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The Cafe - 'TC' So? Your daughter wants her belly pierced? Your cat keeps using the couch as a litter box? Your husband taped the Hockey game over your wedding video? Your neighbor has a gnome collection and it makes you mad? Pour yourself a cup of coffee and come on in to The Café! Talk amongst yourselves...discuss, question, reply, or respond to many subjects!

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Old 10-24-2007, 11:17 AM
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Red face Does your Health Insurance cover Birth Control??

I am wondering if anyone has health insurance that covers birth control?? I recently went in for my annual with my doc and told him that I have been having a minimum of 2 full periods every single month and they are so painful!!! So he gave me a prescription for Loestrin 24 FE so I looked up to see how much it costs and it's very expensive so I can't afford to foot out over $60 a month for this stuff.

So what do you do if you can't afford birth control like this?? Thanx in advance for any suggestions!!!
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Old 10-24-2007, 11:27 AM
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Mine pays for it. Well, not entirely. It is still $19 per month.
Is there a generic you could take?
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Old 10-24-2007, 11:28 AM
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I had a copay with our insurance for BC Pills. Normally it was $25/month.

DH got a Vasectomy 5 years ago, and they covered all but $10 of it. So now I don't need to worry about anything!
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Old 10-24-2007, 11:41 AM
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Yes, ours pays with a $10 co-pay
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Old 10-24-2007, 11:47 AM
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I'm not certain, and assume that there are many different answers based on different policies, but is it possible yours might be covered because your need for them stems from a medical issue, rather than a pregnancy prevention issue?

I have a friend who takes them not as BC, but because of severe skin problems. In her case, you could they are a medicine, rather than a prophylactic.
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Old 10-24-2007, 11:51 AM
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Originally Posted by wowitsdark View Post
I'm not certain, and assume that there are many different answers based on different policies, but is it possible yours might be covered because your need for them stems from a medical issue, rather than a pregnancy prevention issue?

I have a friend who takes them not as BC, but because of severe skin problems. In her case, you could they are a medicine, rather than a prophylactic.
I was wondering about that too....My Best Friend has a prescription for BC for problems with her period and they cover 90% of the cost each month. If she had the script for actual BC they would only cover 20%
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Old 10-24-2007, 11:55 AM
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I am pretty sure that I read that Walmart added some birth control pills for $9 a month to their program.
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Old 10-24-2007, 12:04 PM
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Was also thinking that maybe if your insurance won't cover it, that maybe you could talk to your doctor about the concern over the cost, and he might be able to prescirbe something that you can get a generic for to help ease the burdern......
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Old 10-24-2007, 02:43 PM
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Originally Posted by study View Post
I am wondering if anyone has health insurance that covers birth control?? I recently went in for my annual with my doc and told him that I have been having a minimum of 2 full periods every single month and they are so painful!!! So he gave me a prescription for Loestrin 24 FE so I looked up to see how much it costs and it's very expensive so I can't afford to foot out over $60 a month for this stuff.

So what do you do if you can't afford birth control like this?? Thanx in advance for any suggestions!!!
I believe our insurance covers most RX's under our three tier plan. ($10 for generics, $20 for name brand and $40 for non-formulary). To be honest, I'd be really upset if they didn't cover them since WE pay over $125 each check for our health insurance. I know that they cover the insertion of IUD's since I did check about that last year.

We haven't needed any birth control for most of our married life, though (infertility issues).

I would check with your insurance and see if they won't cover it more for you since you are needing it for other reasons instead of BC. They might, it's worth a try. Good luck!
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Old 10-24-2007, 03:57 PM
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Have your Doctor talk to your insurance company. Since they're for medical reasons and not birth control your insurance should cover them like any other drug. Might have to fight them a little to get it covered but they should cover them.


My insurance covers them, I have a $10 co-pay, if I do mail order then it's $20 for a three month supply. I don't get why all insurance companies don't cover them. Isn't it cheaper to pay out a couple hundred a year for pills then to pay thousands for a baby.
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Old 10-24-2007, 04:34 PM
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Wow those of you who are able to get them covered by insurance are very lucky!!! I do have a call into my doctor's office to see if there's any kind of generic or some other type that is cheaper and if they don't then I am going with the other suggestion -that since I am not taking them for preventing pregnancy but rather for a medical issue - I would hope that our insurance would cover it!! Guess at this point I will have to wait and see what my doc's office says. Thanks so much to all who have responded - you guys always seem to have such great advice and answers!!!!
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Old 10-24-2007, 04:41 PM
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My assumption is that they don't pay for them if they don't fix anything that is medically or physically wrong. There are probably a lot of things one can take to prevent natural consequences of any number of things people engage in as part of a normal course of living their lives that aren't covered by medical insurance.

I don't believe insurance companies should be required to pay for anything specifically. They can offer policies to cover whatever they want, and then it's up to the consumer (be it an individual or an employee) to decide which policy covers the things they want/need.

