Page 21 - NAPA 2021-2022

■ FDA-approved contraceptives 2 Lactation consultations which may include
comprehensive breastfeeding education,
Cervical cap (P) with spermicide (OTC) support, counseling, clinical management
Contraceptive implant system (inserted and interventions provided to women during
by doctor) the antenatal, perinatal, and postpartum
Contraceptive patch (P) period to support the initiation, maintenance
Contraceptive ring (P) and continuation of breastfeeding, including
when provided to women who encounter
Diaphragm (P) with spermicide (OTC) difficulties breastfeeding due to anatomic
Female condom (OTC) variations, complications, and feeding problems
IUD (inserted by doctor) with newborns.
Morning after pill (generic only) (OTC) Perinatal depression screening and counseling
Oral contraceptive (brand name (P) only ■ Preventive drugs for adults
when generic equivalent drug is medically Aspirin (81mg) (OTC )
1
inappropriate, as determined by the
individual’s health care provider). Colon Preparations–age 50–74 (P)
Preauthorization and medical review of Folic Acid—women of childbearing age (P)
brand name oral contraceptives is required. Smoking Cessation (OTC )
1
Oral contraceptive (generics) (P) Vitamin D (600IU–800IU)—age 65 years and
Shot/injection (generic only) (P) older (P)
3
Spermicide (OTC) Statins (generic low to moderate intensity)—
adults age 40 to 75 (P)
Sponge (OTC) with spermicide (OTC)
Sterilization implant Truvada (200 mg-300 mg) (emtricitabine/
tenofovir) until generic becomes available
Sterilization surgery
■ Prenatal care ■ Preventive drugs for children
Fluoride—preschool age (P)
Routine prenatal obstetrical office visits
Iron—6–12 mo. risk of anemia (OTC )
1

Additional information on
To verify your benefits, check your
benefits contract, your enrollment preventive services is available
materials or log into My Account at at healthcare.gov/coverage/
carefirst.com/myaccount.
preventive-care-benefits

1 Requires a prescription from a physician and must be purchased at a pharmacy to obtain the zero-cost share.
2 Prescriptions must be purchased at a network pharmacy to obtain the zero-cost share. Members may be able to receive up to a 12-month
supply of prescription contraceptives. Requires a prescription from a physician, or from a Maryland or D.C. board-certified network
pharmacist, for the contraceptive(s). For Maryland members, a prescription is not required for certain OTC emergency contraceptives. Ask
your pharmacist if you have any questions regarding dispensing amount.
3 Includes brand name Depo-SubQ Provera 104 (injection)
(P) Prescription Required
(OTC) Over the Counter

CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare
Advantage is the business name of CareFirst Advantage, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan
(District of Columbia), Inc. In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. In Virginia, CareFirst MedPlus is the business name of First
Care, Inc. of Maryland (used in VA by: First Care, Inc.). CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst Advantage, Inc., Trusted Health Plan (District
of Columbia), Inc., CareFirst BlueChoice, Inc., First Care, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. BLUE CROSS®, BLUE
SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.
CST2178-1P (9/20)