Frequently Asked Questions about Contraceptive Coverage

For Benefit Eligible University Employees

When will the changes to the University’s medical plans related to the coverage of contraceptives take effect?
The changes to the University’s medical plans related to contraceptive coverage will take effect July 1, 2018.

Why is the University making changes with regard to contraceptive coverage under its medical plans?
Fr. Jenkins sent a letter to the campus community in February explaining the reasons for the changes. To read the letter, please visit here.

How were the decisions made about which contraceptives would be covered under the University’s plans?
Recommendations about coverage were formulated after consultation with moral theologians and medical experts and considering comments from the University community. These recommendations were approved by Fr. Jenkins.

Where can I get more information about the Catholic Church’s teaching on contraception?
As Fr. Jenkins indicated in his letter to the campus community in February, the University will provide to all who sign up for health care benefits a statement of the Catholic teaching on contraception. There will also be references to further material for those interested in learning more. The statement and references will be part of the materials we make available on July 1st.

Which contraceptive drugs will be covered under the University’s medical plans?
Hormonal contraceptives whose primary purpose is either to prevent ovulation and/or to prevent fertilization will be covered. The list of covered contraceptives, which includes oral contraceptives, injectables, hormonal patches, and vaginal rings, will become part of the University’s OptumRx Formulary effective July 1 and can be found here: Formulary Contraceptives. Those contraceptives that have as their primary function the prevention of implantation or interference with the development of a pregnancy are not covered under the University’s plans. Emergency contraceptives are also not covered.

Are IUDs and contraceptive implants covered under the University’s medical plans?
Certain IUDs and contraceptive implants are covered under the University’s medical plans, specifically those that have as their primary mechanism either the prevention of ovulation and/or the prevention of fertilization. (Note: Because IUDs and implants require placement by a medical provider, the provision of these forms of contraception is considered a medical service). Copper IUDs are not covered.

What Natural Family Planning services will be covered under the University plans?
Counseling and Instructional office visits that are associated with Natural Family Planning, as well as essential equipment, such as fertility monitors and the associated testing strips, will be covered under the plans.

Is there a co-payment for contraceptive drugs and services as there is for other drugs and services under the University’s medical plans?
Yes, the out-of-pocket costs for contraceptives are the same as for other drugs and services under the University’s plans.

Will the Wellness Center Pharmacy, operated by Walgreens, fill prescriptions for contraceptives? Can Wellness Center physicians prescribe them?
While the University does not promote the use of contraceptives, the Wellness Center Pharmacy will fill contraceptive prescriptions for those drugs that are covered under the University’s medical plans. Physicians at the Wellness Center may use their medical judgment to prescribe any covered drugs or services within their scope of practice. Wellness Center physicians are not certified to offer IUD placement. Where appropriate, they will refer patients to gynecologists in the local community.

What will happen if I currently receive contraceptives through the existing third-party plan?
The third party plan, made available through the University’s Third Party Administrator (TPA), will no longer be offered after July 1, 2018. The TPA will send a notice with further information.

Can I appeal if my physician recommends a contraceptive that is not covered under the University’s medical plans?
Yes, just as there is an appeal process for other drugs and services that are not covered under the plans, you can file an appeal, based on medical necessity, for coverage. To initiate an appeal, your provider should contact OptumRx at 866.270.0234.

Will there be any changes to the Flexible Spending Accounts (FSA) in July?
Given that employees have already made their elections for 2018, there will be no changes to the rules about what is eligible for FSA reimbursement in 2018. Beginning in 2019, the reimbursement rules will be changed to align with the medical plans. In other words, those medical services that are excluded under the medical plans will also be excluded from FSAs.

I have other questions about the contraceptive coverage that will be provided under the University’s medical plans. Where can I get more information?
By May 1, 2018, plan participants will receive a Summary of Material Modifications that will outline these changes and provide more details.