Insurers can't use more restrictive ways to pay back medical providers for these services. They must treat the following things equally:

Financial requirements

  • Deductibles
  • Copayments
  • Coinsurance
  • Out-of-pocket limits

Treatment limits

  • Limits on the number of days or visits
  • Other limits on the amount or length of treatment
  • Insurer approval for services (prior authorization)
  • Medically necessary services
  • Requirements to try cheaper medications first (step therapy)
  • Provider reimbursement rates

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