An Act to Require Health Insurance Coverage for Federally
Maine Legislature, Session 132, LD 0163
Committee: Health Coverage, Insurance and Financial Services
Sponsors: ARFORD, DAUGHTRY
Amends: 24 MRSA §2332-J, 24-A MRSA §2756, 24-A MRSA §2847-G, 24-A MRSA §4247, 24-A MRSA §4302

Legislative Document
No. 163
H.P. 96
House of Representatives, January 14, 2025
An Act to Require Health Insurance Coverage for Federally 
Approved Nonprescription Oral Hormonal Contraceptives and 
Nonprescription Emergency Contraceptives
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative ARFORD of Brunswick.
Cosponsored by President DAUGHTRY of Cumberland and
Representatives: BOYER of Cape Elizabeth, CLOUTIER of Lewiston, CLUCHEY of 
Bowdoinham, GRAMLICH of Old Orchard Beach, MATHIESON of Kittery, STOVER of 
Boothbay, Senators: BAILEY of York, TALBOT ROSS of Cumberland.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24 MRSA §2332-J, sub-§1, as enacted by PL 1999, c. 341, §1 and affected 
by §5, is amended to read:
1.  Coverage requirements.  All individual and group nonprofit hospital and medical 
services plan policies and contracts and all nonprofit health care plan policies and contracts 
that provide coverage for prescription drugs or outpatient medical services must provide 
coverage for all prescription contraceptives, nonprescription oral hormonal contraceptives 
and nonprescription emergency contraceptives approved by the federal Food and Drug 
Administration or for outpatient contraceptive services, respectively, to the same extent 
that coverage is provided for other prescription drugs or outpatient medical services in 
accordance with the requirements of this section.  For purposes of this section, the term 
"outpatient contraceptive services" means consultations, examinations, procedures and 
medical services provided on an outpatient basis and related to the use of contraceptive 
methods to prevent an unintended pregnancy.  This section may not be construed to apply 
to prescription drugs or devices that are designed to terminate a pregnancy.
Sec. 2.  24 MRSA §2332-J, sub-§4, as enacted by PL 2021, c. 609, §1, is amended 
to read:
4.  Coverage of contraceptive supplies.  Coverage required under this section must 
include coverage for contraceptive supplies in accordance with the following requirements.  
For purposes of this section, "contraceptive supplies" means all contraceptive drugs, 
devices and products approved by the federal Food and Drug Administration to prevent an 
unwanted pregnancy, including nonprescription oral hormonal contraceptives and 
nonprescription emergency contraceptives.
A.  Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement.
B.  If the federal Food and Drug Administration has approved one or more therapeutic 
equivalents of a contraceptive supply, an insurer is not required to cover all those 
therapeutically equivalent versions in accordance with this subsection, as long as at 
least one is covered without any deductible, coinsurance, copayment or other cost-
sharing requirement in accordance with this subsection.
C.  Coverage must be provided for the furnishing or dispensing of prescribed 
contraceptive supplies and nonprescription oral hormonal contraceptive supplies 
intended to last for a 12-month period, which may be furnished or dispensed all at once 
or over the course of the 12 months at the discretion of the health care provider for 
prescribed contraceptive supplies.
D.  A prescription is not required to obtain a nonprescription oral hormonal 
contraceptive or nonprescription emergency contraceptive.
E.  A nonprofit hospital or medical service organization or nonprofit health care service 
organization shall establish mechanisms to ensure that an enrollee who seeks coverage 
for a nonprescription oral hormonal contraceptive or nonprescription emergency 
contraceptive at a pharmacy has the option to obtain the nonprescription oral hormonal 
contraceptive or nonprescription emergency contraceptive at the point of sale without 
payment of any cost-sharing amount or to make the purchase at the pharmacy through 
an out-of-pocket payment at the point of sale and submit a claim for reimbursement. 
