I have a very good Third Way that is already available in many insurance plans:
I used to work for a prescription benefit manager and many plans my employer had had a method whereby certain meds would only be covered with a Prior Authorization. Some reasons might be high usage, interactions with other meds or Medical Necessity. I saw numerous plans where birth control would require Prior Auth and the plan would only pay where there was medical necessity; some condition where a medical care provider decided that birth control medications were the most effective means of treating a given condition (Ovarian Cysts are a good example as mentioned upthread). In other words, the MD/NP would provide the insurance company with documentation of the patient’s condition and a treatment that would not be otherwise covered would be covered.