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.