Dec 13, 2023
Anthem has added new benefits to coverage for contraception, mental health and substance use.
Anthem is increasing coverage effective January 1, 2024, to comply with new state mandates on a suicide and crisis lifeline, contraceptives, and other behavioral health crisis service providers.
CA SB523 Contraceptive Equity Act of 2022
- Anthem will cover FDA-approved over-the-counter contraceptive drugs, devices, and products at in-network pharmacies with no cost share or medical management restrictions. No prescription will be required.
- Anthem will also cover vasectomy services and procedures with no cost share for in-network services, except for HSA plans that require deductibles first. Medical management restrictions, including prior authorization, will not apply.
- Benefits for vasectomy services and procedures will be the same for any plan member, including spouses and non-spouse dependents.
- Exemptions to contraceptive coverage are available for employers with religious objections.
CA 2022 AB988 Suicide and Crisis Lifeline
- Anthem will reimburse 988 behavioral health call centers, mobile crisis teams, and other behavioral health crisis service providers for medically necessary treatment of mental health or substance use disorders.
- This provision applies to treatment received in and out of the plan’s network.
- Members who receive the treatment out of the plan’s network will pay no more than the cost share amounts they would pay for the same covered services received in the plan’s network.
- No prior authorization is required for the medically necessary treatment of mental health or substance use disorders provided by a 988 center, mobile crisis team, or other provider of behavioral health crisis services.
