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CommercialCoverageMedium impact

Formulary update: Oral contraceptive update scheduled for April 1, 2019

Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, OB-GYN +1 more·Physician
Effective date
Apr 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

BCBSRI is removing many high-cost oral contraceptives from the $0 ACA coverage list effective April 1, 2019, while maintaining them on formulary with generic copays. Taytulla will be completely removed from the formulary due to available lower-cost alternatives.

Action Required

Action needed
Before April 1, 2019: Billing team should inform providers that patients on affected high-cost oral contraceptives may face new copays and should be counseled about switching to ACA-covered alternatives. Update patient communication protocols to discuss formulary changes during visits. Monitor for increased prior authorization requests or coverage denials for oral contraceptive prescriptions.