How to Get Emergency Contraception. How much do emergency contraceptive pills cost? The cost of emergency contraceptive pills ('. Coverage of Contraceptive Services: A Review of Health Insurance Plans in Five States. Insurance coverage of contraceptives has been the focus of legislative efforts at the state and federal level for many decades. With the passage of the Patient Protection and Affordable Care Act (ACA) came the requirement that most private plans provide coverage for women. Federal guidance issued on preventive services coverage requirements states that plans are permitted to apply reasonable medical management techniques to . Information was collected from 2. California, Georgia, Michigan, New Jersey, and Texas) about how they are applying reasonable medical management (RMM) techniques in their coverage of women. Find out about the 15 methods of contraception. Contraceptive injection. Contraceptive implant. IUD (intrauterine device, coil).
Interviews were conducted with plan officials for nine carriers and reviews of publicly available plan documents on contraceptive coverage policies were conducted for an additional 1. In total, the information collected from the interviews and document review represent well over 2. Key findings include: There is variation in how the contraceptive coverage provision is being interpreted and implemented by health plans. While most carriers are complying with the spirit of this requirement, there are exceptions. Specifically, we found that a higher share of plans place limits on certain contraceptive methods: Vaginal Ring: While 1. Nuva. Ring placing no RMM limitations or no cost- sharing requirements to policyholders, five plans only cover Nuva. Ring with cost- sharing and one plan does not cover it all. The birth control patch is a thin. How Much Does It Cost? The patch usually costs between $15 and $50. How Do I Get the Birth Control Patch? How Much Does the Birth Control Patch Cost? Medicaid or other state programs may lower your health care costs. We found this to be the contraceptive method that is least likely to be covered by carriers (Table A). Some carriers report that they do not cover different contraceptive methods with the same chemical formulation. Because the carriers provide no- cost coverage of oral contraceptives, they may not cover or may charge cost- sharing for the Nuva. The contraceptive patch. Costs slightly more than the Pill. She will need to use back up birth control for the first week of the new cycle. The Cost: Each shot costs between $35 and $75, and sometimes comes with an additional doctor’s visit fee of $20 to $40. Ring or Patch, because it has the same chemical formulation that they are already covering with oral contraceptive pills. Implants and Patch: Some carriers place limitations in coverage of the contraceptive implants, with two carriers failing to offer coverage of any implant available, even with cost- sharing and with three carriers covering the contraceptive patch, but only with cost- sharing. Intrauterine Devices: Ten carriers cover all three FDA- approved IUDs with no RMM limitations and no cost- sharing. One carrier, however, does not cover Para. Gard, which is the only non- hormonal IUD available to women. Emergency Contraceptive Pills: While most carriers covered the progestin- based Plan B emergency contraceptive (EC) pill or its generic equivalents, only 1. RMM limitations or cost- sharing. The ella EC pill is a different formulation and has a longer window of effectiveness and it may be preferable for women with a higher body mass index (BMI) than progestin- based EC pills, however, it does not have a generic equivalent. Two carriers do not cover ella at all. Ring. Nuva. Ring. Patch. Ortho. Evra. Patch. Xulane (Generic)1. Injection. Depo- Provera. Injection. Depo- Provera. Generic. 16–2–2. Injection. Depo- Sub. Q Provera 1. Implant. Implanon. Implant. Nexplanon. IUD . It is also not clear whether any carrier has an established expedited appeal process that would allow a woman timely access to emergency contraceptives that are not covered under the policy. Ten carriers cover sterilizations without cost- sharing. However, it was difficult to ascertain coverage for sterilization from both the interviews and the plan document review for seven other carriers. In particular, there is uncertainty about the extent to which carriers cover the ancillary services associated with female sterilization, such as follow up visits and anesthesia. Despite significant national attention to the availability of a religious accommodation to plans serving employers with a religious objection to some or all contraceptive methods, insurers reported that they have received very few notifications from employers qualifying for the accommodation. Carriers have not identified difficulties in implementing the accommodations that have been requested by employers. Information about the contraceptive coverage policies used by health insurance carriers is not easily accessible. Many carriers we approached for this project were unwilling to participate in an interview; only nine out of 2. Furthermore, many of the publicly available documents do not clearly identify plan coverage decisions when it comes to how different contraceptive methods are covered and the limitations of the coverage. This makes it extremely difficult, if not impossible for policyholders to ascertain their current plan. This report finds that there is variation in how insurance carriers are interpreting the guidelines for contraceptive coverage issued by HHS, and that not all methods may be covered without cost- sharing to women policyholders. The CDC and the Office of Population Affairs have clearly stated that offering women the full range of FDA- approved contraceptive methods is an element of high quality family planning services and emphasizes the importance of contraceptive choice in reducing a woman. For many women with private insurance coverage, access to this range of options is now a reality; for some however, their choice of plan may still result in limitations of their contraceptive options. The authors would like to thank Cristina Jade Pe. The authors would also like to thank the staff of the health insurance carriers who participated in the study.
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