1. Health
Dawn Stacey M.Ed, LMHC

A Victory For Women's Health: Contraception Must Now Be Covered by Health Insurance Plans

By August 1, 2011

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The Department of Health and Human Services (DHHS) rolled out new guidelines to expand the Affordable Care Act (signed into law by President Obama in March 2010) to include women's preventative services. The DHHS has adopted the full recommendations suggested by the Institute of Medicine. These new services will now allow women to receive a comprehensive set of preventive services without having to pay a co-payment, co-insurance or a deductible.

Effective for all new private health plans written on or after August 1, 2012, plans must now cover, without out-of-pocket costs, all FDA-approved birth control options (to include the pill, Ortho Evra Patch, NuvaRing, IUDs, Implanon and Depo Provera) as well as sterilization procedures (vasectomies, tubal ligation, Essure, and Adiana). Plans will also allow for patient education and contraceptive counseling for all women of reproduction age.

Additionally, these new guidelines  include:

  • Coverage for an annual well-woman preventive care visit
  • Gestational diabetes screening for pregnant women
  • Breastfeeding support, supplies and counseling
  • Counseling and screening for HIV and domestic violence
  • Screening for human papillomavirus (HPV) and other STIs

As of now, existing plans will be grandfathered in (they are exempt from these requirements), but this is likely to change within a few years. One of the greatest benefits of these new guidelines is the inclusion of long-acting reversible contraceptives (Mirena, ParaGard and Implanon). These methods tend to have high up-front costs, so now they will be more affordable - thus removing a huge barrier to effective contraceptive use. Women will now have easier access to the most effective birth control methods.

Research shows that consistent use of birth control helps women to avoid unintended pregnancies and improve birth spacing. This results in substantial benefits for the health and well-being of women, infants, families and society.

| FREE Contraception Newsletter | Twitter | Facebook| Share Your Stories or Tips | Contraception Forum |

Photo Courtesy of Getty Images

Comments
August 2, 2012 at 7:00 pm
(1) Becca says:

Today I whet to buy my nuva ring and my insurence company still thinks they don’t have to pay for it. I have been on the phone all day with them and I guess we just understand the law differently. My insurence company is Regence. Have any other women gotten the nuva ring covered under their insurence ?

August 3, 2012 at 12:48 am
(2) Michele says:

Becca, from wht I understand, the new provisions of the law may not go into effect on your policy right away. When your policy renews for the year, the new law will be applied.

August 3, 2012 at 7:06 pm
(3) Aisling says:

It will not cover all forms of birth control – this includes brand names, like NuvaRing. Also it does not go in effect until your insurance plan renews or you begin a new plan.

August 4, 2012 at 1:18 pm
(4) Dawn Stacey says:

Becca- I saw your comment on my site regarding your insurance company not covering NuvaRing. It is my understanding that although the new healthcare law went into effect on August 1, 2012, this does not mean that you will see the benefits yet. It is anticipated that most people will likely start benefiting in January 2013, since this when the new insurance plan year for many health insurance policies takes effect. So basically, your private insurance plan will have to cover these services, but will do so when it is time for the plan to be renewed. Hope this makes sense. See: Why Do I Still Need to Pay for My Contraception? What Happened to the Affordable Care Act?

August 16, 2012 at 1:14 pm
(5) Erin says:

Although your article says vasectomies should be covered, that seems like a gray area. My insurance company says they’re not covered because a vasectomy is a procedure performed on a male and is therefore not covered by provisions for female wellness in the Affordable Care Act. My husband and I are hoping to have the procedure done as soon as possible but think our health insurance should cover at least part of the bill. What is your understanding of this issue?

Thank you for your assistance.

September 11, 2012 at 9:18 am
(6) Izabelle says:

My new plan with Aetna went into effect on Sept. 1st. Yesterday, September 10th, they told me that they don’t have to cover the Nuvaring. First they told me that they don’t have to cover it because it is a brand. After talking to a supervisor, they told me that they don’t have to cover it because it is an implant. (which it is not). Anyone know how I can get them to cover it??

