{"data":{"id":"us-wv/w.-va.-code-33-42-4","jurisdiction":"us-wv","citation":"W. Va. Code § 33-42-4","heading":"Limitations on conditions of coverage.","body":"No health benefits policy may require as a condition to the coverage of basic primary and preventative obstetrical and gynecological services that a woman first obtain a referral from a primary care physician: Provided, That for a health maintenance organization authorized under article twenty-five-a of this chapter, direct access, at least annually, to a women's health care provider for purposes of a well woman examination shall satisfy the foregoing requirement. No health benefits policy may require as a condition to the coverage of prenatal or obstetrical care that a woman first obtain a referral for those services by a primary care physician. No health benefits policy providing coverage for surgical services in a hospital inpatient or outpatient setting may deny coverage for: (1) Reconstruction of the breast following mastectomy; or (2) reconstructive or cosmetic surgery required as a result of an injury caused by an act of family violence as defined in section three, article two-a, chapter forty-eight of this code, when the person inflicting the injury was convicted of a felony, a lesser included misdemeanor offense, or a charge of domestic battery for inflicting the injury.","path":["CHAPTER 33. INSURANCE.","ARTICLE 42. WOMEN\\'S ACCESS TO HEALTH CARE ACT."],"source_url":"https://code.wvlegislature.gov/33-42-4/","current_through":"as of 2026-08-03; contains at least the enactments of the 2026 Regular Session","vintage":"","retrieved_at":"2026-09-06T00:28:52Z","sha256":"97da979db214e58b99b84a45f8bc6191a7896fc43a3c987392664b21a1b02600","source_id":"us-wv","stale":true,"prev":"us-wv/w.-va.-code-33-42-3","next":"us-wv/w.-va.-code-33-42-5"},"notice":"GroundRules: Original legal text. Not legal advice."}