Though the Obama Administration
finalized how women covered by most private health plans will have
contraceptive coverage without cost-sharing as guaranteed under the Affordable
Care Act, there is still confusion over which types and brands of contraceptives
will be available without copay.
Here are the facts.
The ACA requires insurance plans to
offer options in each of the five major contraceptive categories: barrier
methods, hormonal methods, implanted devices, emergency contraception and
permanent methods. Plans can treat contraception much like other prescription
drugs, categorizing drugs in a tiered system where some are available for free,
while others come with varying co-pays. Plans must cover a specific
contraceptive without cost-sharing if it’s ordered by a women’s doctor for
medical reasons.
This means that employer health
insurance plans don’t have to cover every type of birth control approved by the
FDA; they can charge co-pays for some brands or products as long as they offer
others for free. Patients should check with their insurers before their
doctor’s appointment. Otherwise, they may not know which specific type of
contraception their insurer covers until the pharmacy rings it up.
The National Women’s Law Center is
establishing a hotline where women can share difficulties with paying for or
accessing contraception through their insurers. NWLC plans to release a report
with their findings. Stay tuned for updates.
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