Results tagged “Insurance” from Blog for Choice
House Republicans have rightly been taking a lot of heat in polls and the media lately for the government shutdown.
What you might not have heard is that these same anti-choice leaders tried to use the budget negotiations to give bosses authority to deny their female employees birth control coverage. Even when we were like 48 hours away from defaulting on our nation's debt and on the brink of a financial collapse, House Republicans had birth control on their brains.
Read more about these ridiculous antics on NARAL Pro-Choice America's Buzzfeed Community page.
Just over one year ago, Obamacare made contraceptive services available to women at no out-of-pocket cost, thanks in large part to your hard work. Under the new health-care law, prescription birth control, mammograms, STI counseling and treatment, and other services are now available without a co-pay. This is huge. Because over half of women 18-34 have struggled to afford prescription birth control, ensuring access to affordable birth control marks the greatest advancement for women's health in a generation. And already it's helped more than 27 million women. But even as we celebrate the benefit's first anniversary, many women are still footing the bill for their birth control. And they want to know why.If this has happened to you, you're not alone. Since the birth-control policy first went into effect on August 1, 2012, women's health advocates have heard similar stories--those of women facing co-pays at the pharmacy counter and insurance companies falling short of delivering on the law's full promise.
Here's what we know and what you can do if this is happening to you:
First, remember that Obamacare requires that all "new" health plans must comply with the contraceptive coverage requirement. "New" means plans that were created or purchased after Obamacare was enacted. Old plans--called "grandfathered" plans--don't have to comply. But keep in mind that "grandfathered" plans won't be grandfathered forever--if they change their plans in a substantial way, they lose that status. In fact, we expect 90% of grandfathered plans to lose their status in the next year or so, at which point they will be required to comply and provide birth control without a co-pay. So if your plan is grandfathered, that might be the reason you're still being charged a co-pay. Ask your benefits administrator if your health plan is grandfathered.
But if you're being charged a co-pay, it could also be because your insurance company believes that Obamacare allows it to pick and choose the contraceptives they cover cost-free. They have some wiggle room, to be sure. But even so, the birth-control policy is stronger than some companies think it is. Here's the skinny.
Some insurance companies are interpreting a section of the law
that lets them control costs to also allow them to charge a co-pay for some
forms of birth control but not others. This is why some women are being told
that they can't get the Nuva Ring without co-pay, or that only generics are
covered without a co-pay. Our allies raised concerns about this, and here's
what the government said in reply:
- Your insurance company can charge you a co-pay for a name-brand contraceptive, but only if there's also a generic version available. If there isn't a generic version, they have to cover the name-brand drug without a co-pay.
- And if your doctor determines that the name-brand drug is "medically appropriate" for you, then your insurance company must provide a waiver process that will let you get your name-brand birth control without a co-pay (see question 14 of the FAQs: http://www.dol.gov/ebsa/faqs/faq-aca12.html). (Keep in mind, this is different than the typical appeal consumers file when they're denied coverage for a service.)
If you're one of the women experiencing problems here, head over
to the National Women's Law Center (NWLC) website--they've built a toolkit to help you fight
for the coverage Obamacare says you should have. Its got answers to the
questions women are asking, a fantastic script to use when you call your
insurance company for answers, and sample letters to send your insurance
company if they charge a co-pay for your specific type of birth control.
The bottom line is, don't give up! It may take some work, but we fought too hard for birth-control coverage to give up easily! Not only that, but the work you do to educate your insurance company could make all the difference in the world for other women in your plan who may be missing out on the birth-control benefit.
It's National Women's Health Week, and here at Blog for Choice, we're sharing stories about how Obamacare helps women--and men--get quality, affordable health care.
The Affordable Care Act, a.k.a. Obamacare, prohibits insurance companies from discriminating against people with pre-existing conditions. That's great news for Ted in Wisconsin and his kids:
After losing our employer-sponsored health insurance, our family of five was uninsured for months. We had so many pre-existing conditions, such as our kids' asthma, every private insurance company denied our application for coverage. I'm happy that insurance companies can no longer deny coverage my asthmatic children. It's terrifying to witness your children struggling to breathe, knowing there's no way to afford the preventative medication they desperately need. To overturn the health-care law would return our family to the days of this terrifying desperation. To deny even children the basic right of accessible and affordable health care would be a moral outrage.
Thanks to Obamacare, Ted and his children can breathe a little easier. Literally.
This week is National Women's Health Week, an opportunity to recognize the need for women to have control over their own health care and family-planning decisions.
And now, thanks to the Affordable Care Act, a.k.a Obamacare, we have a lot to celebrate when it comes to women's health.
Just how does Obamacare benefit women? Each day this week, we'll share a story here at Blog for Choice about how the law helps real women get quality, affordable health care.
Today, we're focusing on the no-cost birth control policy, which will give women near-universal contraceptive coverage. Let's hear from Amanda in Ohio:
At the age of 23 I was a working professional, but still unable to afford the cost of insurance. (At that time, young people stopped being covered by their parents' insurance soon after their college graduation.) Although I was working full-time as an intern to further my career, my employer did not cover my insurance, nor could I afford to pay it. Hence, I was not on birth control for two years before I decided to return to grad school. The institution I attended mandated that students without health care purchase insurance through the school, which I did. However, the full cost of birth control was not covered and I could not afford the monthly co-pay. At this point, I had been off birth control for at least three years.
