Massachusetts Bill Requiring Contraceptive Coverage (H 948)

H 948 would require insurance carriers to provide all contraceptive methods without a co-pay.

Under the bill, health care service plans would be required to provide coverage for all FDA-approved contraceptive drugs, devices and products available over-the-counter. Health plans would need to include at least one therapeutically equivalent of a contraceptive drug, device or product that is FDA-approved, if available. If a therapeutically equivalent version is not available or is deemed medically inadvisable by the enrollee’s provider, a health care service plan would need to provide coverage for an alternate prescribed therapeutically equivalent version of the contraceptive drug, device or product.

H 948 also requires coverage for:

• voluntary sterilization procedures;
• patient education and counseling on contraception; and
• follow-up services related to the drugs, devices, products and procedures covered under this provision, including, but not limited to, management of side effects, counseling for continued adherence and device insertion and removal.

Health care service plans would not be able to impose a deductible, coinsurance, copayment or any other cost-sharing requirement.  Medicaid beneficiaries would not be subject to any cost sharing.

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