Starting Jan. 1, 2023, a new Massachusetts law affects health insurance coverage of abortion and abortion-related services by ConnectiCare of Massachusetts, Inc.
"Abortion" is defined as any medical treatment intended to cause the termination of, or to terminate, a clinically diagnosable pregnancy except for the purpose of producing a live birth. "Abortion" shall not include care related to a miscarriage.
The following are considered “abortion-related services” when they are provided along with a payable abortion procedure:
- Pre-operative evaluation and examination.
- Pre-operative counseling.
- Laboratory services, including pregnancy testing, blood type, and Rh factor.
- Rh(D) immune globulin (human).
- Anesthesia (general or local).
- Post-operative care.
- Advice on contraception or referral to family planning services.
Also considered "abortion-related care'' when provided along with a covered surgical or medicinebased abortion are:
- Pre-abortion evaluation and examination.
- Post-abortion care.
Under the amended law:
- ConnectiCare of Massachusetts, Inc. must cover all abortion and abortion-related care to most people covered under its insured health plans*. Covered people include subscribers, spouses, and dependents.
- ConnectiCare of Massachusetts, Inc. may require that members get their services from in-network providers and that its utilization review procedures be followed but is not permitted to impose any unreasonable restrictions or delays in getting care.
- The benefits, including the prescribing, dispensing, and administration of mifepristone with misoprostol, or misoprostol alone, will not have deductibles, coinsurance, copayment, or other cost-sharing requirements. An exception to the no cost-sharing requirement may exist for high deductible health plans.
*ConnectiCare of Massachusetts, Inc. is not required to offer coverage for abortion and abortion-related care to members of an employer that is a church or qualified church-controlled organization, if the employer asks that these services not be covered. Please contact your employer group for more information regarding this exemption, if applicable.
Please note: There are laws in some states outside of Massachusetts that restrict abortion and abortion-related care. If you are interested in getting these services in another state or live in another state and intend to get these services in Massachusetts, you should carefully review the other state’s laws.