Is birth control covered by health insurance?

Answer 1

Coverage for Birth Control pills depends on the plan that you or your employee purchased, not the insurance company. Under the Affordable Care Act (Obamacare), the majority of plans cover birth control pills. To check that your plan does, call the phone number on the back of the card and ask about your particular drug coverage.

Answer 2

Your health/medical plan must have a prescription plan with it in order for your prescriptions to be covered. Your medical insurance carrier is separate from your prescription medicine carrier. Both are processed through two totally different companies and people don't understand that!

Birth controls used to never be covered a few years ago, but now birth controls are starting to be paid for by insurance. Not all birth controls are covered, but to be sure, you can contact the benefits customer service # on the back of your insurance card. It is recommended to get a prescription of a generic because it will be cheaper. Brand name drugs will have a higher copay and can SOMETIMES not be a formulary drug. Formulary means something preferred. Insurances have a 3-tier drug copay. The lower one is for generics, middle is for formulary brand names, and the highest one is for nonformulary ones. Also, make sure your prescription deductible has been met.

Your insurance may require a prior authorization (PA) before they will pay for any drug, whether birth control or not. Your pharmacy should be able to let you know if your prescription requires a PA or not once you bring a prescription in and they file it on your insurance. In cases that need a PA, your doctor needs to contact your insurance directly to get an override showing that it's medically necessary, etc. In cases like these, it means your insurance company prefers another drug over that one, in which your doctor can always change it to that drug. If your doctor prescribes you a drug and there is a generic for it but you want the brand name, your insurance is not required to cover it. Most usually pays a percentage but barely anything at all. Wal-Mart Pharmacy offers certain prescription birth controls with or without insurance for only $9 a month.

Answer 3

Coverage for birth control pills is based on your employer's choices, not the insurance company's. Under the Affordable Care Act (Obamacare), the vast majority of plans must cover birth control pills fully. To check that your plan is covered under the ACA, call the number on the back of your insurance card and find out about coverage for birth control.

Answer 4

In the past, whether you had coverage depended on what the employer agreed to pay, not the insurance company. Now, birth control must be a covered benefit under any health plan in the US effective 8/1/12; however, if your renewal date from your plan isn't until January, the change doesn't go into effect until then.