In November 2017, the Contraceptive ACCESS bill was signed into law. This landmark legislation strengthened Massachusetts law to ensure access to no-copay birth control while (1) improving access to the full range of contraceptive options and (2) removing existing barriers to care. The Contraceptive ACCESS law is even more important now, during the COVID-19 crisis, as we are all working to reduce trips to places like pharmacies.
Here’s what you need to know about this law and what it means for the contraception options that are available to you:
1. You should not have to pay a copay, deductible, or any kind of cost sharing for your contraceptive method, whether it’s the pill, an IUD, the ring, or the implant. (Note: Insurers are allowed to require therapeutic equivalents, meaning the generic of a pill or one type of IUD, unless your health care provider demonstrates that you need a particular brand for medical reasons.)
2. If you are taking the pill, using the ring, or using the patch, your insurance should cover a 12-month supply dispensed AT ONCE without any out of pocket cost. In other words, you should get 12-months worth of pill packs, rings, or patches in a single visit to the pharmacy without paying anything.
To be eligible for these benefits, you must meet the following requirements:
- You are on the birth control pill, patch, or ring.
- You have been on one specific brand of contraception for more than 3 months.
- You are planning on continuing to use this form of birth control for at least the next 12 months.
- You have Massachusetts-based health insurance, including MassHealth, insurance acquired through the Massachusetts Health Connector, private insurance, or insurance through your Massachusetts-based employer.
- For those who receive health insurance through an employer or university: the employer or university does not self-insure. This applies to any employer or university that sponsors your health insurance, including yours, your parents’, or your partners’. Your Human Resources department (or Student Affairs Office, if you are a student) will know if your employer or university self-insures. Additionally, note that an exemption from this law does exist for employers who are churches or qualified church-controlled organizations. If you are unsure if your employer falls in this category, contact us at firstname.lastname@example.org.
- If an employer or university self-insures, that means they take on the risk, cost and underwriting of health insurance to their employees or students. When self-insuring, an employer or university pays each time a member makes a claim instead of paying a premium to an insurer. It is common for universities and employers with hundreds of employees to self-insure.
We have heard some reports that individuals have had trouble accessing this benefit. If you’re interested in obtaining a 12-month supply of your birth control and filling out a quick survey about your experience doing so, read this information sheet. If you indicate that we can contact you, we will follow up with you to help you obtain your 12-month supply if you have not already.
3. Your insurance is required to cover emergency contraception, either with a prescription or dispensed by a pharmacist under a standing order from a physician, without any cost-sharing. Some pharmacies have standing orders for over-the-counter emergency contraception on file, but we’re working on legislation which would require that EVERY pharmacy have standing orders for ALL forms of emergency contraception. Call your local pharmacy beforehand to make sure they are able to process insurance coverage for over the counter emergency contraception. Please email email@example.com if you have any questions or problems accessing this benefit.