Carolina Benefits

BCBSNC Implements Required Changes to Preventive Services

Phasing in Changes According to Federal Guidance Received in February 2013

Date: 10/16/2013

In February 2013, the federal government provided clarification on some of the preventive services that health plans must cover at 100% for non-grandfathered plans.  There were several items for which BCBSNC’s initial interpretation differed from this clarification, and we’ve implemented the changes in phases.

 

Changes Effective Beginning July 1, 2013

How BCBSNC Covered Certain Preventive Services for Non-Grandfathered Plans on June 30, 2013 How BCBSNC Covered Certain Preventive Services for Non-Grandfathered Plans Beginning July 1, 2013
BRCA counseling and evaluation: covered at 100%
(BRCA is a breast cancer genetic test.)
BRCA test and counseling and evaluation associated with the test: covered at 100%. (The BRCA test is subject to medical necessity review.)
Insertion of contraceptive devices: covered at 100% Insertion and removal of contraceptive devices: covered at 100%*

* Coverage at 100% does not apply to members enrolled on a group health plan with a religious group exemption/safe harbor in effect.

 

We updated www.bcbsnc.com/preventive with these changes in July 2013.

 

Changes Effective Beginning September 1, 2013

How BCBSNC Covered Certain Preventive Services for Non-Grandfathered Plans on August 30, 2013 How BCBSNC Will Cover Certain Preventive Services for Non-Grandfathered Plans Beginning September 1, 2013
Over-the-Counter Contraceptives: Not Covered at 100% Over-the-Counter Contraceptives: Covered at 100%*

  • Examples: sponges, female condoms and spermicides

* Coverage at 100% does not apply to members enrolled on a group health plan with a religious group exemption/safe harbor in effect.

 

We updated www.bcbsnc.com/preventive with these changes on September 13, 2013.

 

These changes are effective “at once,” beginning on either July 1 or September 1 for members enrolled on a non-grandfathered plan. Contraceptive coverage may not apply to members enrolled on a group health plan with a religious group exemption/safe harbor in effect.