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Thank you! But they do have to account for one version of each birth control method, and cannot favor one method over others. If your employer is religious — such as a church — it is not required to provide contraceptive coverage. If you work at a religiously affiliated institution, such as a university or hospital, your employer may not be required to buy contraceptive coverage, but the insurance company still has to pay for it.
This is the so-called religious accommodation. 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. Insurance companies should certainly not shoulder all of the blame for low utilization rates and the headaches of consumers. In fact, a just-released informational bulletin from the Centers for Medicare and Medicaid Services CMS outlines some of the other existing barriers, including reimbursement and administrative challenges.
CMS also describes strategies that states may use to reduce these barriers. This highly informational brief is available here. The brief also includes details on innovative strategies that three states have successfully implemented to increase rates. In spite of these complexities, progress has been made by insurance companies in recent months to expand IUD and implant coverage. In fact, since we started monitoring the formularies and covered benefits in , several plans have made updates.
And the accomplishments of the ACA in assuring women have access to multiple contraceptive options cannot be overstated. While our analysis of this issue is far from scientific, it illustrates the challenges women face in learning about covered options, and obtaining the contraceptive option of their choice. We will continue to monitor formularies and medical benefits to assess coverage of the products under different plans.
As IUDs and the implant are the most effective options available, and increasing access could lead to significant strides in public health, plans should actively advertise their coverage of this important benefit, and take the guess-work out for women. You are responsible for cost of any device and medication. See costs below. If you plan to use insurance, you must call your health insurance company, or your prescription plan, using the number on your card, to ask:.
If you want to get an IUD or implant at UHS, you will be asked to sign a waiver stating that you understand you may be asked to personally pay any fees not covered by your insurance. If you cannot or will not sign that waiver, you cannot have an IUD or implant inserted and will need to consider other contraceptive options.
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