The pharmacy may use a standing order to facilitate billing for a nonprescription oral 
hormonal contraceptive or nonprescription emergency contraceptive in accordance 
with this paragraph.
Sec. 3.  24 MRSA §2332-J, sub-§5 is enacted to read:
5.  Rules.  The superintendent may adopt rules as necessary to implement the 
requirements of this section, including rules related to mechanisms to ensure coverage for 
nonprescription 
oral 
hormonal 
contraceptives 
and 
nonprescription 
emergency 
contraceptives and rules regarding notice to enrollees about how to access coverage for 
nonprescription 
oral 
hormonal 
contraceptives 
and 
nonprescription 
emergency 
contraceptives. Rules adopted pursuant to this subsection are routine technical rules as 
described in Title 5, chapter 375, subchapter 2-A.
Sec. 4.  24-A MRSA §2756, sub-§1, as enacted by PL 1999, c. 341, §2 and affected 
by §5, is amended to read:
1.  Coverage requirements.  All individual health policies and contracts, except 
accidental injury, specified disease, hospital indemnity, Medicare supplement, disability 
income, long-term care and other limited benefit health insurance policies and contracts, 
that provide coverage for prescription drugs or outpatient medical services must provide 
coverage for all prescription contraceptives, nonprescription oral hormonal contraceptives 
and nonprescription emergency contraceptives approved by the federal Food and Drug 
Administration or for outpatient contraceptive services, respectively, to the same extent 
that coverage is provided for other prescription drugs or outpatient medical services in 
accordance with the requirements of this section.  For purposes of this section, the term 
"outpatient contraceptive services" means consultations, examinations, procedures and 
medical services provided on an outpatient basis and related to the use of contraceptive 
methods to prevent an unintended pregnancy.  This section may not be construed to apply 
to prescription drugs or devices that are designed to terminate a pregnancy.
Sec. 5.  24-A MRSA §2756, sub-§3, as amended by PL 2021, c. 609, §2, is further 
amended to read:
3.  Coverage of contraceptive supplies.  Coverage required under this section must 
include coverage for contraceptive supplies in accordance with the following requirements.  
For purposes of this section, "contraceptive supplies" means all contraceptive drugs, 
devices and products approved by the federal Food and Drug Administration to prevent an 
unwanted pregnancy, including nonprescription oral hormonal contraceptives and 
nonprescription emergency contraceptives.
A.  Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement.
B.  If the federal Food and Drug Administration has approved one or more therapeutic 
equivalents of a contraceptive supply, an insurer is not required to cover all those 
therapeutically equivalent versions in accordance with this subsection, as long as at 
least one is covered without any deductible, coinsurance, copayment or other cost-
sharing requirement in accordance with this subsection.
D.  Coverage must be provided for the furnishing or dispensing of prescribed 
contraceptive supplies and nonprescription oral hormonal contraceptive supplies 
intended to last for a 12-month period, which may be furnished or dispensed all at once 
or over the course of the 12 months at the discretion of the health care provider for 
prescribed contraceptive supplies.
E.  A prescription is not required to obtain a nonprescription oral hormonal 
contraceptive or nonprescription emergency contraceptive.
F.  An insurer shall establish mechanisms to ensure that an enrollee who seeks coverage 
for a nonprescription oral hormonal contraceptive or nonprescription emergency 
contraceptive at a pharmacy has the option to obtain the nonprescription oral hormonal 
contraceptive or nonprescription emergency contraceptive at the point of sale without 
payment of any cost-sharing amount or to make the purchase through an out-of-pocket 
payment at the point of sale and submit a claim for reimbursement to the insurer. The 
pharmacy may use a standing order to facilitate billing for a nonprescription oral 
hormonal contraceptive or nonprescription emergency contraceptive in accordance 
with this paragraph.
