Insurance Coverage for Contraception
Massachusetts law requires health-insurance plans that cover prescription medication to provide equitable coverage for contraception.
What is required? If a health-insurance plan provides coverage for outpatient prescription medication and devices or outpatient services, it must provide coverage for any Food and Drug Administration-approved outpatient prescription contraception or outpatient contraceptive services.
To which insurance plans does the law apply? Individual and group insurance policies, individual or group medical or hospital service agreements, and health maintenance organization (HMO) policies issued or renewed on or after January 1, 2003 that provide coverage for prescription medication and devices or outpatient services.
Does the law provide additional protections for women? Yes. Coverage for prescription contraception and outpatient contraceptive services must be provided under the same terms and conditions as those for other prescription medication and devices and other outpatient services.
Does the law contain a refusal clause, allowing certain employers and/or insurers to refuse to provide or pay for contraceptive coverage? Yes.
To whom does the refusal clause apply? Employers that are churches or qualified church-controlled organizations.
What does the refusal clause allow? A church or qualified church-controlled organization is not required to provide equitable coverage for contraception.
Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women? No.
Does the law require the refusing entity to notify the persons affected? No.
Are there circumstances under which a refusal clause may not be exercised? No.
Does the law provide a mechanism for women to obtain contraceptive coverage if their employer exercises a refusal clause? No.
Mass. Gen. Laws Ann. ch. 175, § 47W (Enacted 2002); Mass. Gen. Laws Ann. ch. 176A, § 8W (Enacted 2002); Mass. Gen. Laws Ann. ch. 176B, § 4W (Enacted 2002); Mass. Gen. Laws Ann. ch. 176G, § 4O (Enacted 2002).