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Covered Birth Control Options

If you’re not quite ready to expand your family, BlueCross has you covered with medical benefits that include a variety of federally-approved birth control methods, including contraceptive drugs and devices.

For more information on your birth control options, or to find the one that’s right for you: 

Download the 2016 Contraceptive Guide

BlueCross covers at least one version of each of the 18 federally-approved birth control methods. This benefit is available under the Affordable Care Act at no additional cost to you. Specific brands may not be covered in some instances where generics are available.

As a member, you do have the right to appeal if you want a non-covered medication.  BlueCross is here to settle any problems and to serve our members. You or your physician can submit an appeal to the BCBST Pharmacy Management department by faxing the request, along with supporting documentation to 1-888-343-4232 or (423) 535-5100.

Download the Non-Covered Pharmaceutical Exception Request

Please include supporting documentation as follows:

  • Member Name
  • Member ID Number
  • Medication Requested
  • Documented reason why the member cannot take alternatives from the member’s chart
  • If the alternatives do not work – what is the documented reason it does not work?
  • Names of drugs tried and length of trial

Filing a Grievance or Appeal

If you do not agree with a decision, you may ask us to review it.  This is called a “grievance” or “appeal” in your Evidence of Coverage or plan materials.  Please read the grievance/appeal section in your Evidence of Coverage or plan material.  Every member has access to an appeals/grievance process.

Some plans are governed by the Employee Retirement Income Security Act of 1974 (ERISA), which is a Federal Act with specific appeal/grievance rights.  If your health plan is governed by ERISA, you may file a civil action after you finish the grievance/appeal process.  You may also be able to ask for an independent review of a decision.

If your plan is not governed by ERISA you will have appeal/grievance rights outside of ERISA.  Please refer to your plan materials for your rights.

To begin the process or if you are unsure of your rights, call Member Service at the number on your ID card or at (800) 565-9140.

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