Kaiser Health News readers still write in regularly describing battles they’re waging to get the birth control coverage they’re entitled to.That's not supposed to be how it works under the new law. There are some exemptions from the coverage—plans that are still grandfathered under the law, and those for religious employers or houses of worship and the new, SCOTUS-approved Hobby Lobby case. But insurers have to provide for all the different methods of birth control. They can require a substitution of a generic birth control pill for a brand-name one, but they can't tell a patient prescribed one method of hormonal birth control that she will either have to pay for it or use a different method. The government has made that clear to insurers in the rules it has provided, but some insurers are still trying to skirt the law.
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.
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."They likely think they can get away with it because fighting back is a hassle. Women who encounter this refusal by their insurance company have to appeal the decision with the insurer, and they also have to get their state insurance department involved. The companies are likely betting that their customers are confused enough about the new law to not know that they're getting screwed or that they just won't have the time or energy to press their case.
Now that insurance companies can't get their profits by refusing to cover treatments and procedures for the really expensive conditions, it looks like some of them have decided to profit by nickel-and-diming their female customers on the medicine they have to use every day. Because that's what they do. It's one more reason that health care reform isn't finished. As long as insurers think they can save money by getting around providing some treatment, they'll do it.