Thread: Obama Administration: Health Insurers Must Cover Birth Control With No Copays

WASHINGTON -- Health insurance plans must cover birth control as preventive care for women, with no copays, the Obama administration said Monday in a decision with far-reaching implications for health care as well as social mores.

The requirement is part of a broad expansion of coverage for women's preventive care under President Barack Obama's health care law. Also to be covered without copays are breast pumps for nursing mothers, an annual "well-woman" physical, screening for the virus that causes cervical cancer and for diabetes during pregnancy, counseling on domestic violence, and other services.

"These historic guidelines are based on science and existing (medical) literature and will help ensure women get the preventive health benefits they need," said Health and Human Services Secretary Kathleen Sebelius.

The new requirements will take effect Jan. 1, 2013, in most cases. Tens of millions of women are expected to gain coverage initially, and that number is likely to grow with time. At first, some plans may be exempt due to a complex provision of the health care law known as the "grandfather" clause. But those even plans could face pressure from their members to include the new benefit.

Sebelius acted after a near-unanimous recommendation last month from a panel of experts convened by the prestigious Institute of Medicine, which advises the government. Panel chairwoman Linda Rosenstock, dean of public health at the University of California, Los Angeles, said that prevention of unintended pregnancies is essential for the psychological, emotional and physical health of women.

As recently as the 1990s, many health insurance plans didn't even cover birth control. Protests, court cases, and new state laws led to dramatic changes. Today, almost all plans cover prescription contraceptives - with varying copays. Medicaid, the health care program for low-income people, also covers contraceptives.

Indeed, a government study last summer found that birth control use is virtually universal in the United States, according to a government study issued last summer. More than 90 million prescriptions for contraceptives were dispensed in 2009, according the market analysis firm INS health. Generic versions of the pill are available for as little as $9 a month. Still, about half of all pregnancies are unplanned. Many are among women using some form of contraception, and forgetting to take the pill is a major reason.

Read more...http://www.huffingtonpost.com/2011/0..._n_914818.html

Today, almost all plans cover prescription contraceptives - with varying copays. Medicaid, the health care program for low-income people, also covers contraceptives.

Generic versions of the pill are available for as little as $9 a month. Still, about half of all pregnancies are unplanned. Many are among women using some form of contraception, and forgetting to take the pill is a major reason.

I don't think a lack of copay is going to make much of a difference. ..but it will add to the total cost of health care for everyone, not just those seeking the service/product.

Originally Posted by pepperpot

I don't think a lack of copay is going to make much of a difference. ..but it will add to the total cost of health care for everyone, not just those seeking the service/product.

Pregnancy costs more than birth control so that line about cost is a mute point. It is just a form of discrimination that should have been stopped years ago. I go to my specific Dr. because she offers the Depo shot in her office and the medication is billed directly to my insurance company with the cost for a nurse visit. If I went to another Dr. that didn't do it that way I would have to get a prescription that the medication is about $ 100.00 every 3 months plus pay for a nurse visit. So let them cover what should have been covered years ago.

Generic versions of the pill are available for as little as $9 a month. Still, about half of all pregnancies are unplanned. Many are among women using some form of contraception, and forgetting to take the pill is a major reason.

Originally Posted by SLance68

Pregnancy costs more than birth control so that line about cost is a mute point.

Not really moot because if you forget to take the pill and get pregnant, it doesn't matter who paid for the pill, you still end up pregnant.

It is just a form of discrimination that should have been stopped years ago. I go to my specific Dr. because she offers the Depo shot in her office and the medication is billed directly to my insurance company with the cost for a nurse visit. If I went to another Dr. that didn't do it that way I would have to get a prescription that the medication is about $ 100.00 every 3 months plus pay for a nurse visit. So let them cover what should have been covered years ago.

Why is having a copay discrimination?

Not covering it at all would be discrimination.

Say, if you have a copay for your blood pressure medication, is that discrimination too?

It's nice if everything were free, but nothing is really "free", somewhere, someone is paying for it. No such thing as "free".

I don't think a copay is going to make the decision as to whether you use birth control or not. You may not be able to afford it without a copay but copays are usually very affordable.

Originally Posted by pepperpot

Not really moot because if you forget to take the pill and get pregnant, it doesn't matter who paid for the pill, you still end up pregnant.


Why is having a copay discrimination?

Not covering it at all would be discrimination.

Say, if you have a copay for your blood pressure medication, is that discrimination too?

It's nice if everything were free, but nothing is really "free", somewhere, someone is paying for it. No such thing as "free".

I don't think a copay is going to make the decision as to whether you use birth control or not. You may not be able to afford it without a copay but copays are usually very affordable.

They do NOT cover it at all unless I get it from my Dr's office. If I have to get it at the pharmacy I pay for it all. No contraceptives covered on our policy - but they will cover a pregnancy.

Originally Posted by SLance68

They do NOT cover it at all unless I get it from my Dr's office. If I have to get it at the pharmacy I pay for it all. No contraceptives covered on our policy - but they will cover a pregnancy.

So it's covered with a Dr's copay?

Then condoms should be given out for free too then? No Rx required contraception.

According to the article above:

Today, almost all plans cover prescription contraceptives - with varying copays. Medicaid, the health care program for low-income people, also covers contraceptives.

Not sure where your insurance falls in the above.

*I'm not familiar with depo.*


ETA: Just to clarify, I think they should cover Rx contraceptives, but I'm not sure about taking away the copay.

Originally Posted by pepperpot

So it's covered with a Dr's copay?

Then condoms should be given out for free too then? No Rx required contraception.

According to the article above:

Not sure where your insurance falls in the above.

*I'm not familiar with depo.*


ETA: Just to clarify, I think they should cover Rx contraceptives, but I'm not sure about taking away the copay.

They can go to most any health department and get free condoms. I don't have a problem with a copay either on contraceptives but the no copay is too expensive.

Well, I don't mind the 5 dollar copay I was paying for my birth control... but my insurance not only went up this year, I also got a letter from them stating my birth control would go to a $50 copay every month. My husband can get viagra or that other one for like 2 bucks a month... but I have to pay 50? I can't even get pregnant, I take it to control my periods... I'm really pissed off about it.

I think Obamacare has a lot to do with everyone's insurance going up.

Originally Posted by justme23

. My husband can get viagra or that other one for like 2 bucks a month... but I have to pay 50?

I have never understood that logic ....

My co-pay used 2 b 30.00 for 1 month BC. But no co-pay 4 viagra? Thats messed up. They would pay 2 help get your >>>>up and 4 having a baby but not a pk of BC pills?? I use Mirena now and I had 2 pay ALL of it...475.00! (that was 3 years ago).