New Hampshire: Latest State Regulations and Preventive Care Benefits

Preventive Care Benefits

In accordance with new preventive care guidelines, the list of additional preventive care benefits on your plan may have changed. If applicable, these changes will be effective on 1/1/20.  

Please see your Schedule of Benefits as your member cost sharing may have changed for the following preventive services, tests and devices: blood pressure monitor, retinopathy screening, and international normalized ratio (INR) testing. 

If you’re enrolled in a High Deductible Health Plan (HSA) that provides the “Preventive Drug Benefit”, your plan will now cover selective serotonin reuptake inhibitors (SSRI) medications without applying your plan deductible.  Your ID card will include the words “Preventive Drug Benefits” if you have this coverage. 

This past year, the New Hampshire General Court passed laws that expanded coverage for benefits under your fully-insured health plan. Below is a description of the new coverage requirements:

Pediatric Autoimmune Neuro Psychiatric Disorders (PANS/PANDAS)
Senate Bill 224, effective September 17, 2019, requires coverage for pediatric autoimmune neuropsychological disorders (PANS/PANDAS). Additionally, the law requires commercial insurance plans to provide coverage for intravenous immunoglobulin therapy (IVIG) as a treatment for PANS/PANDAS when ordered by a physician and determined to be medically necessary.  

Senate Bill 258, effective January 1, 2020, added “store and forward” and remote patient monitoring as covered services to the telemedicine benefit. “Store and forward” uses electronic communications between the patient and a health care service provider for diagnostic and therapeutic assistance in the care of patients. This includes forwarding or transferring stored medical data via an electronic device. While your plan already covers remote patient monitoring, all plans will now cover “store and forward” services.

Psychiatrist-Supervised Physician Assistants
Senate Bill 225, effective September 17, 2019, allows licensed physician assistants to provide various mental health related services. A licensed, psychiatrist supervised physician assistant is defined as an individual who is licensed as a physician assistant by the state of New Hampshire and whose supervising physician is a licensed psychiatrist. 

Prescription Drugs
House Bill 657, effective September 8, 2019, revises the exception process to allow providers and members to request an exception for prescribed medications not on the formulary or were removed from the formulary within the past 12 months. 

Access to Fertility Treatment
Senate Bill 279, effective January 1, 2020, requires all group health plans to provide coverage for the diagnosis and treatment of infertility. Infertility is defined as the inability of a woman aged 35 or younger to conceive or produce conception during a period of one year. In the case of a woman over age 35, the time period is reduced to 6 months. 

This mandate does not apply to individual plans.

To obtain additional information about your benefits and applicable cost sharing under your plan, please refer to your Evidence of Coverage.