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Virginia Statutes, Title 38.2

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Virginia/Statutes

← All Virginia coverage

Title 38.2, Title 38.2. Insurance

64 chapters · 1,789 sections in this title.

All chapters in Title 38.21,789 Ch 34, Chapter 34. Provisions Relating to A…175 Ch 13, Chapter 13. Reports, Reserves and Ex…121 Ch 18, Chapter 18. Insurance Agents.115 Ch 35, Chapter 35. Accident and Sickness In…81 Ch 10, Chapter 10. Organization, Admission …74 Ch 33, Chapter 33. Life Insurance Policies.58 Ch 14, Chapter 14. Investments.54 Ch 1, Chapter 1. General Provisions.46 Ch 2, Chapter 2. Provisions of a General N…41 Ch 22, Chapter 22. Liability Insurance Poli…41 Ch 42, Chapter 42. Health Services Plans.39 Ch 31, Chapter 31. Life Insurance.38 Ch 41, Chapter 41. Fraternal Benefit Societies.38 Ch 19, Chapter 19. Regulation of Rates Gene…36

175 sections·Filtered byTitle 38.2✕Ch 34✕

Va. Code Ann. § 38.2-3407.4 Explanation of benefits
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A. Each insurer issuing an accident and sickness insurance policy, a corporation issuing subscription contracts, and each health maintenance organization shall file for approval explanation of benefits forms. These explanation of benefit forms shall be subject to the requirements…
Va. Code Ann. § 38.2-3407.4:2 Requirements for prescription benefit cards
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A. Each (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis, (ii) corporation providing individual or group accident and sickness subscription c…
Va. Code Ann. § 38.2-3407.5 Denial of benefits for certain prescription drugs prohibited
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A. Each (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis, (ii) corporation providing individual or group accident and sickness subscription c…
Va. Code Ann. § 38.2-3407.5:1 Coverage for contraceptives
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A. As used in this section: "Contraceptive device" means any device or non-drug product that has been approved as a contraceptive by the FDA. "Contraceptive drug" means any drug approved as a contraceptive by the FDA. "FDA" means the U.S. Food and Drug Administration. "Medical ne…

Va. Code Ann. § 38.2-3407.5:2 Reimbursements for dispensing hormonal contraceptives

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A. As used in this section: "Covered person" means a policyholder, subscriber, enrollee, participant, or other individual covered by a health benefit plan. "Health benefit plan" means any accident and health insurance policy or certificate, health services plan contract, health m…

Va. Code Ann. § 38.2-3407.5:3 Coverage for early refills of prescription eye drops

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A. As used in this section, "covered person," "health benefit plan," and "health carrier" have the same meanings as provided in § 38.2-3438. B. No health carrier whose health benefit plan includes coverage for prescription drugs on an outpatient basis shall deny coverage to a cov…

Va. Code Ann. § 38.2-3407.6 Exclusion of podiatrist not permitted under certain circumstances

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No podiatrist shall be excluded from participating in any preferred provider plan pursuant to this chapter or Chapter 42 (§ 38.2-4200 et seq.) of this title or health maintenance organization pursuant to Chapter 43 (§ 38.2-4300 et seq.) of this title solely because such preferred…

Va. Code Ann. § 38.2-3407.6:1 Denial of benefits for certain prescription drugs prohibited

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A. Each (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, (ii) corporation providing individual or group accident and sickness subscription c…

Va. Code Ann. § 38.2-3407.7 Pharmacies; freedom of choice

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A. Notwithstanding any provision of § 38.2-3407 to the contrary, no insurer or its pharmacy benefits manager, as defined in § 38.2-3465, proposing to issue either preferred provider policies or contracts or exclusive provider policies or contracts shall prohibit any person receiv…

Va. Code Ann. § 38.2-3407.9 Reimbursement for emergency medical services vehicle transportation services

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A. If an accident and sickness insurance policy provides coverage for services provided by an emergency medical services vehicle, any person providing such services to a person covered under such policy shall receive reimbursement for such services directly from the issuer of suc…

Va. Code Ann. § 38.2-3407.9:01 Prescription drug formularies

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A. Each (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, (ii) corporation providing individual or group accident and sickness subscription c…

Va. Code Ann. § 38.2-3407.9:02 Requirement for prescription drug coverage

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No (i) insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, (ii) corporation providing individual or group accident and sickness subscription contra…

Va. Code Ann. § 38.2-3407.9:03 Payment of clean claims to administrators of pharmacy benefits

