WA HB 1971 – Access to Hormone Therapy Medication
Updated June 15, 2026
What’s changing
Premera is expanding the scope to include OptiFlex and self-funded groups beginning January 1, 2027 (as groups renew).
- Flexible plan designs
- Self-funded and OptiFlex groups will default to opt out but can opt in if they choose.
- Preferred Choice plan designs
- OptiFlex groups will default to “opt in” with no ability to opt out.
Contact your Premera account representative for more information on projected claim costs.
Washington House Bill 1971 requires health plans to allow members to receive a full 12-month supply of prescription hormone medication at one time, if they choose. The bill aims to improve access to prescription hormone medications, especially for people in rural areas or with limited resources.
Hormone therapy uses drugs to help manage hormone levels or effects in the body for different health needs. These drugs may treat gender-affirming care, low hormone levels, symptoms of menopause, early puberty, thyroid problems, and other conditions. The requirement applies to FDA-approved drugs that help balance hormone levels.
For information on which drugs are included, see our Prescription Drug Hormone List.
This rule applies to drugs taken regularly that can be stored at room temperature. A smaller supply may be given if the patient asks for it, the provider orders it, or the drug is a controlled substance. For controlled substances, the plan covers up to the legal refill limit. Health plans may still use drug management strategies based on clinical guidelines to support safe and effective care.
The change applies to Washington fully insured group and individual plans beginning on or after January 1, 2026. We’re not proactively offering this change to self-funded or OptiFlex plans at this time. Self-funded groups that would like to offer this additional benefit are encouraged to contact their Premera account representative.