This policy implements Rhode Island General Law 27-20-43 requiring coverage of FDA-approved prescription contraceptive drugs and devices for health plans that provide prescription coverage and are delivered, issued for delivery, or renewed in Rhode Island. It applies only to plans that do not include Preventive Services and notes that benefits may vary by benefit booklet, Evidence of Coverage, or subscriber agreement.

The policy covers FDA-approved prescription contraceptives for BlueCHiP Commercial members and, notwithstanding that state mandated benefits generally do not apply to BlueCHiP for Medicare, this policy includes coverage for BlueCHiP for Medicare. It also states that self-funded groups may choose whether to follow the state mandate, so contract-level variations and exceptions can occur.

Rhode Island General Law 27-20-43 requires every individual or group health insurance contract, plan, or policy that provides prescription coverage and is delivered, issued for delivery, or renewed in Rhode Island to provide coverage for FDA-approved contraceptive drugs and devices requiring a prescription. The statute explicitly states that nothing in the subsection shall be deemed to mandate coverage for the prescription drug RU-486 (mifepristone).

The law also permits a religious employer exemption: a medical service corporation may issue to a religious employer an individual or group health plan that excludes coverage for prescription contraceptive methods contrary to the employer’s bona fide religious tenets. Any religious employer that invokes this exemption must provide written notice to prospective enrollees prior to enrollment listing the contraceptive services the employer refuses to cover. The policy notes that benefits may vary by group/contract and that self-funded groups may or may not follow the state mandate. Additionally, prior authorization is not required for FDA-approved prescription contraceptive drugs and devices under this policy.