What is the law on prescription drug coverage?
The law on prescription drug coverage in Washington is that all health insurers and health plans must provide coverage for prescription drugs, with the exception of certain limited exceptions. The law requires that the coverage be at least equal to the level of coverage for other medical services, and the coverage must be as comprehensive as the insurer or health plan offers in other health service categories. This means that the coverage must include both generic and brand-name drugs. In addition, the law requires that the insurer or health plan must cover drugs that are medically necessary for a diagnosed condition or illness. It is important to note that the law does not require coverage for experimental or investigational drugs. This means that an insurer or health plan is not required to cover a drug that has not been approved by the U.S. Food and Drug Administration (FDA). Insurers and health plans are also required to provide coverage for any drugs that are medically necessary for the treatment of mental or emotional conditions, such as depression or anxiety, as well as drugs that are necessary for the treatment of chronic illnesses, such as diabetes or asthma. Lastly, the law requires that the insurer or health plan must provide coverage for up to a certain amount of a prescribed drug in a month. The coverage limit is determined by the amount the insurer would usually cover for the drug when prescribed for the same condition. In some cases, the amount of the coverage will be less than the cost of the drug, in which case the patient is responsible for the remaining cost.
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