Preventive Care
Learn About Health Net's Preventive Screening Guidelines
Use These Guidelines To Help Keep You And Your Family Healthy
Stay up to date with your health and the health of your family. Use this guide to remind you to schedule well-care visits with your family doctor. Note that the guidelines are refreshed often, and may change. Therefore, you should always follow the care and advice of your doctor. Also note this information is not medical advice. And, it does not show exact benefit coverage. Please check your plan's benefit language for coverage, limits and exclusions.
This schedule comes from the U.S. Preventive Services Task Force, unless otherwise noted.
Contraception Coverage
What is covered in my Health Net FEHB plan?
- You and your covered family members have the right to the form of contraception or birth control that your provider recommends is best for your care.
- Health Net's FEHB plans cover, regardless of your gender identity, at least one form of contraception from each category listed in the Women's Preventive Services Guidelines. There is no out-of-pocket cost for covered contraception.
- The FDA provides examples of contraceptives (PDF) categorized in the Women's Preventive Services Guidelines.
- When providers use dispense as written on the member's prescription, Health Net will automatically provide the therapeutic equivalent contraceptive drugs and drug-led devices at no cost-share as well.
- For plan coverage details, please refer to the plan brochure (Section 5a-Preventive care, 5a-Family planning and Section 5f- Covered medications and supplies).
Health Net FEHB plans also cover sterilization surgery for males (vasectomy). Vasectomies may have out-of-pocket costs. Check the plan brochure (PDF) (Section 5a – Family planning and Section 5c – Surgical procedures) for coverage details and costs.
What if the recommended contraception is not covered?
- Use the contraception exception process if the contraception recommended by your provider is not covered or has an out-of-pocket cost. You or your provider may submit an exception request.
- Members can call the Customer Contact Center at 1-800-522-0088 to submit an exception request.
Need Help? You must first use the contraception exception process to get coverage for contraception recommended by your provider. If you continue to experience problems getting coverage, email your concerns to contraception@opm.gov.