Contraceptive-Only Coverage
The Affordable Care Act requires health plans to provide coverage for all Food and Drug Administration-approved contraceptive methods and counseling services for women without cost to the patient. Your employer certified that your group health plan qualifies for an exception to this federal requirement.
This means your group health plan will not provide coverage for contraceptive services. Instead, Blue Cross and Blue Shield of Nebraska (BCBSNE) is providing separate medical coverage for contraceptive services at no cost to you, as long as you are enrolled in your employer-sponsored group health plan and your employer continues to qualify for this exception. If you have questions, please call the Member Services number on the back of your member ID card.
Any prescription medications, or benefits provided under your pharmacy benefit, would be covered by OptumRx under a similar exemption. To learn more about what is covered on the pharmacy benefit please call the Rx Customer Service number on the back of your member ID card.
ID Cards
You will need to carry two BCBSNE member ID cards – your current card, as well as the contraceptive-only card. The contraceptive-only ID card is for contraceptive services coverage only. The card features the words “Contraceptive Only,” and the member ID number is different from your other BCBSNE ID number.
It is very important that the correct ID card is presented to your health care providers, because charges for contraceptive services will be denied under your health plan ID number (and vice versa). In some cases, you may need to give the provider both ID cards.
Annual female (OB/GYN) exam
Charges for the annual pap smear and exam and associated lab work should be submitted under the health plan ID number. However, if the visit includes anything related to contraceptive services, such as administration of a Depo-Provera shot, those charges need to be submitted under the BCBSNE contraceptive services ID number. In this case, the provider needs to be given both ID cards to file claims correctly.
Coverage Details
Use the resources below to manage your contraceptive-only coverage.
Schedule of Benefits Summary (without pharmacy)
Contraceptive Only Plan Booklet (without pharmacy)
If you have any questions about this information, please call our Member Services department at 844-908-4534.
OptumRx is an independent company, does not provide Blue products, and is solely responsible for its services. Please contact them with questions concerning prescription medications.