Name of Manual - Blue Cross and Blue Shield of Minnesota

New women’s
preventive service
Contraceptive methods
and counseling *
* Some employer
group plans may be
exempt or in
temporary safe harbor
status for
“contraceptive
methods and
counseling” and will
not have to offer
women’s preventive
“contraceptive
methods and
counseling” until their
plan year beginning on
or after August 1, 2013
(continued)
Preventive Services
Required Under the
PPACA (continued)
Blue Cross coverage
An instruction that the person is free
either to decline commencement of
any method or procedure or to
withdraw consent to a method or
procedure at any reasonable time
Methods:
For women ages 12 to 64; limited to
specific oral contraceptives, supplies
and procedures. Coverage may vary
by group and pharmacy benefit
manager (PBM) and is subject to
change if covered formulary
changes. Members should contact
customer service at the number on
the back of their member ID card for
the specific methods covered by their
group or policy.
Blue Cross Blue and Shield of Minnesota Provider Policy and Procedure Manual (07/12/12)
Coding Policies and Guidelines (Coding)
Not all health plans, policies or employer groups will define or
administer the women’s preventive coverage in the same way.
PPACA requires coverage of the women’s preventive items for
non-grandfathered status plans. Blue Cross made a business
decision to apply the women’s preventive benefits to plans that
accepted the prior PPACA preventive care package (dates of
service September 23, 2010 and after) – some of those groups may
be grandfathered status. Also, self–insured groups may offer a
different, or richer, benefit. Groups may have different drugs
covered for “contraceptive methods and counseling” depending
upon the pharmacy benefit manager (PBM) they use. Members
should verify their preventive coverage before receiving benefits by
calling the customer service phone number on the back of their
member identification (ID) card.
11-21