An Act to Require Insurance Coverage for Glucagon-like Peptide-1
Maine Legislature, Session 132, LD 0627
Sponsors: STOVER
Amends: 24-A MRSA §4320-W

Legislative Document
No. 627
H.P. 395
House of Representatives, February 25, 2025
An Act to Require Insurance Coverage for Glucagon-like Peptide-1 
Receptor Agonist Medication
Received by the Clerk of the House on February 20, 2025.  Referred to the Committee on 
Health Coverage, Insurance and Financial Services pursuant to Joint Rule 308.2 and ordered 
printed pursuant to Joint Rule 401.
ROBERT B. HUNT
Clerk
Presented by Representative STOVER of Boothbay.
Cosponsored by Representatives: ANKELES of Brunswick, DHALAC of South Portland, 
GRAHAM of North Yarmouth, GRAMLICH of Old Orchard Beach, MEYER of Eliot, 
ROBERTS of South Berwick, ROEDER of Bangor, SALISBURY of Westbrook.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24-A MRSA §4320-W is enacted to read:
§4320-W.  Coverage for glucagon-like peptide-1 receptor agonist medication
1.  Glucagon-like peptide-1 receptor agonist medication defined.  For the purposes 
of this section, unless the context otherwise indicates, "glucagon-like peptide-1 receptor 
agonist medication" means a glucagon-like peptide-1 receptor agonist medication approved 
by the federal Food and Drug Administration.
2.  Required coverage.  A carrier offering a health plan in this State shall provide 
coverage for glucagon-like peptide-1 receptor agonist medication that is prescribed by a 
health care provider for administration to an enrollee.
3.  Limit on out-of-pocket costs.  A carrier that provides coverage for prescription 
glucagon-like peptide-1 receptor agonist medication may not impose any deductible, 
copayment, coinsurance or other cost-sharing requirement on an enrollee for that coverage 
that results in out-of-pocket costs to the enrollee that exceed $35 per prescription for a 30-
day supply of covered prescription medications under this section, regardless of the amount 
of glucagon-like peptide-1 receptor agonist medication needed to fill the enrollee's 
prescriptions.
4.  Prior authorization prohibited.  A carrier may not make coverage without cost 
sharing as required by subsection 3 dependent on any prior authorization requirement.
Sec. 2.  Education campaign.  By November 1, 2025, the Department of 
Professional and Financial Regulation, Bureau of Insurance shall implement a campaign to 
educate the public and health care providers regarding the coverage requirements under the 
Maine Revised Statutes, Title 24-A, section 4320-W and the health benefits associated with 
the use of glucagon-like peptide-1 receptor agonist medication.
Sec. 3.  Application. That section of this Act that enacts the Maine Revised Statutes, 
Title 24-A, section 4320-W 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.
SUMMARY
This bill requires carriers offering health plans in this State to provide coverage for 
glucagon-like peptide-1 receptor agonist medication approved by the federal Food and 
Drug Administration and prescribed by a health care provider.  It also requires the 
Department of Professional and Financial Regulation, Bureau of Insurance to initiate an 
education campaign regarding the coverage requirements and the health benefits associated 
with the use of the medication.  The requirements of the bill apply to health plans issued or 
renewed on or after January 1, 2026.