Thursday, February 21, 2013

Your Birth Control Should Be Free

Do you get prescription birth control - the pill, the patch, or the vaginal ring?
If so, make sure that you are not charged a copay when you pick it up at the pharmacy. Many people are still being charged erroneously - I was, until I complained to my insurance company.

Under the Affordable Care Act, women no longer have to pay a copay for prescription birth control. (I wish it didn't require a prescription, but that's a whole different rant). This change officially took place on January 1, 2013.

When I picked up my birth control last month, I realized I was still being charged a copay, and I wasn't sure when I was supposed to stop. I asked the pharmacist, and he told me that about 80% of women at his pharmacy are no longer paying a copay, and I shouldn't be either. (My pharmacist rocks.) He advised me to contact my insurance company to find out what was going on.

That day, I called the company. The representative had no idea what I was talking about. When I explained that under the ACA, I should not be paying a copay, he scanned through my information on his computer screen, and said "I don't see anything about that in your account."

"It's not in my account," I said, "it's the Affordable Care Act. It's a law."

He was totally clueless. He kept scanning through my account. I asked to speak to a supervisor and, not surprisingly, he stalled me, and kept insisting that "my account" shows nothing about eliminating the copay. "Look, I'm a doctor, I know what I'm talking about," I told him. HELLO.  It didn't help. He played dumb.

Frustrated, I gave up. I thought about complaining - maybe to the Better Business Bureau, or maybe the ACA has a provision for insurance companies playing dirty tricks? But first I tried one more time. I called again later that day, and spoke to a woman, who knew exactly what I was talking about. She agreed that I should not be paying a copay, and that, in fact, I should be reimbursed for the 2 copays I had already paid since January 1. She was very helpful, and very apologetic. She said she would register a complaint and it should be fixed within 3 business days. She took my phone number - my cell number, which I never give out - and my email, and assured me someone would contact me.

Two days later, I got 2 telemarketing calls to my private, unregistered cell phone, and several spam emails to my email account that rarely gets spam. Thanks, insurance company. I sent them an angry email, and got an autoreply informing me how I can look up their privacy policies. pbbbtth.

An entire month went by, and it was time to pick up the next prescription before I realized I had never heard back about the copay. I called again, and the person said that my account now shows that I do not need to pay copays (yay), but said nothing about being reimbursed. He submitted another ticket, told me I would hear back within 3 business days, and asked for my phone number. I told him Hell No You People Sold My Number Last Time. He claimed that they don't do that, and I called bullshit. I said I would call them back, even though it means going through that awful robot lady who can't understand anything I say and yet insists on requiring voice commands instead of numerical options until I end up yelling "I WANT TO SPEAK TO A %&#@$ HUMAN BEING" and then I finally get transferred to an agent.

In summary, if you pick up your birth control at a pharmacy, you should NOT be paying a copay.
If you are paying a copay, call your insurance company immediately, and demand that they fix it, and that they reimburse you for ones you have already paid.
If they try to give you a line about your plan being "grandfathered in," do the research yourself and verify whether or not this is true - it may be a stalling tactic.

Here's the government website where you can read about the ACA.
Here's information on how the ACA improves access to preventive care services for women, and makes many of them free.
Here's the information about grandfathered health plans.
Here's the consumer assistance program.

3 comments:

Anonymous said...

Yeast Infection No More


Miranda said...

I'm DESPERATE for answers. I just started my first month of BC and paid 25 dollars at the pharmacy. I called my insurance and the guy told me they should all be free of a copay and to call this pharmacy number. She laughed at me and said 'free birth control? ha!' and I asked well if the one I'm prescribed still has a copay, do you have a list of the ones that are covered? and she said they all have a copay. Then I called the pharmacy I filled my prescription, he also laughed at me saying 'if it was up to us no one would be getting their BC free here' Rude!! I don't know who to speak to to get this taken care of!!

Anonymous said...

i am in the same process of doing this as well, i was pay $50!! if this is true, they might owe me for more than a year...