The Affordable Care Act, also known as health care reform, requires
non-grandfathered health plans to cover contraceptive services for women with
no out-of-pocket costs (i.e., $0 cost-sharing). There are two exceptions to
this requirement:
- Religious employer exemption. Religious employers can elect not
to provide coverage and their employees are not eligible for coverage.
- Non-profit religious organization. Non-profit religious
organizations can elect not to cover contraceptives for religious reasons but
are not exempt as a "religious employer."
For these non-profit religious organizations, the Affordable Care Act requires
that IBC pay the cost of certain contraceptive services.
Eligible members within these organizations will receive a separate ID card
that indicates "Contraceptive Coverage." Using this ID card, contraceptive
methods approved by the U.S. Food and Drug Administration will be covered at an
in-network level with no cost-sharing under the medical benefit and covered
with no cost-sharing for generic products and for those brand products for
which we do not have a generic equivalent under the pharmacy benefit at retail
and mail order pharmacies.*
It is important that only contraceptive services for these members be billed
using the ID number on the Contraceptive Coverage ID card.* In addition,
contraceptive services will not be covered when any other ID card is used.
Contraceptive Coverage ID card sample
IBC Medical and Rx Contraceptive Coverage
Medical Contraceptive Coverage Only ? No IBC Rx Coverage*
Please contact your Network Coordinator if you have any questions about this
coverage or billing.
*Contraceptive services are covered under the pharmacy
benefit only if the member has an IBC prescription drug plan.