NRS 689A.04045
Coverage for prescription drug previously approved for medical condition of insured.

1.

Except as otherwise provided in this section, a policy of health insurance which provides coverage for prescription drugs must not limit or exclude coverage for a drug if the drug:

(a)

Had previously been approved for coverage by the insurer for a medical condition of an insured and the insured’s provider of health care determines, after conducting a reasonable investigation, that none of the drugs which are otherwise currently approved for coverage are medically appropriate for the insured; and

(b)

Is appropriately prescribed and considered safe and effective for treating the medical condition of the insured.

2.

The provisions of subsection 1 do not:

(a)

Apply to coverage for any drug that is prescribed for a use that is different from the use for which that drug has been approved for marketing by the Food and Drug Administration;

(b)

Prohibit:

(1)

The insurer from charging a deductible, copayment or coinsurance for the provision of benefits for prescription drugs to the insured or from establishing, by contract, limitations on the maximum coverage for prescription drugs;

(2)

A provider of health care from prescribing another drug covered by the policy that is medically appropriate for the insured; or

(3)

The substitution of another drug pursuant to NRS 639.23286 or 639.2583 to 639.2597, inclusive; or

(c)

Require any coverage for a drug after the term of the policy.

3.

Any provision of a policy subject to the provisions of this chapter that is delivered, issued for delivery or renewed on or after October 1, 2001, which is in conflict with this section is void.

Source: Section 689A.04045 — Coverage for prescription drug previously approved for medical condition of insured., https://www.­leg.­state.­nv.­us/NRS/NRS-689A.­html#NRS689ASec04045.

689A.040
Contents of policy 689A.041
Coverage relating to mastectomy. 689A.042
Coverage relating to complications of pregnancy. 689A.043
Coverage of newly born and adopted children and children placed for adoption. 689A.044
Required coverage for certain tests and vaccines relating to human papillomavirus 689A.046
Benefits for treatment of alcohol or substance use disorder. 689A.0403
Procedure for arbitration of disputes concerning independent medical, dental or chiropractic evaluations. 689A.0404
Coverage for use of certain drugs for treatment of cancer. 689A.0405
Coverage for mammograms for certain women 689A.0413
Coverage for certain gynecological or obstetrical services without authorization or referral from primary care physician. 689A.0415
Coverage for hormone replacement therapy in certain circumstances 689A.0417
Coverage for health care services related to hormone replacement therapy in certain circumstances 689A.0418
Coverage for drug or device for contraception and related health services 689A.0419
Coverage for certain services, screenings and tests relating to wellness 689A.0423
Coverage for treatment of certain inherited metabolic diseases. 689A.0424
Policy that includes coverage for maternity care must not deny coverage for gestational carrier 689A.0425
Individual health benefit plan that includes coverage for maternity care and pediatric care: Requirement to allow minimum stay in hospital in connection with childbirth 689A.0427
Coverage for management and treatment of diabetes. 689A.0428
Coverage for management and treatment of sickle cell disease. 689A.0435
Coverage for autism spectrum disorders. 689A.0445
Coverage for prostate cancer screening. 689A.0447
Coverage for orally administered chemotherapy. 689A.0455
Coverage for treatment of conditions relating to severe mental illness. 689A.0463
Coverage for services provided through telehealth 689A.0465
Coverage of treatment of temporomandibular joint. 689A.04033
Coverage for treatment received as part of clinical trial or study. 689A.04036
Coverage for continued medical treatment. 689A.04042
Coverage for screening for colorectal cancer. 689A.04045
Coverage for prescription drug previously approved for medical condition of insured. 689A.04046
Coverage for prescription drugs irregularly dispensed for purpose of synchronization of chronic medications. 689A.04047
Coverage for early refills of topical ophthalmic products.
Last Updated

Jun. 24, 2021

§ 689A.04045’s source at nv​.us