This article is for primary care providers caring for our members
In 2017, Massachusetts passed the ACCESS Act (Act Advancing Contraceptive Coverage and Economic Security in our State) to ensure that Massachusetts residents continue to have access to affordable birth control. We want to make sure that you and your patients are aware of the protections available under this law as you discuss the best options for their contraceptive prescriptions. We cover the vast majority of generic—and some brand name—contraceptives with no member copay, deductible, or coinsurance.
The ACCESS Act also allows patients to choose fill their contraceptive medication or birth control prescription for up to a 12-month supply at one time, either at the retail pharmacy or through mail order. After the member has used the medication for at least 3 months, members in most fully-insured health plans are eligible to fill for a 12-month supply.*
Please encourage patients interested in obtaining a 12-month supply at one time to call the number on their Blue Cross membership card to confirm eligibility. In addition, please note that:
- You will need to write the prescription for a 12-month supply for the member to fill a year’s supply at one time.
- The pharmacy cannot dispense a 12-month supply if the prescription is written for a smaller quantity. For example, if the prescription is written for one month with 3 refills, the pharmacy can only dispense a maximum 4-month supply.
- If the member loses the medication that has been dispensed, you will need to write a new prescription and request that the pharmacy override the existing prescription.
* Please note that self-insured and church-based accounts may choose not to provide this coverage.
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