Effective January 1, 2013, IBC 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 IBC's 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-ASK-BLUE. For additional information, please contact
your Network Coordinator.
*For members with an IBC 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.
NaviNet? is a registered trademark of NaviNet,
Inc., an independent company.