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A. As used in this section, "clean claim," "carrier," and "provider contract," shall have the meanings set forth in subsection A of § 38.2-3407.15. B. Any contract between a carrier and its pharmacy benefits administrator or a carrier and a participating pharmacy, or its contract…

Va. Code Ann. § 38.2-3407.9:04 Medication synchronization

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A. As used in this section: "Carrier," "health plan," and "provider contract" have the meanings ascribed thereto in subsection A of § 38.2-3407.15. "Enrollee" and "provider" have the meanings ascribed thereto in subsection A of § 38.2-3407.10. "Network pharmacy" means a pharmacy …

Va. Code Ann. § 38.2-3407.9:05 Step therapy protocols

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A. As used in this section: "Carrier" means any (i) insurer issuing individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; (ii) corporation providing individual or group accide…

Va. Code Ann. § 38.2-3408 Policy providing for reimbursement for services that may be performed by certain practitioners other than physicians

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A. If an accident and sickness insurance policy provides reimbursement for any service that may be legally performed by a person licensed in this Commonwealth as a chiropractor, optometrist, optician, professional counselor, psychologist, clinical social worker, podiatrist, physi…

Va. Code Ann. § 38.2-3409 Coverage of dependent children

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A. Any group or individual accident and sickness insurance policy or subscription contract delivered or issued for delivery in the Commonwealth which provides that coverage of a dependent child shall terminate upon that child's attainment of a specified age, shall also provide in…

Va. Code Ann. § 38.2-3410 Construction of policy generally; words "physician" and "doctor" to include dentist

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Each accident and sickness insurance policy or subscription contract shall be construed according to the entirety of its terms and conditions as set forth in the policy and as amplified, extended or modified by any rider, endorsement, or application attached to and made a part of…

Va. Code Ann. § 38.2-3411 Coverage of newborn children required

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A. Each individual and group accident and sickness insurance policy or individual and group subscription contract providing coverage on an expense incurred basis, and each health maintenance organization providing a health care plan for health care services that provides coverage…

Va. Code Ann. § 38.2-3411.1 Coverage for child health supervision services

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A. Every individual or group accident and sickness insurance policy, subscription contract providing coverage under a health services plan, or evidence of coverage of a health care plan delivered or issued for delivery in the Commonwealth or renewed, reissued, or extended if alre…

Va. Code Ann. § 38.2-3411.2 Coverage of adopted children required

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A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis, each corporation providing individual or…

Va. Code Ann. § 38.2-3411.3 Coverage for childhood immunizations

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A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual o…

Va. Code Ann. § 38.2-3411.4 Coverage for infant hearing screening and related diagnostics

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A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual o…

Va. Code Ann. § 38.2-3412.1 (Effective until July 1, 2027) Coverage for mental health and substance use disorders

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A. As used in this section: "Adult" means any person who is 19 years of age or older. "Alcohol or drug rehabilitation facility" means a facility in which a state-approved program for the treatment of alcoholism or drug addiction is provided. The facility shall be either (i) licen…

Va. Code Ann. § 38.2-3414 Optional coverage for obstetrical services

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A. Each insurer proposing to issue a group hospital policy or a group major medical policy in this Commonwealth and each corporation proposing to issue group hospital, group medical or group major medical subscription contracts shall provide coverage for obstetrical services as a…

Va. Code Ann. § 38.2-3414.1 Obstetrical benefits; coverage for maternal mental health postpartum services

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A. As used in this section, "maternal mental health" means a mental health condition that occurs during pregnancy or during the postpartum period and includes postpartum depression. B. Notwithstanding the provisions of § 38.2-3419 or subdivision A 1 of § 38.2-6506, each insurer p…

Va. Code Ann. § 38.2-3415 Exclusion or reduction of benefits for certain causes prohibited

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No group accident and sickness insurance policy, nor any group subscription contract, delivered or issued for delivery in this Commonwealth or renewed, reissued or extended if already issued, shall contain any provision excluding or reducing the benefits of any insured or subscri…

Va. Code Ann. § 38.2-3417 Deductibles and coinsurance options required

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A. An insurer issuing accident and sickness insurance or a corporation issuing subscription contracts on an expense incurred basis shall make available in offering such coverage or contract to the potential insured or contract holder one or more of the following options under whi…

Va. Code Ann. § 38.2-3418 Coverage for victims of rape or incest

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Each hospital expense, medical-surgical expense, major medical expense or hospital confinement indemnity insurance policy issued by an insurer, each individual and group subscription contract providing hospital, medical, or surgical benefits issued by a corporation, and each cont…

