HHS has responded to two separate reports that raised concerns about women paying for birth control that was supposed to be free under the ACA. HHS has now clarified that nongrandfathered plans must provide a cost-free option in all 18 FDA contraceptive categories. Insurers are allowed to exercise reasonable medical management within a contraceptive category. HHS also clarified that nongrandfathered plans must cover the following without cost-sharing:
- BRACA testing for some asymptomatic women if deemed appropriate by her attending provider.
- Pregnancy-related coverage for dependents.
- Gender-specific preventive services for transgender people when deemed medically appropriate.
- Coverage of anesthesia when receiving a preventive colonoscopy.
Employers should confirm that their insurer or administrator is administering claims in accordance with this latest guidance.
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