Thanks – Izabelle

October 10, 2012 at 10:50 am
(7) Rachel says:

I’m in the same boat as everyone else. My insurance company says they don’t have to cover Nuvaring – even after taking health care reform into account. http://healthamerica.coventryhealthcare.com/web/groups/public/@cvty_regional_chcpa/documents/webcontent/c069508.pdf

Is there any resource out there that has a definitive legal grounds that they need to cover Nuvaring?

January 23, 2013 at 1:58 am
(8) Mary says:

It’s after January first, and everything I can find says the AFA should be in full affect with birth control. I saw a slight change in my coverage (premiums went up, I changed to a lower premium with slightly less coverage) last fall, and shortly after my generic birth control was free. After my research I decided to give Nuvaring a try since it was supposedly covered. Unfortunately, when I was at the pharmacy counter I had a total of $85. YIKES. I needed my BC for the month, so I paid, but I don’t know where to go for a clear answer. Here is what my insurance provider says it covers, which doesn’t match what my other research covers.
https://my.cigna.com/teamsitepublic/pdf/839232_HCR_Preventive_Care_V02.pdf
Is this legal?? Can anyone tell me exactly where in the original documents it explains this so I can hold my insurance accountable?

February 24, 2013 at 11:33 pm
(9) Miranda says:

Mary – I’m in the exact same position. Cigna is suggesting I choose another form of birth control, and not identifying how or why it is legally possible to not cover “non-oral” birth control. I’m filing a complaint with the state insurance commission office.

March 4, 2013 at 10:45 pm
(10) Kerri says:

Is the Mirena IUD covered under this new plan?

March 5, 2013 at 3:24 pm
(11) Karen says:

She explained (and America’s Health Insurance Plans later confirmed) that insurers can still charge a co-pay for branded drugs when generics are available.

The law is now in affect but Aetna is not covering Nuvaring. To my knowledge there is no generic equivalent. The company has two cervical caps listed as generic equivalents, but they really are not. How do you get the law enforced?

May 4, 2013 at 5:07 pm
(12) britt says:

Wooo! What you couldn’t pay $9 per month for, I am now paying an extra $100 per month in insurance premiums. Taking a hit for other women’s rights!

July 1, 2013 at 5:21 pm
(13) Kaity says:

Anyone that’s having problems with their insurance covering Nuvaring, I have BLUE CROSS & BLUE SHIELD and they PAY FOR IT COMPLETELY! I’m having a tubal done in 2 weeks.. it’s a shame i can’t just give my extra nuvaring to someone who needs it. I remember when i had a lapse in coverage and i had to fork out $75 for one.

July 11, 2013 at 3:05 pm
(14) cassie says:

I just filled a uncaring prescription yesterday. My doctor gave me one at her office and when I got the prescription filled my total was $0.00! I have united health care by the way.

October 6, 2013 at 12:49 pm
(15) Ivy says:

According to the website below, the National Woman’s Law Center has a hotline for if/when your insurance isn’t giving you Nuva-Ring or Ortho Evra.

http://bitchmagazine.org/post/how-will-the-affordable-care-act-affect-my-birth-control-coverage-on-october-1st

October 9, 2013 at 7:39 pm
(16) Rachel says:

My employer recently switched health care providers from Blue Cross Blue Shield to Aetna. Blue Cross covered the Nuvaring, however, I was informed by Aetna they do not. I don’t understand how they can’t cover it since they do not offer a generic version of the drug. I understand they don’t cover brand names, but it clearly says IF there is a generic version offered. There is not generic verison so why isn’t it covered?

October 14, 2013 at 10:52 pm
(17) Sarah Giles says:

All these women who can’t get Nuvaring covered when it should be, I am one of them also. I have read all the verbiage and there is no reason why they shouldn’t be covered except they just don’t want to. Sounds like a perfect opportunity for a class action law suit against both Aetna and Cigna.

January 21, 2014 at 9:03 am
(18) kristina says:

So is a tubal supposed to be covered 100%? Minus your copay for dr visits I’m sure?

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