Anyone's Insurance NOT cover birth control?

So I just got on DH's insurance which I was initially excited about....until I found out that they do not cover birth control. Apparently they don't consider it a medical need.

Also, DH is NYPD. Does this mean that all female cops or wives of cops don't have birth control covered?

Re: Anyone's Insurance NOT cover birth control?

When I worked for Catholic Health Services, it was not covered.
However, viagara was.

Re: Anyone's Insurance NOT cover birth control?

Posted by EnV-McC

So I just got on DH's insurance which I was initially excited about....until I found out that they do not cover birth control. Apparently they don't consider it a medical need.

Also, DH is NYPD. Does this mean that all female cops or wives of cops don't have birth control covered?

Re: Anyone's Insurance NOT cover birth control?

Re: Anyone's Insurance NOT cover birth control?

Re: Anyone's Insurance NOT cover birth control?

I have never had birth control covered. I have been under a lot of plans. But just 3 months ago, it started being covered. DH said maybe the laws changed, but I have no idea.

Re: Anyone's Insurance NOT cover birth control?

Re: Anyone's Insurance NOT cover birth control?

The BC I was on under my insurance was on the "3rd tier" and my copay was 75 dollars a month. But I was able to get it at costco's pharmacy for less then that not going thru insurance at all.

Message edited 10/5/2010 9:01:43 PM.

Re: Anyone's Insurance NOT cover birth control?

Re: Anyone's Insurance NOT cover birth control?

Go to planned parenthood, I think you can get it real cheap there. That's what my friend does. She pays $120 bucks and gets an entire year's supply at a time. Then for everything else, she goes to her real ob/gyn.
Or, I know many BC companies are now making it affordable to pay out of pocket, I guess since many ins. companies don't cover it. I was on Loestrin FE a little while ago and it came with a card that ensures you only pay $24 a month for it.
I have paragard now, and I know they have payment plans.
I've been really fortunate, I've never had to really pay for bc, so it kills me that anyone would have to pay a ton for it. Especially because the medical costs are sky high for havnig a baby!

Re: Anyone's Insurance NOT cover birth control?

DH is also NYPD, and just told me that if you get the additional prescription rider (it's like $5 a month) it's covered.

His vasectomy was covered, so I don't see why birth control shouldn't be. That's like a gender discrimination lawsuit looking to happen.

Re: Anyone's Insurance NOT cover birth control?

I know my bcp was only $2.00 more without insurance. I hope yours isn't too expensive if you can't get coverage. I've heard Wal-Mart has a list of prescriptions that are a lot cheaper. If you shop there, check that out.

Re: Anyone's Insurance NOT cover birth control?

I have NYPD GHI and my 500.00 IUD was covered

Re: Anyone's Insurance NOT cover birth control?

Posted by Jenna

I have NYPD GHI and my 500.00 IUD was covered

Re: Anyone's Insurance NOT cover birth control?

Re: Anyone's Insurance NOT cover birth control?

Re: Anyone's Insurance NOT cover birth control?

Thanks so much ladies.

I am going to look into the additional rider tomorrow and if all else fails, I will look into planned parenthood. This whole situation makes me nervous about other things that may or may not be covered down the line.

Re: Anyone's Insurance NOT cover birth control?

DH is NYPD - and we have GHI.

My BC was always covered -- I had to only do a $5 copay.

For just about every single prescription, my copay is only $5.

I'm not 100% sure if it is all covered thru just GHI or if I gave my pharmacy his Caremark card also.

Are you sure it's just a particular brand they aren't covering?

Message edited 10/6/2010 7:29:30 AM.

Re: Anyone's Insurance NOT cover birth control?

I agree with the Planned Parenthood idea - I used to go there when I was a teenager, and I got it free since I didn't want to go through insurance and didn't make a ton of money. They do make you do the exam, as a PP said, but it's worth it to save the money!

My husband's insurance also doesn't cover bc because they say it's not a "medical necessity" and unless I could have a doctor say I needed it for a medical reason, I would have to pay for it myself. However, DH and I always pay out of pocket, and then submit our receipts and a form to the insurance company (Blue Cross Blue Shield) and they reimburse us. So my $30 payment for bc comes back to me a couple of months later :)

Re: Anyone's Insurance NOT cover birth control?

