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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Are Contraceptives Covered Without Cost?

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Question: I have coverage with Blue Cross through Covered California. Is my plan required to cover contraceptives without cost?

Answer: Yes, your plan must cover the full range of FDA-approved contraceptive methods, but can impose some restrictions on the contraceptives offered at no cost to you. For example, the plan may require that you choose a provider within the network, and use generic rather than brand name contraceptives, unless the brand name is medically necessary. If the generic drug or device does not work for you, you can ask your doctor to request a waiver from the insurance plan to receive the brand name drug or device without cost sharing.

2 Comments

Sue, Covered California will end when funding for the ACA is terminated. Post ACA, California may provide a better health insurance environment for your daughter, but that remains to be seen. In the meantime, she needs to make sure her coverage is paid every. The new regime says they want to continue “preexisting conditions coverage” with limitations, one being that the insured maintains uninterrupted coverage. Each insurance has its own drug formulary. In California, those drug formularies are required to be posted on the carrier’s website.

My daughter lives in Oregon has epilepsy and is covered under the ACA. She is very worried that if the new administration repeals the ACA, she won’t be able to get insurance. She works part-time but makes enough to live on. If she moved to CA, would Covered California still exist after the ACA?

Also, she went through a lot of epilepsy meds before she found one that works. It’s expensive, and only covered 50% by 2017 ACA plans. All of the generics caused allergic reactions or didn’t work. Is there a published formulary of drugs Covered California covers, or would it cover this expensive drug with a letter from her neurologist describing all she went through to get to this drug?

Thank you for your time.

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