Effective October 1, 2010, under the Patient Protection and Affordable Care Act, health insurers are required to offer preventive services to commercial members at no cost-sharing. As a result, three classes of drugs (including all strengths/dosages) that are currently covered under the IBC pharmacy benefit with a prescription are now considered preventive for certain ages and genders:
Therefore, these drugs will be covered at a $0 copayment for the genders and ages indicated above. We will reprocess claims and reimburse members within the gender and age parameters for any copayments paid for these drugs since October 1, 2010.
Note: These changes do not apply to Special CareSM, Children’s Health Insurance Program (CHIP), or Medicare Advantage HMO and PPO members.