Sec. 6.  24-A MRSA §2756, sub-§4 is enacted to read:
4.  Rules.  The superintendent may adopt rules as necessary to implement the 
requirements of this section, including rules related to mechanisms to ensure coverage for 
nonprescription 
oral 
hormonal 
contraceptives 
and 
nonprescription 
emergency 
contraceptives and rules regarding notice to enrollees about how to access coverage for 
nonprescription 
oral 
hormonal 
contraceptives 
and 
nonprescription 
emergency 
contraceptives. Rules adopted pursuant to this subsection are routine technical rules as 
described in Title 5, chapter 375, subchapter 2-A.
Sec. 7.  24-A MRSA §2847-G, sub-§1, as enacted by PL 1999, c. 341, §3 and 
affected by §5, is amended to read:
1.  Coverage requirements.  All group insurance policies and contracts, except 
accidental injury, specified disease, hospital indemnity, Medicare supplement, disability 
income, long-term care and other limited benefit health insurance policies and contracts 
that provide coverage for prescription drugs or outpatient medical services must provide 
coverage for all prescription contraceptives, nonprescription oral hormonal contraceptives 
and nonprescription emergency contraceptives approved by the federal Food and Drug 
Administration or for outpatient contraceptive services, respectively, to the same extent 
that coverage is provided for other prescription drugs or outpatient medical services in 
accordance with the requirements of this section.  For purposes of this section, the term 
"outpatient contraceptive services" means consultations, examinations, procedures and 
medical services provided on an outpatient basis and related to the use of contraceptive 
methods to prevent an unintended pregnancy.  This section may not be construed to apply 
to prescription drugs or devices that are designed to terminate a pregnancy.
Sec. 8.  24-A MRSA §2847-G, sub-§4, as amended by PL 2021, c. 609, §3, is 
further amended to read:
4.  Coverage of contraceptive supplies.  Coverage required under this section must 
include coverage for contraceptive supplies in accordance with the following requirements.  
For purposes of this section, "contraceptive supplies" means all contraceptive drugs, 
devices and products approved by the federal Food and Drug Administration to prevent an 
unwanted pregnancy, including nonprescription oral hormonal contraceptives and 
nonprescription emergency contraceptives.
A.  Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement.
B.  If the federal Food and Drug Administration has approved one or more therapeutic 
equivalents of a contraceptive supply, an insurer is not required to cover all those 
therapeutically equivalent versions in accordance with this subsection, as long as at 
least one is covered without any deductible, coinsurance, copayment or other cost-
sharing requirement in accordance with this subsection.
D.  Coverage must be provided for the furnishing or dispensing of prescribed 
contraceptive supplies and nonprescription oral hormonal contraceptive supplies 
intended to last for a 12-month period, which may be furnished or dispensed all at once 
or over the course of the 12 months at the discretion of the health care provider for 
prescribed contraceptive supplies.
E.  A prescription is not required to obtain a nonprescription oral hormonal 
contraceptive or nonprescription emergency contraceptive.
F.  An insurer shall establish mechanisms to ensure that an enrollee who seeks coverage 
for a nonprescription oral hormonal contraceptive or nonprescription emergency 
contraceptive at a pharmacy has the option to obtain the nonprescription oral hormonal 
contraceptive or nonprescription emergency contraceptive at the point of sale without 
payment of any cost-sharing amount or to make the purchase at the pharmacy through 
an out-of-pocket payment at the point of sale and submit a claim for reimbursement to 
the insurer. The pharmacy may use a standing order to facilitate billing for a 
nonprescription oral hormonal contraceptive or nonprescription emergency 
contraceptive in accordance with this paragraph.
Sec. 9.  24-A MRSA §2847-G, sub-§5 is enacted to read:
5.  Rules.  The superintendent may adopt rules as necessary to implement the 
requirements of this section, including rules related to mechanisms to ensure coverage for 
nonprescription 
oral 
hormonal 
contraceptives 
and 
nonprescription 
emergency 
contraceptives and rules regarding notice to enrollees about how to access coverage for 
nonprescription 
oral 
hormonal 
contraceptives 
and 
nonprescription 
emergency 
contraceptives. Rules adopted pursuant to this subsection are routine technical rules as 
described in Title 5, chapter 375, subchapter 2-A.
