Effective January 1, 2013, AmeriHealth will apply age restrictions to the corresponding National Drug Codes (NDCs) for Plan B One-Step^® (Levonorgestrel, Next Choice^®). As a result, Plan B One-Step^® and generic versions will not be covered for women age 17 and older. Claims for women age 17 and older will deny since Plan B One-Step^® is available over the counter without a prescription, and AmeriHealth prescription drug programs exclude coverage for drugs dispensed without a prescription. This change will not impact other emergency contraception options available by prescription, which will continue to be covered with no cost-sharing as required by the Affordable Care Act. The requirement to cover contraceptives is effective for plan years on or after August 1, 2012.* To verify eligibility, please use the NaviNet^® web portal or call the Provider Automated System at 1-800-275-2573. For additional information, please contact your Network Coordinator or Hospital/Ancillary Services Coordinator.

*For members with an AmeriHealth prescription drug plan, generic prescription oral contraceptives are covered with no cost-sharing at retail and mail-order participating pharmacies. Cost-sharing applies to brand and non-formulary prescriptions. For customers who are eligible for a temporary safe harbor, the effective date for contraceptive services is for plan years on or after August 1, 2013. If a customer is a "religious employer" as defined by the interim final rules issued by the Departments of Health and Human Services, Labor, and Treasury, they may be exempt from the requirement of providing contraceptive coverage in their medical and/or prescription drug plans.

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