KFF Examines Key Considerations for the Implementation of Insurance Coverage for Over-the-Counter Contraceptives


With federal regulators in search of public enter at the doable advantages, prices, and implementation issues of requiring non-public medical insurance plans to hide over the counter preventive merchandise with out a prescription, a new KFF post explores the problems related to masking over the counter contraceptives. Those contraceptives come with Opill, the primary day-to-day oral contraceptive tablet to obtain FDA popularity of over the counter availability.

The research attracts at the courses realized from KFF group of workers interviews with greater than 80 key avid gamers nationally and in states that experience handed rules or taken different movements to increase get entry to to delivery keep watch over with out a clinician’s prescription. It describes implementation demanding situations and methods together with standardized billing protocols for over the counter merchandise, enrollees and pharmacists’ consciousness of required protection, and the have an effect on of mitigating pharmacist and pharmacy group of workers overload.

Below present federal coverage pointers, insurers are in most cases required to hide prescribed FDA-approved contraceptives with out a affected person cost-sharing. In October 2023, the Departments of Treasury, Exertions, and Well being and Human Products and services issued a request for info associated with requiring non-public insurers to hide over the counter preventive services and products and provides with out a prescription. Feedback at the proposal are due on December 4.


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