During the spring of my first year of grad school, I experienced a ruptured ovarian cyst. The pain associated with this was excruciating, beyond anything I have experienced before in my life. It actually felt like an organ had burst inside of me. I could barely walk, or even think, I was in so much pain. A friend rushed me to the emergency room, where I underwent eight hours of testing (x-rays, ultrasounds, etc.) before they could figure out what had happened since the amount of fluid and tissue from the ruptured cyst was so great. After the painful ordeal and recovery, I had to visit an ob-gyn where I learned that being on birth control actually prevented the formation of cysts. I subsequently went on birth control, though it meant I had to borrow money to pay for the copay.
Although I followed protocol and contacted my insurance prior to going to the emergency room, they still would not pay because I did not go to the university health center, which is not equipped for emergency situations. If it took a hospital eight hours to diagnose and treat me, I wonder how a health center without emergency treatment capabilities would have fared?
The insurance company still refuses to cover the service and the $5,000 has been in dispute for years, while negatively impacting my credit and ability to apply for loans.
Basically, because I could not afford insurance or birth control copay as a young woman in my early and mid twenties, (that would have prevented cysts from developing), I now face thousands of dollars of debt, bad credit, and a diminished quality of life as a result.
The new policy will prevent this situation from happening to other young women who dream of having both a professional career and a healthy body. I don't think that is too much to ask...
Fortunately for women like Amanda, Obamacare means that insurance plans will cover the medicine they need without a copay.
Unfortunately, anti-choice politicians like Mitt Romney are fighting tooth and nail to make it harder for women like Amanda to get the health care they need. They're pushing for the Supreme Court to overturn the health-care law, and if that doesn't work, they'll try to repeal it in Congress.
That would have devastating consequences for women like Amanda.
Check back here at Blog for Choice every day this week to read more personal stories!
signed into a law a measure banning insurance coverage of abortion care from the state's new health-insurance exchange.
Kasich's action means that states have thus far enacted a whopping 68 anti-choice measures in 2011.
Kellie Copeland, executive director of NARAL Pro-Choice Ohio, said that anti-choice politicians in Columbus were clearly out of touch with Ohioans' values and priorities:
Politicians should never be allowed to limit the kinds of insurance benefits that women are allowed to purchase with their own money. All women deserve the same peace of mind that they can obtain the health care they need, regardless of where their insurance comes from. It is appalling that Governor Kasich signed this bill, which clearly violates the Ohio Constitution, into law. Surely there are better ways to spend taxpayer dollars than defending unconstitutional legislation in court.
But I guess Gov. Kasich and his anti-choice allies are what you'd call "constitutional conservatives": conserve the parts of the Constitution you like, ignore the parts you don't.
The health-reform law signed by President Obama in 2010 marks one of the biggest improvements in women's health in a generation.
At the same time, anti-choice Sen. Ben Nelson (D-Neb.) was able to insert into the legislation restrictions on abortion coverage that are discriminatory and unfair.
The Department of Health and Human Services (HHS) is currently considering how to implement a provision in the health-care law that imposes financial and administrative burdens on plans that offer, and for consumers who purchase, abortion coverage in the state health-care exchanges.
In fact, there is a real risk that abortion coverage could become so complicated in state exchanges that women could lose their access to it.
Imposing any additional administrative burdens on abortion coverage would be a major setback for women's health. That's why 34,826 Americans submitted comments urging HHS to protect women's access to abortion coverage in the new insurance exchanges.
Nancy Keenan, president of NARAL Pro-Choice America, said that the Nelson restrictions could impose serious constraints on abortion coverage:
This provision may jeopardize private insurance coverage of abortion, coverage that most private insurers currently offer. These measures violate a principle on which we've been consistent and clear since the health-reform process started: women should not lose ground in the new health-care system.
No, they should not.
Thank you to the 34,826 Americans who spoke out. Together, we'll make sure that women in need of abortion care across America can continue to access these services and have them covered by their insurance plans.
When you hear the words "pro-choice," you probably think about protecting a woman's right to choose safe, legal abortion, and improving access to birth control.
But being pro-choice also means protecting a woman's right to choose to become pregnant. Sometimes this isn't as easy as it might seem. Here's one woman's story that illustrates why:
She was a working mom in West Seattle, Washington, and was using an intrauterine device (IUD) as a method of birth control. Her insurance company, Regence BlueShield, had covered the implantation of the IUD.
But when she wanted her IUD removed so that she could get pregnant again, Regence refused to cover the procedure. According to the insurance company, removing the IUD wasn't "medically necessary." But it most certainly was necessary for conceiving a second child.
Fortunately, this was one woman who wouldn't take the insurance company's "no" for an answer. She filed a complaint with the state insurance commissioner --and won.
Regence had to reimburse the woman--with interest--the cost of having her IUD removed. Not only that, but the insurance commissioner found nearly one thousand other women whose similar claims had also been illegally denied. Regence had to reimburse them too, and pay an additional $100,000 in fines.
This was possible because Washington state has a contraceptive-equity law, meaning that insurance companies must cover prescription contraception to the same extent as other medications. In Washington and 27 other states, covering birth control is required.
Unfortunately, there are 22 states where denying such coverage is still perfectly legal.
That's one reason why the health-reform law signed by President Obama is so important. Beginning next year, all newly-issued insurance plans throughout the country will cover the full range of FDA-approved contraception without an additional copay. (Got questions? We've got answers.)
This means that women from Alaska to Alabama will have the same right that women in Washington now have. They'll be able to choose the birth-control method that's right for them--and choose to plan a pregnancy when they want to.
As for that woman in West Seattle: not only did she win her fight with the insurance company, she's now also the mother of a six-month-old baby girl.
We're just concerned that policy, however well-intentioned or virtuous, not ever mask a net tax increase.