Iowa Admin. Code r. 191-75.18 - Contraceptive coverage
(1) A
carrier that provides benefits for outpatient prescription drugs or devices
shall provide benefits for prescription contraceptive drugs or prescription
contraceptive devices which prevent conception and are approved by the United
States Food and Drug Administration or generic equivalents approved as
substitutable by the United States Food and Drug Administration.
(2) A carrier is not required to offer
benefits for over-the-counter contraceptive drugs or contraceptive devices that
do not require a prescription for purchase.
(3) A contraceptive drug or contraceptive
device does not include surgical services intended for sterilization,
including, but not limited to, tubal ligation or vasectomy.
(4) A carrier shall make available benefits
for services related to outpatient contraceptive services for the purpose of
preventing conception if the policy or contract provides benefits for other
outpatient services provided by a health care professional.
(5) If a carrier does not provide benefits
for a routine physical examination, the carrier is not required to provide
benefits for a routine physical examination provided in the course of
prescribing a contraceptive drug or contraceptive device.
This rule is intended to implement Iowa Code chapter 514C.
Notes
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