Home Administrative Billing & Reimbursement BlueCard® Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

Reminder: Contraceptive coverage update for religious organizations

January 9, 2014

The Patient Protection and 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 contraceptive coverage, and their employees are not eligible for contraceptive 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, Health Care Reform requires IBC to pay the cost of certain contraceptive services for eligible employees and eligible dependents of non-profit religious organizations that elect not to cover contraceptives. 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.* For these members, it is important that only contraceptive services be billed using the ID number on the Contraceptive Coverage ID card.*

Contraceptive Coverage ID card sample

For a complete listing of medical contraceptive services, please refer to the current version of Medical Policy #00.06.02: Preventive Care Services on the Medical Policy Portal. 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.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
Connect with us     Facebook     Twitter     Flickr     YouTube     Walk the Talk    Independence Pinterest    Independence LinkedIn    Independence Instagram Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer
© 2023 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.