Health Insurance Coverage for Birth Control

Archived Q&A and Reviews

My insurance doesn't cover an IUD - does yours?

June 2007

Hi! I just gave birth to my first, and I am wondering if anyone has any experience with a private insurance plan that covers IUDs. I just learned from my current provider, Blue Shield PPO, that they will not cover any ''implant contraceptives''. Any tips would be most appreciated, as my husband and I are now shopping for new health plans. Thank you! Jamie

I don't know the answer to your question, but I can tell you that Cigna POS does NOT cover it. When I got my IUD last year, I explained to my doctor's office that the insurance wouldn't cover it, and they knocked off the $150 ''insertion fee'' so I only had to pay the actual cost of the mirena IUD (plus markup I'm sure)- about $400. It was definitely worth the cost in my opinion, especially considering that it lasts for five years. anon
United Health covered my IUD, but that was 3-1/2 years ago.
Mine was covered by my Blue Shield HMO. My doctor's office made me pay and then get reimbursed because they were somewhat disbelieving of an HMO covering an IUD. Apparently they found it quite unusual. It all worked out great though. Good Luck!

HMO & one-month-at-a-time refills for The Pill

April 2004

I've just gone back on the pill after about 4 years & am annoyed to find that even though the dr will give me a 6 month prescription, both my previous & current HMO will only pay for one month at a time. If I sign up for a mail-order service, they will give me a 3 month supply, but that's all. Is this standard, is there a good reason for them to do this or is it purely to make money for themselves & most importantly, has anyone got around their HMO on this? (My husband's employer doesn't have a person who handles HMO grievances, unfortunately.) Thanks. Shocked

I've just been through this getting the pill for my daughter (her choice - personally I prefer the diaphragm). The cheapest way is to get a generic, rather than brand name, type of pill - which of course has the same ingredients, in both type of chemical and amount. Our doctor had prescribed a 35microgram oestrogen pill. I looked around and discovered one with 20 micrograms, called Allesse. The generic type for this is called Aviane. (I do hope I've remembered all the numerical details right - I think so). We called the doctor back and asked for a prescription of Aviane. This seems to suit my daughter well, and I feel slightly better knowing it's a lower oestrogen dose. And it's the cheapest way to get the pill, having the prescription sent by mail order every 3 months, for this 'generic' type. There's an informative website, that gives details of the various types of pill and amounts of oestrogen and progesterone in them, at: Hope that helps, Jan
I hear your frustration with your prescription benefit plan. Similiarly, I have a prescription (not BCP but about the same cost/month)--and the first and only time I tried to use my benefit plan I could only get a one month supply that basically wasn't covered because of the co-pay. After reeling from the absurdity of the explanations I was given by the benefits plan, I shopped around and ended up going to an on-line drugstore where I can by a 6 month supply for the same cost as the one month supply that wasn't covered by insurance. My doctor calls the prescription in and it is shipped to me in about 5 days. As annoying as it is to have to self-pay while paying for insurance also, it just makes much more sense to me...the system is *imperfect* (to put it mildly) but it's still in my power to make economically sound decisions. I would love to hear others solutions as well. anonymous
I work for a very large corporation with great benefits, and I have the same plan. One month supply retail, or 3 month supply mail order. I think it's very common. I have my doctor write a 3 month prescription with 3 refills, so that one prescription actually lasts one year. When I have about a one month supply left, I just put the order in for a 3 month supply refill, and it comes before I run out. Anon
I had the same experience. I think HMO's do it because they have no way of knowing if you'd be covered next month -for example, you may change jobs and get a different carrier, as opposed to the UC Berkeley insurance, that covers you for the semester. EP
This is pretty standard for HMO, PPO, or whatever insurance you have. I haven't seen them giving a 6 month supply in years. I've never heard of trying to get around this. It's not like you're going to get a lower copay, or at least I haven't heard of that. I'm not sure why this changed, but I'm sure they could explain if you asked. Shocked a long time ago
Our current insurance (a PPO with very good prescription ceoveage)only allows a one-month supply of birth control pills, and so did the large HMO we had prior to that. Interestingly, they did allow a 3 month supply of the mini-pill, which I took for a while while nursing (before it completely wiped out my sex drive). Unfortunately I think it is very common now for insurances to only allow you to pick up one month of pills at a time, which is inconvenient. It's probably their way of collecting a copay for each month's supply. You could try to fight it, but I suspect you won't get far. Gayle