Blues’ RA Limited Choice program expands in 2015

Under the Affordable Care Act, an employer is not required to offer contraceptive coverage if it qualifies as a religiously accommodated group.

In 2015, Blue Cross Blue Shield of Michigan and Blue Care Network are expanding a program that allows members of these groups to have women’s contraceptive services with no cost sharing when services are obtained from an in-network Blues provider.

To obtain this coverage, members must enroll in Religious Accommodation Limited Choice coverage and use the RA Limited Choice ID card when obtaining contraceptive services.

What’s covered under the RA Limited Choice program?

Contraceptive coverage for members of a religiously accommodated group as defined above depends on whether the group’s plan covers one of the following:

• Medical services such as sterilization and intrauterine devices
• Medical services such as sterilization and intrauterine devices, and prescription contraceptive drugs

Note: A member is eligible for prescription drug coverage if that coverage is included in the group’s plan.

How do members enroll in RA Limited Choice coverage?

Here are the steps:

• We’ll send an RA Limited Choice enrollment form to members of religiously accommodated organizations in the late January to early February timeframe.
• Members can obtain coverage for women’s contraceptive services according to their group plan if they fill out the form and return it to us.
• Upon receipt of the completed form, we’ll send members an RA Limited Choice ID card.
• Members present the RA Limited Choice ID card when obtaining contraceptive services from an in-network provider, and the provider bills Blue Cross for payment of the claim using information on the card. The member won’t have to do anything further or make any kind of payment.

Note:

• The member must be enrolled in the RA Limited Choice program on the date of service to ensure the service is paid.
• If a member does not present the RA Limited Choice ID card when obtaining contraceptive services, claims for the services will be rejected when billed to the member’s group coverage. The services will then have to be billed again using the information on the RA Limited Choice card.

If services are billed using information from the member’s group coverage, the following message will be provided by the Provider Automated Response System, or PARS. (This interactive voice response system replaces CAREN.)

"For additional national health care reform benefits, please transfer to a provider servicing representative."

The RA Limited Choice ID card

The top ID card is for members who have coverage for medical contraceptive services only.

The bottom ID card is for members who have both medical and prescription contraceptive coverage. (The RxLimited logo, located on the bottom right corner of the card, indicates prescription coverage for contraceptives.)

Reimbursement program ending in 2015

A reimbursement program was in effect during 2014 for members of certain religious employer groups. These members paid up front for contraceptive services and sent the receipts to Blue Cross for reimbursement.

We encourage members to send Blue Cross these receipts so they can be paid.

Note: Members who have selected RA Limited Choice coverage and have the RA Limited Choice ID card cannot pay for contraceptive services and send the receipts to us for reimbursement.