BCBSRI coverage for abortion and reproductive health services
Updated on 27 de abril, 2023
With the Supreme Court ruling on Dobbs v. Jackson Women's Health Organization, the federal right to abortion is no longer guaranteed, and each state may make its own laws on the issue. These laws may vary significantly across the United States. In Rhode Island and other New England states, abortions continue to be legal under state law. However, prohibitions are likely to be passed in a number of other states.
These FAQs can help you understand how your BCBSRI health plan covers abortion and other reproductive health services.
How are abortion services covered under BCBSRI health plans?
BCBSRI plans cover surgical and medical abortions (which use medication to end a pregnancy), whether those services are received at a hospital, clinic, or other healthcare facility; at a provider’s office; or through telemedicine. You do not need prior authorization (preapproval) or a referral to receive these services.
However, under some BCBSRI plans, abortions are only covered in the case of rape or incest or if a person’s life is in danger unless an abortion is performed. If you have questions about your specific plan details, please check with Customer Service or your employer.
Do recent federal court decisions affect access to the medication abortion drug mifepristone in Rhode Island?
Access to mifepristone remains legally protected in Rhode Island. Rhode Islanders have access to the same coverage, treatments, and care that they had before these federal court rulings. You can find more information from the Rhode Island Department of Health.
Does BCBSRI Doctors Online offer medical abortion or miscarriage services?
No, BCBSRI Doctors Online—which offers video visits with doctors—does not offer medical abortion or miscarriage services. However, they do provide other reproductive services, including family planning and contraceptive counseling.
What if I live in a state where abortion becomes illegal?
BCBSRI is exploring how its plans can provide travel expenses if access to abortion is limited or not available in your state. We will provide more information as we develop these options in coordination with the Blue Cross Blue Shield Association (BCBSA), the national association of all Blue plans, which is committed to ensuring the needs of our communities and our customers are met. For questions about your specific plan, please check with Customer Service or your employer.
What is my coverage for contraception and family planning services?
Under your BCBSRI health plan, you are covered at 100% for the range of FDA-approved methods of contraception, family planning practices, and sterilization procedures that help prevent unintended pregnancy and improve the chances of a healthy pregnancy. Please note that a provider’s prescription is required for 100% coverage of prescription or over-the-counter contraceptives, which you will need to get at the pharmacy counter.
The following services are covered at no cost to you:
- Birth control pills or patches with a prescription
- Emergency contraception with a prescription
- Intrauterine devices (IUDS)
- Sterilization, such as tubal ligation surgery or via implant, including anesthesia and other services related to the procedure
- Provider visits for counseling related to contraception
- Female condoms, diaphragms, spermicides, cervical caps, and other methods with a prescription
Please note that not all brands of contraception are covered by your plan. If you or your provider feel that you need a different brand than the ones covered at 100%, your provider can fill out this simple exception form.
If you had a provider’s prescription and already paid out of pocket for contraception not covered by your plan, you can request reimbursement after your provider has completed the exception form and it’s been approved. Please contact Customer Service for assistance.
*Not all employers offer this coverage under their plan. Please check with your employer for details.
What other reproductive and preventive health services are covered under my plan?
Under your BCBSRI health plan, you are covered at 100% for a range of services, including:
- Support for breast-feeding equipment and replacement supplies
- Well visits with a primary care provider or Ob/gyn
- Screening for HIV
- Counseling for sexually transmitted infections
- Human papilloma virus (HPV) screening
- Domestic violence screening
- Preventive cancer screenings for breast cancer, cervical cancer, and colon cancer
In addition to those services, BCBSRI members in fully insured (and many self-funded) health plans can be reimbursed for doula services up to $1,500. Trained and certified doulas provide emotional, physical, and educational support before, during, and after childbirth to help ensure your experience is as healthy and positive as possible. Learn more about doula coverage and other help with your pregnancy.
How can I stay up-to-date on any changes to my coverage?
If the legal situation changes and affects your BCBSRI health plan benefits, we will update this page with that information.