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Contraceptive coverage update for religious organizations

December 2, 2013

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.


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