Va. Code Ann. § 38.2-3418.1 Coverage for mammograms

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A. 1. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis, each corporation providing individual…

Va. Code Ann. § 38.2-3418.10 Coverage for diabetes

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A. As used in this section: "Cost-sharing payment" means the total amount a covered person is required to pay at the point of sale in order to receive equipment and supplies that are covered under the covered person's policy, contract, or plan. "Equipment and supplies" means bloo…

Va. Code Ann. § 38.2-3418.11 Coverage for hospice care

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A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual o…

Va. Code Ann. § 38.2-3418.12 Coverage for hospitalization and anesthesia for dental procedures

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A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual o…

Va. Code Ann. § 38.2-3418.13 Coverage for the treatment of morbid obesity

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A. Notwithstanding the provisions of § 38.2-3419, in the large group market, each insurer proposing to issue accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing accid…

Va. Code Ann. § 38.2-3418.14 Coverage for lymphedema

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A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical, coverage on an expense-incurred basis; each corporation providing individual …

Va. Code Ann. § 38.2-3418.15 Coverage for prosthetic devices and components

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A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual o…

Va. Code Ann. § 38.2-3418.15:1 Coverage for prosthetic devices and components

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A. As used in this section: "Component" means the materials and equipment needed to ensure the comfort and functioning of a prosthetic device. "Limb" means an arm, a hand, a leg, a foot, or any portion of an arm, a hand, a leg, or a foot. "Medically necessary prosthetic device" i…

Va. Code Ann. § 38.2-3418.16 Coverage for telemedicine services

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A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual o…

Va. Code Ann. § 38.2-3418.17 Coverage for autism spectrum disorder

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A. Notwithstanding the provisions of § 38.2-3419 and any other provision of law, each insurer proposing to issue accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing a…

Va. Code Ann. § 38.2-3418.18 Coverage for formula and enteral nutrition products as medicine

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A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual o…

Va. Code Ann. § 38.2-3418.19 Coverage for organ, eye or tissue transplant

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A. Notwithstanding the provisions of § 38.2-4319, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual o…

Va. Code Ann. § 38.2-3418.1:2 Coverage for pap smears

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A. Notwithstanding the provisions § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, each corporation providing individual or gr…

Va. Code Ann. § 38.2-3418.1:3 Cost sharing for breast examinations

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A. Notwithstanding the provisions of § 38.2-3419 or subdivision A 1 of § 38.2-6506, and in addition to the coverage required by § 38.2-3418.1, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or…

Va. Code Ann. § 38.2-3418.2 Coverage of procedures involving bones and joints

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A. Each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense-incurred basis, each corporation providing individual or group accident and sickness subscription contr…

Va. Code Ann. § 38.2-3418.20 Coverage for hearing aids and related services [Not in effect]

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A. As used in this section: "Hearing aid" means any wearable, nondisposable instrument or device designed or offered to aid or compensate for impaired human hearing and any parts, attachments, or accessories, including earmolds, but excluding batteries and cords. Hearing aids are…

Va. Code Ann. § 38.2-3418.21 (For contingent effective date, see Acts 2026, c. 1048, cl. 2) Coverage for hearing aids and related services

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A. As used in this section: "Hearing aid" means any wearable, nondisposable instrument or device designed or offered to aid or compensate for hearing loss and any parts, attachments, or accessories, including earmolds, but excluding batteries and cords. Hearing aids are not to be…

Va. Code Ann. § 38.2-3418.22 (For contingent effective date, see Acts 2026, c. 1048, cl. 2) Coverage for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome

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A. As used in this section: "Pediatric acute-onset neuropsychiatric syndrome" or "PANS" means a clinically defined disorder characterized by the sudden onset of obsessive-compulsive symptoms (OCD) or eating restrictions, concomitant with acute behavioral deterioration in at least…

Va. Code Ann. § 38.2-3418.23 Coverage for treatment of menopause and perimenopause

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A. As used in this section: "Menopause" means the permanent cessation of menstruation due to loss of ovarian follicular function during which the body produces less estrogen and progesterone. "Perimenopause" means the transitional period between full reproductive functioning and …

Va. Code Ann. § 38.2-3418.3 Coverage for hemophilia and congenital bleeding disorders

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A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual o…

Va. Code Ann. § 38.2-3418.4 Coverage for reconstructive breast surgery; notice; eligibility

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A. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual o…