Insurers Illegally Denying Contraceptive Coverage

[Content Note: War on agency; classism. NB: Not only women need access to birth control.]

Despite the Hobby Lobby decision that created an exemption for religious private employers, most employers and insurers are still required to cover contraceptives. But Kaiser Health News has found there are still all sorts of attempts to deny coverage of certain types of contraception or deny coverage of contraception altogether:

In one of those messages recently, a woman said her insurer denied free coverage for the NuvaRing. This small plastic device, which is inserted into the vagina, works for three weeks at a time by releasing hormones similar to those used by birth control pills. She said her insurer told her she would be responsible for her contraceptive expenses unless she chooses an oral generic birth control pill. The NuvaRing costs between $15 and $80 a month, according to Planned Parenthood.

Under the health law, health plans have to cover the full range of FDA-approved birth control methods without any cost sharing by women, unless the plan falls into a limited number of categories that are excluded...

As an official from the federal Department of Health and Human Services said in an email, "The pill, the ring and the patch are different types of hormonal methods … It is not permissible to cover only the pill, but not the ring or the patch."

Guidance from the federal government clearly states that the full range of FDA-approved methods of birth control must be covered as a preventive benefit without cost sharing. That includes birth control pills, the ring or patch, intrauterine devices and sterilization, among others.

But despite federal guidance, "we've seen this happen, plenty," says Adam Sonfield, a senior public policy associate at the Guttmacher Institute, a reproductive health research and education organization. "Clearly insurance companies think things are ambiguous enough that they can get away with it."

If you are denied coverage, your defense is to appeal the decision, and get your state insurance department involved.

And throughout the duration of that process, you get to pay for your own birth control out of pocket, if you can afford to. And if you can't, too bad. And if you get pregnant, well, hope you live within distance of an accessible abortion clinic, and can afford an abortion.

This is not a functional healthcare system.

An insurance company, trying to save money to pass onto its wealthy shareholders, denies the $15-$80 a month coverage of a NuvaRing to a woman who is insured by them. The woman then has to pay that cost herself, at least until the insurance company is forced to reverse their illegal denial of coverage. She is subsidizing the profits of a corporation and earnings of wealthy shareholders.

And that's the best case scenario after this sort of denial of coverage. In the worst case scenario, a woman who can't afford $15-$80 a month gets pregnant, and can't afford an abortion, either, and then has a child she didn't want and can't afford. Escalating costs passed on to her because an insurance company made an illegal decision about her coverage.

This is not a functional healthcare system.

A for-profit healthcare system will never be a functional healthcare system. Not for people who truly depend on it to access healthcare.

[H/T to Shaker Kathy_A.]