In light of the U.S. Supreme Court's recent decision limiting access to reproductive health care in parts of the country, the Department of Financial Regulation (DFR) wants to ensure that Vermonters understand their rights to this important coverage.
Under the Affordable Care Act (ACA), health insurance plans must provide coverage at no cost to consumers for contraceptive services and supplies, including the full range of prescription birth control, counseling, treatment of complications, and any other related services.
Birth control can include options such as birth control pills, IUD insertion and removal, emergency contraception, and sterilization procedures such as tubal ligation.
“Contraception is crucial for helping people avoid unintended pregnancies and provides many health, social, and economic benefits,” Deputy Commissioner of Insurance Emily Brown said in a news release.
Vermont now allows certain pharmacists, as well as other health care providers, to prescribe the pill, patch, ring, and emergency oral contraceptives, providing additional new avenues for Vermonters to obtain no-cost contraceptives at pharmacies.
Additionally, Vermonters have access to a full, 12-month supply of contraceptives which can be dispensed all at once, saving individuals additional trips to the pharmacy for refills. Vasectomies for non-high-deductible health plans are also covered for Vermonters with no out-of-pocket expense.
While health insurance plans are required to cover all methods of birth control, they may only cover certain brands or generic versions with no out-of-pocket cost. DFR recommends checking with your health insurer to understand exactly what is covered.
DFR also recommends these consumer resources:
• Vermonters can visit the Department of Health's website for more information on birth control and family planning: bit.ly/685-Health.
• The Office of the Health Care Advocate (HCA) is a free resource for Vermonters who have questions about health insurance. If you have received an insurance denial or have questions about your insurance benefit, contact the HCA for confidential help. You can call the HCA's HelpLine at 1-800-917-7787 or visit vtlawhelp.org/health to submit an online help request.
• DFR is available to assist Vermonters with health insurance issues. Vermonters are encouraged to contact the Department's consumer services team if they have any questions or issues. Call 1-800-964-1784 or email dfr.insuranceinfo@vermont.gov.
• The Board of Pharmacy and the Secretary of State's Office of Professional Regulation published rules on how pharmacists may prescribe contraceptives. For more information, visit Vermont Prescribing Protocols at sos.vermont.gov.
• MVP Health Care members in Vermont can access additional information on their contraceptive coverage benefits by visiting mvphealthcare.com/vt or by calling 888-687-6277 (toll free) or 800-662-1220 (TTY) between 8 a.m. and 6 p.m. (EST).
Members can also visit the Prescription and Pharmacy Benefits section of MVP Health Care's website for a list of no-cost preventative contraceptives. Vermont providers can access coding and other clinical guidance through MVP's updated Provider Resource Manual, or by calling 800-684-9286 (toll free) or 800-662-1220 (TTY) between 8:30 a.m. and 5 p.m. (EST).
• For detailed information about the covered drugs for Blue Cross and Blue Shield of Vermont members, see the Blue Cross prescription drug formulary list at bluecrossvt.org. Blue Cross's preventative care guide has a list of covered services and extensive contraceptive methods.
• Cigna members can access information on their contraceptive coverage benefits at bit.ly/685-cigna. Members can also call customer service at 800-997-1654 or the number on the back of their ID card for additional information about their contraceptive coverage.
For additional information, visit the Vermont Department of Financial Regulation on dfr.vermont.gov.