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.