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Except as provided in subsection (2) of this section:
A nongrandfathered health plan issued or renewed on or after January 1, 2026, that provides coverage for maternity services may not impose any cost-sharing requirements for in-network covered prenatal services including, but not limited to, office visits, laboratory services, ultrasounds and other imaging, prenatal screening tests, and prenatal vitamins, and covered in-network postnatal services including, but not limited to, office visits, lactation specialists, cesarean section follow-up care, laboratory services, ultrasounds and other imaging, and counseling and therapy services.
A nongrandfathered health plan issued or renewed on or after January 1, 2027, that provides coverage for maternity services may not impose any cost-sharing requirements for prescription drugs prescribed to treat conditions related to pregnancy or pregnancy complications during the prenatal and postnatal periods.
For a health plan that provides coverage of prenatal and postnatal care and is offered as a qualifying health plan for a health savings account, the health carrier shall establish the plan's cost sharing for the coverage of the services described in this section at the minimum level necessary to preserve the enrollee's ability to claim tax exempt contributions from their health savings account under internal revenue service laws and regulations.
For the purposes of this section, the prenatal services period begins on the date of service of the first claim received by the carrier for an enrollee that includes a pregnancy-related or pregnancy complication-related diagnosis code until the delivery or pregnancy end date. All claims for services that include a pregnancy-related or pregnancy complication-related diagnosis code during this period must be covered without cost-sharing. The postnatal services period extends for 12 weeks following delivery for all claims for services provided to an enrollee that include a pregnancy-related or pregnancy complication-related diagnosis code and from 12 weeks up to one year following delivery for all claims for services provided to an enrollee that include a pregnancy complication-related diagnosis code. During these periods, claims for services that include a pregnancy-related or pregnancy complication-related diagnosis code, as applicable, must be covered without cost sharing.
The office of the insurance commissioner may adopt any rules necessary to implement this section.
Each health plan that provides medical insurance offered under this chapter, including plans created by insuring entities, plans not subject to the provisions of Title 48 RCW, and plans created under RCW 41.05.140, are subject to the provisions of RCW 48.43.500, 70.02.045, 48.43.505 through 48.43.535, 48.43.537, 48.43.545, 48.43.550, 70.02.110, 70.02.900, 48.43.190, 48.43.083, 48.43.0128, 48.43.780, 48.43.435, 48.43.815, 48.200.020 through 48.200.280, 48.200.300 through 48.200.320, 48.43.440, section 1 of this act, and chapter 48.49 RCW.