It seems odd that there are probably many insurance companies that will pay for tubal ligations/vasectomies won't also cover BC. Wonder why that is. I'm sure in the end, it's a financial decision. A BC script is no guarantee against pregnancy, given the number of people who say, "I got pregnant while I was on the pill!" or who had a script but missed enough doses to render them ineffective, etc. My guess is that the pills are only as effective as the patient is reliable, and that the stats don't bear out that prescribing them would really save ldr costs in the long run.
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Old 10-24-2007, 05:26 PM
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My insurance covers them. My copay is 10.00 a month so that's not bad at all.
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Old 10-24-2007, 06:20 PM
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My insurance covers them with co-pay for any reason.
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Old 10-24-2007, 07:07 PM
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My insurance covers all prescriptions (that I have tried) 100% including BC pills.

Rebecca
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Old 10-24-2007, 07:57 PM
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I only pay $10...and that's a good thing. Fifty and pregnant would not be funny!
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Old 10-24-2007, 08:40 PM
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No mine does not, and I also was under the impression that most pland didn't either. I get the depo shot and it's costing me $90 every 3 mos. I am actually going for one tomorrow, and I my drs office recommended that I get it as a prescription and then bring it to them for them to give..I am not sure how this will work, or what the cost is going to be. I am hoping better than $90.
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Old 10-24-2007, 09:43 PM
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Our unsurance covers the RX, I have a $12 copay, but they DON'T cover the Dr.'s appointment I need to get the pills. Doesn't make much sense to me.



Back when I didn't have insurance, I got my pills from Planned Parenthood, they were cheaper. I don't know how you feel about them, but it could be worth a call?
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Old 10-25-2007, 02:55 AM
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A bit OT, but . . . . Loestrin 24 has 24 active pills (and iron in the placebo pills), while normal pills have 21 active pills. Sounds very clever, but I did NOT find that it made much of a difference. A cheaper generic might be worth a try too.
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Old 10-25-2007, 09:19 AM
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Originally Posted by flipper113 View Post
Our unsurance covers the RX, I have a $12 copay, but they DON'T cover the Dr.'s appointment I need to get the pills. Doesn't make much sense to me.
You're right that doesn't make sense at all! Its been a long time since I've been on them (dh had a vasectomy, best decision we made ) but I would always get my prescription during my well woman exam (ie. physical and pap)
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Old 10-25-2007, 09:24 AM
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A bit OT, but . . . . Loestrin 24 has 24 active pills (and iron in the placebo pills), while normal pills have 21 active pills. Sounds very clever, but I did NOT find that it made much of a difference. A cheaper generic might be worth a try too.
My doctor wrote me a script for the ones without iron and they weren't covered by my insurance. I had him change it to the one with iron, so now it's covered. I toss the last 7 iron pills.
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Old 10-25-2007, 09:31 AM
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Originally Posted by flipper113 View Post
Our unsurance covers the RX, I have a $12 copay, but they DON'T cover the Dr.'s appointment I need to get the pills. Doesn't make much sense to me.



Back when I didn't have insurance, I got my pills from Planned Parenthood, they were cheaper. I don't know how you feel about them, but it could be worth a call?

I too used to be a patient at Planned Parenthood when I didn't have any insurance and actually decided to give them a call yesterday to see if they even offer that brand and type and unfortunately they don't. But thought it was a shot!!!
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Old 10-25-2007, 09:33 AM
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Originally Posted by foryoubabyblue View Post
A bit OT, but . . . . Loestrin 24 has 24 active pills (and iron in the placebo pills), while normal pills have 21 active pills. Sounds very clever, but I did NOT find that it made much of a difference. A cheaper generic might be worth a try too.

Well I did call a local pharmacy and they said that as of now there is no generic for this brand!!! Really stinks!!!
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Old 10-25-2007, 09:50 AM
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Smile Woo Hoo - Finally got some great news!!!!!

I just got off the phone with my insurance agent and she said that all they need is a letter from my doctor stating the reason I was prescribed this medication and since it is a medical issue - the insurance will cover it along with my paying a $30 copay. So I can work with $30!!!! Now I am off to call the doc's office and have them fax a letter to the insurance company so I can get what I need!!!

Thanks to all you guys for all your help and suggestions!!!!!

Hope all of you have a Terrific Thursday!!!!
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Old 10-25-2007, 09:53 AM
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That's great news! Make sure you copied down their name
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Old 10-25-2007, 09:57 AM
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That's great news! Make sure you copied down their name

You bet I did - I learned early on - when making phone calls always make a note of the person's name and extension number that you spoke with so that way you have something to reference and boy has it ever helped in times I needed it before!!!!!
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Old 10-25-2007, 01:12 PM
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Originally Posted by study View Post
I just got off the phone with my insurance agent and she said that all they need is a letter from my doctor stating the reason I was prescribed this medication and since it is a medical issue - the insurance will cover it along with my paying a $30 copay. So I can work with $30!!!! Now I am off to call the doc's office and have them fax a letter to the insurance company so I can get what I need!!!

Thanks to all you guys for all your help and suggestions!!!!!

Hope all of you have a Terrific Thursday!!!!
I'm glad your ins co is gonna cover these for you!
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Old 10-26-2007, 09:11 AM
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I'm glad your ins co is gonna cover these for you!
Thanx so much Amy!!! That was very sweet of you!!! Hope you have a Fantastic Friday!!!
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