Still Paying for Birth Control? Stop That Right Now
The Affordable Care Act was seen as a huge win for women when it was signed into law in 2010. Under the Act, women with health insurance are entitled to important preventative services, such as birth control and well-woman visits with no co-pay or deductible.
So you can imagine the surprise (and annoyance) of some insured women who have had to pay out of pocket for those expenses.
That’s exactly what happened to one of our editors: She recently switched insurance companies and called her new company to find out how to get a 90-day mail-order prescription for her birth control (since that's what our company's health plan covers). She was told it wasn’t covered, though, and that it would cost her $200.
Um…what? Apparently, this is happening often because the Obama administration has issued guidance to insurance companies and consumers to make sure everyone is aware that insured women are able to have access to contraception with no out-of-pocket expense to them.
RELATED: Friendly Reminder: Your Birth Control Should Probably Be Free
In a move that the administration says is intended to “eliminate any ambiguity,” the U.S. Departments of Health and Human Services and Labor and the Treasury released a statement reiterating that insurers must cover—without cost-sharing—at least one form of contraception in each of the methods that the FDA has identified for women in its current Birth Control Guide, which includes the ring, the patch, and intrauterine devices. (There are currently 18 methods IDed.)
“The Affordable Care Act was a major step forward in helping women get the health care services they need to stay healthy," said Sylvia M. Burwell, Health and Human Services Secretary, in a press release. "Tens of millions of women are eligible to receive coverage of recommended preventive services without having to pay a co-pay or deductible, including contraception,” . "Today, we are clarifying these coverage requirements, including access to the full range of contraceptive methods identified by the FDA, access to genetic counseling and testing for the BRCA gene as a preventative tool in the fight against cancer, and access to preventive services for transgender individuals.”
RELATED: 7 Reasons to Switch Your Birth Control
Why now? According to the press release, “Issues have been raised by some women and from members of Congress that insurance companies were not covering the contraceptive method recommended by doctors, as well as concerns from issuers that the existing guidance did not provide enough detail about how specific types of contraception should be covered.”
The organization also issued clarification on several important topics:
1. If a woman is at an increased risk for having the BRCA-1 or BRCA-2 cancer susceptibility gene, an insurer must cover preventative screening, genetic counseling, and genetic testing with no cost to her, as long as she has not already been diagnosed with a BRCA-related cancer.
2. Insurance companies cannot limit preventative services based on a person’s assigned sex at birth, gender identity, or recorded gender.
3. If a plan covers dependent children, they must provided recommended preventative services for those children, including those related to pregnancy and prenatal care.
4. Plans can’t charge co-pays or deductibles for anesthesia performed with preventative colonoscopies.
RELATED: Your Biggest Affordable Care Act Questions—Answered
Hopefully this new guidance will clear up any uncertainty surrounding the cost of certain services under the Affordable Care Act. But keep this in mind: If your insurance company tries to charge you for birth control or other well-woman services, something is wrong.
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