Sec. 10.  24-A MRSA §4247, sub-§1, as reallocated by RR 1999, c. 1, §37, is 
amended to read:
1.  Coverage requirements.  All health maintenance organization individual and 
group health contracts that provide coverage for prescription drugs or outpatient medical 
services must provide coverage for all prescription contraceptives, nonprescription oral 
hormonal contraceptives and nonprescription emergency contraceptives approved by the 
federal Food and Drug Administration or for outpatient contraceptive services, 
respectively, to the same extent that coverage is provided for other prescription drugs or 
outpatient medical services in accordance with the requirements of this section.  For 
purposes of this section, the term "outpatient contraceptive services" means consultations, 
examinations, procedures and medical services provided on an outpatient basis and related 
to the use of contraceptive methods to prevent an unintended pregnancy.  This section may 
not be construed to apply to prescription drugs or devices that are designed to terminate a 
pregnancy.
Sec. 11.  24-A MRSA §4247, sub-§4, as amended by PL 2021, c. 609, §4, is further 
amended to read:
4.  Coverage of contraceptive supplies.  Coverage required under this section must 
include coverage for contraceptive supplies in accordance with the following requirements.  
For purposes of this section, "contraceptive supplies" means all contraceptive drugs, 
devices and products approved by the federal Food and Drug Administration to prevent an 
unwanted pregnancy, including nonprescription oral hormonal contraceptives and 
nonprescription emergency contraceptives.
A.  Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement.
B.  If the federal Food and Drug Administration has approved one or more therapeutic 
equivalents of a contraceptive supply, a health maintenance organization is not required 
to cover all those therapeutically equivalent versions in accordance with this 
subsection, as long as at least one is covered without any deductible, coinsurance, 
copayment or other cost-sharing requirement in accordance with this subsection.
D.  Coverage must be provided for the furnishing or dispensing of prescribed 
contraceptive supplies and nonprescription oral hormonal contraceptive supplies 
intended to last for a 12-month period, which may be furnished or dispensed all at once 
or over the course of the 12 months at the discretion of the health care provider for 
prescribed contraceptive supplies.
E.  A prescription is not required to obtain a nonprescription oral hormonal 
contraceptive or nonprescription emergency contraceptive.
F.  A health maintenance organization shall establish mechanisms to ensure that an 
enrollee who seeks coverage for a nonprescription oral hormonal contraceptive or 
nonprescription emergency contraceptive at a pharmacy has the option to obtain the 
nonprescription oral hormonal contraceptive or nonprescription emergency 
contraceptive at the point of sale without payment of any cost-sharing amount or to 
make the purchase at the pharmacy through an out-of-pocket payment at the point of 
sale and submit a claim for reimbursement to the health maintenance organization. The 
pharmacy may use a standing order to facilitate billing for a nonprescription oral 
hormonal contraceptive or nonprescription emergency contraceptive in accordance 
with this paragraph.
Sec. 12.  24-A MRSA §4247, sub-§5 is enacted to read:
5.  Rules.  The superintendent may adopt rules as necessary to implement the 
requirements of this section, including rules related to mechanisms to ensure coverage for 
nonprescription 
oral 
hormonal 
contraceptives 
and 
nonprescription 
emergency 
contraceptives and rules regarding notice to enrollees about how to access coverage for 
nonprescription 
oral 
hormonal 
contraceptives 
and 
nonprescription 
emergency 
contraceptives. Rules adopted pursuant to this subsection are routine technical rules as 
described in Title 5, chapter 375, subchapter 2-A.
