Healthcare

HB 1088 amends Pennsylvania's 1921 Insurance Company Law to require casualty insurance policies to cover blood pressure monitors. This directly affects policyholders who rely on these devices for managing health conditions like hypertension, ensuring they are not excluded from standard coverage. The bill adds a specific provision mandating insurers to include blood pressure monitors as covered items under casualty insurance policies. It changes insurer obligations without altering broader policy terms, focusing on making a common medical device accessible through existing insurance frameworks.

HB 1140 requires health insurers and Medicaid/CHIP managed care plans in Pennsylvania to cover all FDA-approved contraceptives - including prescription drugs, devices, emergency contraception (like levonorgestrel), and oral contraceptives - without any out-of-pocket costs for enrollees. It specifically prohibits prior authorization or step therapy for emergency and oral contraceptives, and mandates coverage for sterilization procedures and related services like counseling. The bill directly affects health insurers, managed care plans, and their enrollees by expanding contraceptive coverage under state insurance regulations. It exempts male condoms from coverage requirements but ensures no cost-sharing for covered contraceptive methods.

HB 535 bans Pennsylvania health insurers from setting annual or lifetime dollar limits on core health benefits for enrollees, whether services are provided by in-network or out-of-network providers. It applies to all individual and group health insurance policies (excluding specific types like Medicare supplements or dental/vision-only plans) and prohibits limits on benefits that were already covered without such caps in 2025 policies. The Insurance Department can enforce this through fines up to $5,000 per violation (or $10,000 for willful violations), with annual caps of $500,000 for insurers. The law does not require coverage of specific benefits but eliminates existing dollar limit practices for covered services.

HB 755 requires health insurers in Pennsylvania (excluding grandfathered plans) to cover all preventive health services listed by the Insurance Department without cost-sharing, such as copays or deductibles. This directly affects insurers who must comply with the coverage rules and enrollees who gain access to preventive care like vaccinations and screenings at no extra cost. The bill empowers the Insurance Department to create and update the preventive services list through a public comment process (15+ business days) and enforce compliance with penalties for violations. It aligns with federal preventive care standards but allows Pennsylvania to adjust the list based on public input and evidence-based guidelines.

HB 404 amends Pennsylvania's Insurance Company Law to extend health insurance coverage for children under family policies. It requires policies to cover dependent children up to age 26 (previously 19) and prohibits insurers from denying or restricting coverage based on a child's financial dependency, residency, marital status, school enrollment, or employment. The bill also allows group health plans to extend coverage for adult children up to age 29 if they meet specific conditions, such as not being married, having no dependents, and residing in Pennsylvania or attending school full-time. This affects all health insurance policies sold in Pennsylvania that provide dependent child coverage.