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DOL: Plans Must Cover All Contraceptives, Not Just Some
HR Daily AdvisorLink to more items from this source
[Guidance Overview]
May 11, 2015

"Plans and insurers must cover all 18 contraception methods approved by the [FDA] ... 'Reasonable medical management' still may be used to steer members to specific products within those methods of contraception. A plan or insurer may impose cost-sharing on non-preferred items within a given method, as long as at least one form of contraception in each method is covered without cost-sharing. However, an individual's attending provider must be allowed to override the plan's drug management techniques if the provider finds it medically necessary to cover without cost-sharing an item that a given plan or insurer has classified as non-preferred[.]"

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