Frequently Asked Questions About Insurance Coverage for Contraception
FREQUENTLY ASKED QUESTIONS ABOUT INSURANCE COVERAGE FOR CONTRACEPTION
- Will my contraception be free?
Probably not. As with other prescription drugs, there will be a co-pay for prescription birth control. Anti-discrimination law requires that contraception be covered in the same way as other comparable prescriptions.
If you do not have insurance, and need free or reduced-cost contraception, call 1-800-230-PLAN to find the Planned Parenthood clinic nearest you. - What if my prescription is covered but the co-pay is expensive?
This may not be fair. The EEOC Decision states:
"Respondents (employers) must cover the expenses of prescription contraceptives to the same extent, and on the same terms, that they cover the expenses of the types of drugs, devices, and preventive care
-Respondents (employers) must also offer the same coverage for contraception-related outpatient services as are offered for other outpatient services
-Respondents' (employers) coverage must extend to the full range of prescription contraceptive choices. Because the health needs of women may change -- and because different women may need different prescription contraceptives at different times in their lives -- Respondents (employers) must cover each of the available options for prescription contraception. Moreover, Respondents must include such coverage in each of the health plan choices that it offers to its employees."
This wording is not specific regarding co-pays, but if there is a discrepancy in payment for birth control and other prescriptions, you should talk to your employer about this. Feel free to contact us for any assistance. - What if my state has a "contraceptive equity" law in place?
Your state law may or may not ensure that you get your contraception covered. Self-insured employer health benefit plans are not mandated by state laws, regulations or rules. They are subjected to federal laws (Title VII of the Civil Rights Act of 1964). If you need help finding out about whether your state law applies to you, contact us or your local Planned Parenthood affiliate. - What are the differences between state, federal and private insurance requirements?
25 States have contraceptive equity rules, regulations, or laws regulating insurance company plans to include prescription contraception. Many of these states have "Conscience clauses" which permit religiously affiliated companies to deny coverage even if their employees are not religiously oriented.
The federal laws apply to self-insured or state-insured employers. These companies are regulated by the Title VII: Civil Rights Act of 1964, and the Pregnancy Discrimination Act. The Equal Employment Opportunities Commission (EEOC) is the federal agency that monitors all discrimination charges.
The EPICC bill has yet to be enacted. This bill would ensure coverage prescription contraception and services in all insurance plans nationwide. In September 2001, at the request of Sen. Ted Kennedy, Jennifer Erickson and other women's organization leaders testified before the Committee of Health Education, Labor & Pensions of the US Senate to promote the EPICC bill. - How do I know if my employer is self insured?
You can ask your human resources director, benefits administrator or supervisor. Self-Insured companies are required to have 15 or more employees and are subject to Title VII discrimination laws, just like companies that are not self-insured. Do not let your employer tell you that they don't have to cover your contraception just because the company is self-insured! - What if my insurance covers birth control pills but not the brand I need?
The EEOC and Erickson v. Bartell decisions both site that employers are required to cover "each of the available options for prescription contraception to the same extent, and on the same terms, that it covers other drugs, devices and preventative care�" The decisions do not address specific brands only that a wide range should be covered. If you are not getting insurance coverage for one of the FDA-approved methods of contraception, contact us. - What if I am on my parent's/spouse's insurance plan?
If you are considered a "dependent" on a spouse's or parent's health plan, then your spouse or parent can use the sample letters provided in the Take Action page on the website and give them to their employer to ask for equitable coverage. - What about fertility treatments?
Insurance coverage for fertility treatments is a different issue for consideration. Since both male and female employees can benefit from such treatment there would not be the same standard for discrimination that is addressed by this process.
