Harvard Pilgrim Health Care continues its support and adherence to the Massachusetts ACCESS Law (Advancing Contraceptive Coverage and Economic Security in our State) that notably provides members with coverage for FDA-approved contraceptive drugs, devices and other products without cost sharing -- including emergency contraceptives -- and permits a member continuing on a prescription contraceptive to fill up to a 12-month supply of their prescription at one time. Since the ACCESS Law’s effective date in 2018, Harvard Pilgrim Health Care has coordinated with pharmacists and providers to enable Massachusetts fully and self-insured commercial members to have access to coverage for up to a 12-month supply of prescription birth control in a single dispensing to meet this legislative mandate.
Specifically, the ACCESS Law requires coverage of “prescription contraceptives intended to last for: (A) not more than a 3-month period for the first time the prescription contraceptive is dispensed to the covered person; and (B) for not more than a 12-month period for any subsequent dispensing of the same prescription, which may be dispensed all at once or over the course of the 12-month period, regardless of whether the covered person was enrolled in the plan or policy at the time the prescription was first dispensed.” In order to facilitate such access, providers must write the prescription for up to a 12-month supply. Members may not access more than one 12-month prescription in a single dispensing in a plan year.
If you have questions about your coverage, contact Harvard Pilgrim Health Care member services at the number on your member ID card.
 Coverage is not mandated for male condoms or FDA-approved oral contraceptive drugs that do not have a therapeutic equivalent.
 Exceptions may apply. For example, if the FDA has approved 1 or more therapeutic equivalents of a contraceptive drug, device or product, plans are not required to include all such therapeutically equivalent versions in its formulary as long as at least 1 is included and covered without cost-sharing.