Contraceptive coverage
Contraceptive coverage is available at no cost to GEHA members. The contraceptive benefit includes at least one option in all methods of contraception (as well as the screening, education, counseling and follow-up care).
Pharmacy contraceptive exception process
If your physician believes a non-formulary contraceptive is medically necessary for you, an exception review can be initiated by your physician. Providers can contact CVS Caremark Prior Authorization Department to obtain the appropriate exception form, or you may download the Preventive Services Contraceptive Zero Copay Exceptions Form and provide to your provider for completion and submission to CVS Caremark.
Exception requests for contraceptive coverage will be processed within 24 hours of receiving complete information.
Reimbursement process
Reimbursement for over-the-counter contraceptives (prescription required) can be submitted by sending in your original prescription receipt with the prescription number included, obtained from your pharmacy to:
CVS Caremark
P.O. Box 52136
Phoenix, AZ 85072-2136
Members planning on submitting receipts for reimbursement are encouraged to not use their HSA, health FSA or HRA (including any related debit cards) to purchase the contraceptives.
Additional information
- Contraception coverage (OPM) — For questions about contraceptive services or difficulty accessing contraception coverage or other reproductive health care, contact OPM at contraception@opm.gov.
- Consumer Protections
- ReproductiveRights.gov — Know Your Rights: Reproductive Health Care
- For additional questions, please call CVS Caremark at 844.4.GEHARX or 844.443.4279; visit CVS Caremark's website; or review Section 5(f) of your FEHB Plan Brochure.
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