QUEST Integration – Contraceptive Services

Original Effective Date:

08/01/1994

Current Effective Date:

01/01/2017

Oral Contraceptives

Oral contraceptives are limited to generic drugs and those brands listed on the HMSA’s QUEST Integration Drug Formulary.

Patients may receive up to twelve months of oral contraceptives on one prescription.

Diaphragms/Cervical Cap

Diaphragms/cervical caps are covered as listed on the QUEST Integration Formulary.

Over-the-counter Supplies

Contraceptive items such as condoms, spermicide creams or gels are covered as listed on the QUEST Integration Formulary.

Injectables

e.g., generic Depo-Provera (medroxyprogesterone acetate)

Limited to one injection per period of effectiveness (e.g., Depo-Provera may be administered every three months for a maximum of four injections per calendar year).

Revision History