An intrauterine device (IUD) is a small T-shaped contraceptive device that
is inserted into the uterus by a practitioner in an office setting after a
pelvic exam. The following four IUDs are currently approved by the U.S. Food
and Drug Administration:
- Liletta
- Mirena®
- ParaGard®
- Skyla®
These devices work through different mechanisms and have varying risks,
durations of efficacy, and success rates. Providers should evaluate each member
to determine which IUD is most appropriate, given her unique circumstances and
medical history. Currently, IUDs are eligible for coverage under either the
member?s medical or pharmacy benefit.
Effective January 1, 2016, IUDs will only be eligible for
coverage under the member?s medical benefit, as these devices must be inserted
by a physician in the office setting. These devices will no longer be eligible
for coverage under the pharmacy benefit through FutureScripts®.
In addition, the removal of an existing IUD and insertion of a replacement IUD
will also only be eligible for coverage under the member?s medical benefit.
If you have any questions about these changes, please contact Customer
Service at 1-888-YOUR-AH1 (1-888-968-7241) for AmeriHealth New
Jersey or at 1-800-275-2583 for AmeriHealth Pennsylvania.