Sec. 13.  24-A MRSA §4302, sub-§1, ¶A, as amended by PL 2009, c. 439, Pt. A, 
§2, is further amended to read:
A.  Coverage provisions, benefits and any exclusions by category of service, type of 
provider and, if applicable, by specific service, including but not limited to the 
following types of services, exclusions and limitations:
(1)  Health care services excluded from coverage;
(2)  Health care services requiring copayments or deductibles paid by enrollees;
(3)  Restrictions on access to a particular provider type;
(4)  Health care services that are or may be provided only by referral; and
(5)  Childhood immunizations as recommended by the United States Department 
of Health and Human Services, Centers for Disease Control and Prevention and 
the American Academy of Pediatrics; and
(6)  Coverage requirements for contraceptive supplies, as defined in section 4247, 
subsection 4, and the procedures an enrollee must follow to access coverage for 
over-the-counter contraceptive supplies and nonprescription contraceptives at a 
pharmacy without an out-of-pocket cost at the point of sale or by submitting a claim 
for reimbursement;
Sec. 14.  Application. This Act applies to all policies, contracts and certificates 
executed, delivered, issued for delivery, continued or renewed in this State on or after 
January 1, 2026. For purposes of this Act, all contracts are deemed to be renewed no later 
than the next yearly anniversary of the contract date.
Sec. 15. Department of Professional and Financial Regulation, Bureau of 
Insurance review. The Department of Professional and Financial Regulation, Bureau of 
Insurance shall monitor compliance of health insurance carriers with the requirements for 
coverage of nonprescription oral hormonal contraceptives and nonprescription emergency 
contraceptives set forth in this Act and any rules adopted by the bureau to implement the 
requirements of this Act, including any complaints or barriers to implementation. The 
bureau shall also review any federal guidance developed in response to the "Request for 
Information" regarding a proposed regulation to extend the application of the preventive 
services requirements under Section 2713 of the federal Public Health Service Act to over-
the-counter preventive items and services available without a prescription by a health care 
provider, including contraceptive supplies. No later than November 4, 2026, the bureau 
shall provide a report to the joint standing committee of the Legislature having jurisdiction 
over health coverage, insurance and financial services matters with an update on 
implementation of the requirements of this Act, including recommendations for legislation 
to improve implementation, and on the status of any proposed federal regulations related 
to coverage of nonprescription oral hormonal contraceptives and nonprescription 
emergency contraceptives by health insurance carriers. The joint standing committee of the 
Legislature having jurisdiction over health coverage, insurance and financial services 
matters may report out legislation based on the report to the 133rd Legislature in 2027.
SUMMARY
This bill expands the requirements in current law for coverage of contraceptives to 
include nonprescription oral hormonal contraceptives and nonprescription emergency 
contraceptives approved by the federal Food and Drug Administration.  The bill provides 
that a prescription is not required for insurance coverage for nonprescription oral hormonal 
contraceptives and nonprescription emergency contraceptives and requires insurers to 
establish mechanisms to ensure that an enrollee who purchases a nonprescription oral 
hormonal contraceptive or nonprescription emergency contraceptive at a pharmacy has the 
option to make the purchase pursuant to a standing order issued for billing purposes without 
a payment required at the point of sale or to make the purchase with a payment at the point 
of sale and submit a claim for reimbursement to the insurer.  The requirements apply 
beginning January 1, 2026.
The bill requires health insurance carriers to notify enrollees, at least annually, of the 
coverage requirements for contraceptive supplies and the procedures an enrollee must 
follow to access coverage for nonprescription oral hormonal contraceptives and 
nonprescription emergency contraceptives at a pharmacy without an out-of-pocket cost at 
the point of sale or by submitting a claim for reimbursement. The bill also authorizes the 
Department of Professional and Financial Regulation, Bureau of Insurance to adopt rules 
to implement the provisions and also requires the bureau to monitor implementation by 
health insurance carriers and to report to the joint standing committee of the Legislature 
having jurisdiction over health coverage, insurance and financial services matters no later 
than November 4, 2026.