Re: Anyone's Insurance NOT cover birth control?

Found this online. Hope it helps:

On January 1, 2003, New York State’s Women’s Health and Wellness Act went into effect. This law mandates that health insurance plans issued in New York State that provide coverage for prescription drugs must also include coverage for prescription contraceptives. To find out more about the coverage your insurance plan provides, call their customer service number to ask for more details. If you want this coverage and it is not offered through your employer’s health insurance, call NARAL Pro-Choice New York at 212-343-0114 for ways to lobby your employer to include coverage for birth control.

Re: Anyone's Insurance NOT cover birth control?

When I had the optional rider for presciptions with GHI, BC was covered.

Re: Anyone's Insurance NOT cover birth control?

Here is the law:

CONTRACEPTIVES (amendments to §§3221, 4303, and 4322)

Contracts containing prescription drug coverage issued on or after January 1, 2003 must include coverage of contraceptive drugs and devices prescribed by any health care provider authorized to prescribe under the Education Law. Contracts containing prescription drug coverage issued prior to January 1, 2003 must be revised to comply with Chapter 554 of the Laws of 2002 upon renewal, alteration, or modification in 2003.

The law requires that coverage of contraceptive drugs and devices be included in contracts and certificates only through the addition of a rider. Commercial Insurers, Article 43 Corporations, and HMOs must amend insurance contracts and certificates that provide for coverage of contraceptive drugs and/or devices so that such coverage is provided by the rider. Therefore, contracts and certificates that contain such coverage must be amended to remove it. The rider must only contain coverage for the contraceptive drugs and devices. Commercial Insurers, Article 43 Corporations, and HMOs may issue either a single amendment rider that removes the existing benefit and adds the contraceptive drugs and devices coverage required by the Act or, in the alternative, issue two riders, one to remove the existing benefit from the contract/certificate and the other to add the coverage required by the Act. The contraceptive coverage rider and associated premium rates are required to be approved by the Department prior to use. Although the law does not amend Insurance Law §3216, there is nothing in the law that prohibits Commercial Insurers from offering contraceptive coverage to policyholders of individual health insurance products.

The copayments for contraceptive drugs and devices must be commensurate with those charged under the contract’s prescription drug coverage. Commercial Insurers, Article 43 Corporations, and HMOs may charge a provider office visit copayment for contraceptive devices that require an office visit. For those Commercial Insurers, Article 43 Corporations, and HMOs charging a separate copayment for contraceptive devices, such copayment must be consistent with the prescription drug copayment.

A religious employer, as defined in the law, may request a contract without such coverage where contraception is contrary to its religious tenets, provided that it meets the criteria set forth in §§3221(l)(16)(A)(1) or 4303(cc)(1)(A) of the law. To ensure that such criteria have been met, appropriate questions may be added to the group policyholder application or by a supplemental application designed for this purpose.

The religious employer opting not to include contraceptive coverage must provide written notice of its decision to prospective enrollees prior to enrollment with the plan, listing the contraceptive health care services the employer refuses to cover for religious reasons. Where such group contractholder makes an election not to purchase coverage for contraceptive drugs or devices, the Commercial Insurer, Article 43 Corporation, or HMO is to provide written notice to certificateholders upon enrollment of their right to directly purchase the coverage and of the premium cost therefor. Individual certificateholders have the right to purchase the rider for coverage directly from the Commercial Insurer, Article 43 Corporation, or HMO at the prevailing small group community rate for such rider whether or not the employee is part of a small group. The premium rate for individual certificateholders who exercise the right must be the same as the community rate charged to all small groups for this rider.

I would also check and see what your copay is. Once my gyn prescribed me one that had no generic and my copay for non-generic was $35. I asked my gyn for a different pill and then I only had to pay $5 copay.

Re: Anyone's Insurance NOT cover birth control?

my DH is NYPD as well, his insurance does not cover my BC, however, with my specific BC, they give you a card that you pay no more than $24 a month so that is what I end up paying (I take Loestrin 24)

Re: Anyone's Insurance NOT cover birth control?

It could very well be the brand. My insurance won't cover some brand scripts but will cover the generic.