To start, the formularies were hard to find and difficult to navigate. For example, one of the plans provides three separate links that define the covered pharmaceutical benefits — one for drugs that require prior authorization, one for maintenance drugs, and another preferred drug list, or PDL.
Each list includes dozens of drug names. Even as a researcher who is accustomed to sometimes tedious work, I grew discouraged trying to navigate and understand the formularies. Many women would no doubt feel similarly defeated and confused. And, as mentioned above, there are inconsistencies among companies as to whether the product is listed as a medical benefit or a pharmacy benefit, which can be misleading.
While phone calls to insurance providers to discuss covered benefits are often an option, woman must first understand what specifically to ask for. And, who has time for phone calls? As Health Savings Accounts HSAs and high-deductible plans are becoming increasingly commonplace, more people are forced to make decisions on their own about health care options.
Overcomplicated formularies and vague information on covered contraceptive benefits create major challenges and unnecessary work, and could act as a barrier to receiving care and making informed decisions about contraception. Giving women simple and easy-to-find information on covered benefits reduces these barriers, and empowers women to make informed decisions using the available information. We did find that many of these plans have the implant and IUDs included as a medical benefit, however a lack of a standard method for classifying the coverage is problematic for women.
Plans should make certain that they are staying true to the law and covering all FDA-approved methods of birth control, including IUDs and the implant, and work make sure this information is easily-accessible for women.
Furthermore, prior authorization is required for some products under some plans, which means that your medical provider must obtain permission from your health plan to confirm that it will cover the device prior to insertion. This creates yet another barrier, and a time-lag, which can prohibit same-day insertion. In the face of an increasing emphasis on individuals taking charge of their healthcare, doctors and other healthcare providers can still play a role in helping women to understand their options and covered benefits.
This includes understanding the new guidance that these methods are front-line for pregnancy prevention in any women of reproductive age and discussing the most effective options IUDs and implants first when providing guidance to women on contraception. This simple paradigm shift could result in many more women learning about the benefits of IUDs and the implant.
Then they may work with their providers to understand what specific products suit their needs and are covered under their plans. More local providers are also stocking these methods, to avoid the barrier of a follow up appointment. S hould you use birth control pills, condoms or an intrauterine device IUD? Women choose their birth control based on many factors, like effectiveness or comfort—but cost has been less of a consideration, ever since the Affordable Care Act.
A provision in the act required employers to provide contraception to all women in their health plans without charging a copay or coinsurance fee.
Estimates suggest that more than 55 million women had access to birth control without co-pays because of the mandate. Going forward, the price of birth control may matter more. On Oct. But some worry that the IUD —one of the most effective and low-maintenance types of birth control—could become prohibitively expensive. And though an IUD may be a better financial investment over time, since women can use the device for several years, such a high initial price tag is beyond the means of many women.
Health care analytics company Amino analyzed billions of health insurance claims from to mid to understand how much an IUD could cost women if their insurance no longer covered it.
Most Planned Parenthoods are Title X clinics. You can look up Title X clinics in your area here. By Hiranmayi Srinivasan June 22, Save Pin FB More.
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