Are birth control pills free with ObamaCare?
The Obamacare rule on contraception is that plans must cover each of the FDA categories by at least one drug or one service. The plans do not have to cover everything related to contraception. Comparison shopping provides an excellent tool for determining the best value in health insurance coverage. Start comparing health insurance rates and providers now by using our FREE tool above!
The Birth Control Mandate
The Birth Control Mandate require qualified health plans to provide at least one covered type of birth control. Subscribers must examine plan provider’s information materials to determine which contraception methods they cover and whether those are acceptable types.
All qualified health plans must cover FDA-approved contraception methods prescribed by an authorized health care provider.
The plan must cover these medical and preventive health services with no co-payment or out of pocket costs without regard to meeting the deductible thresholds. Exceptions exist for Grandfathered plans and those of religious objector organizations and companies.
One Type of Birth Control per Person
The FDA has 18 categories of approved birth control methods. Obamacare plans cover at least one drug or service in each of the 18 for each insured woman. This coverage must have no out of pocket costs. This requirement is part of the essential birth control benefit. The covered contraception methods prescribed by a plan holder’s doctor include patient contraception education and reproductive counseling.
Essential Health Benefits
Birth control is part of the essential health benefits under the Affordable Care Act. Covered persons can get free birth control under qualified health plans. Some plans have exemptions and subscribers should search the plan before selecting to determine if the benefits they seek have no-cost coverage.
FDA Approved Contraception
The below-listed types of medicines and devices are FDA approved methods.
- Internal barriers – these include technology like diaphragms and sponges
- Hormonal methods- such as birth control pills and vaginal rings
- Implanted devices-including intrauterine blocking devices
- Emergency contraception like Plan B® and ella®, useful when an events have occurred without prevention.
- Sterilization procedures – a rare but effective method.
Controversy and Confusion
HHS issued a guidance and clarification on coverage and the 18 types of birth control approved by FDA and potentially available through the Birth Control Mandate. The guidance clearly stated that insurers must cover at least one form of contraception in each of the 18 categories approved by the FDA. The clarification proceeded after findings that insurers were not offering all categories, and some offered none at all. At issue were medical management approaches by insurers aimed at controlling costs, which is also an Obamacare objective. Insurers retained leeway to provide coverage and use lower cost drugs, devices and medical procedures.
Women had to pay for their contraception when employed by a religious entity like a church, or a company whose owners decide to object to contraception on religious grounds. While it may seem to impose a burden on the insured women, the law nonetheless upholds the religious objections to birth control over the economic interests of women as employees.
This rule gives the business owners and employers the right to determine that the woman must pay although the national policy is the exact opposite.
The same result occurs in Grandfathered employer plans that do not provide contraception without charges, co-pays or coinsurance. The Obama administration made a set of rules with third party payment provisions to cover women who work for employers who raise religious objections to paying for birth control services for employees.
Non-profit Religious Organization
The Regulations set up an alternative procedure for health plans provided by non-profit religious organizations. They may object to contraception, and the insurer provides payment for a woman’s contraceptive services. The net result is insured contraceptive services without copay or co-insurance from the covered woman employee or dependent. This is a fair result for the woman employee group whose religious beliefs are not involved. As a matter of the employer-employee relationship, the exempt organization or employer correctly strikes a rational balance. The employer leaves the decision as it does not favor to those who are involved as medical advice.
Free Basic Contraception Under the ACA
The Affordable Care Act requires insurers to provide contraception services without additional charges, co-pay or coinsurance. This coverage does not extend to every birth control medicine or services. A provider can still charge for brand-name drugs when a generic is available and for higher priced services when it could use a lower cost alternative. The legal obligation is to provide at least one service or medicine in each of the 18 categories of birth control approved by the FDA. Comparison shopping is a key to getting the type of birth control one wishes to have. Comparison shopping can focus on the elements of plan coverage that matter most to the subscriber. Start comparing health insurance rates now by entering your zip code in our FREE tool below!