-Sharing Calculation
§33-16-3ff. Mental Health Parity
§33-16-3g. Third Party Reimbursement for Mammography, Pap Smear or Human Papilloma Virus Testing
§33-16-3gg. Incorporation of the Health Benefit Plan Network Access and Adequacy Act
§33-16-3h. Third Party Reimbursement for Rehabilitation Services
§33-16-3hh. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs
§33-16-3i. Coverage of Emergency Services
§33-16-3j. Hospital Benefits for Mothers and Newborns
§33-16-3k. Limitations on Preexisting Condition Exclusions for Health Benefit Plans
§33-16-3l. Renewability and Modification of Health Benefit Plans
§33-16-3m. Creditable Coverage
§33-16-3n. Eligibility for Enrollment
§33-16-3o. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing
§33-16-3p. Required Coverage for Reconstruction Surgery Following Mastectomies
§33-16-3q. Required Use of Mail-Order Pharmacy Prohibited
§33-16-3r. Coverage for Patient Cost of Clinical Trials
§33-16-3s. Third-Party Reimbursement for Kidney Disease Screening
§33-16-3t. Required Coverage for Dental Anesthesia Services
§33-16-3u. Special Enrollment Period Under the American Recovery and Reinvestment Act of 2009
§33-16-3v. Required Coverage for Treatment of Autism Spectrum Disorders
§33-16-3x. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications
§33-16-3y. Eye Drop Prescription Refills
§33-16-3z. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs
§33-16-3zz. Lyme Disease to Be Covered by All Health Insurance Policies
§33-16-5. Contingencies for Which Benefits or Reimbursement of Expenses Permitted
§33-16-6. Rider Changing Individual Policy to Group Policy Prohibited
§33-16-7. Hospital Indemnity Policies Not to Exclude Coverage for Confinement in Government Hospital
§33-16-8. Continuum of Care Services
§33-16-10. Policies Discriminating Among Health Care Providers
§33-16-12. Child Immunization Services Coverage
§33-16-13. Equal Treatment of State Agency
§33-16-14. Coordination of Benefits With Medicaid
§33-16-16. Insurance for Diabetics
§33-16-17. Commissioner to Propose Rules
§33-16-18. Assignment of Certain Benefits in Dental Care Insurance Coverage