Members are covered for Family Planning Services without a referral or Prior Authorization from AmeriHealth Caritas Northeast. Members may self-refer for routine Family Planning Services and may go to any physician or clinic, including physicians and clinics not in the AmeriHealth Caritas Northeast Network. Members that have questions or need help locating a Family Planning Services provider can be referred to Member Services at 1-855-809-9200.
AmeriHealth Caritas Northeast members are entitled to receive family planning services without a referral or co-pay, including:
- Medical history and physical examination (including pelvic and breast)
- Diagnostic and laboratory tests
- Drugs and biologicals
- Medical supplies and devices
- Continuing medical supervision
- Continuing care and genetic counseling
Infertility diagnosis and treatment services, including sterilization reversals and related office (medical or clinical) drugs, laboratory, radiological, and diagnostic and surgical procedures are not covered.