Every now and then I’ll hear someone grumble about how their insurance doesn’t cover birth control pills, but do cover Viagra, and how unfair is that? However, casual searches I’ve done indicated the opposite- insurance companies are more likely to cover birth control pills than Viagra. I would assume there are obvious reasons for this- preventing pregnancy is cost-effective for the insurance company, and on top of that birth control pills have been around much longer. I’m sure the prevalence of generics helps keep costs down.
FTR, my own insurance covers BCPs but NOT Viagra. In fact, a bottle of 6 little blue pills costs the equivalent of a year’s supply of (covered under prescription plan) birth control pills.
We went through this and a bunch of related issues in this recent Pit thread, but you’ll have to read it all to disentangle the information from the mere venting. (I could have read it all myself and disentangled them for you, but I was too lazy, sorry.)
From the little bit of research I’ve done in this area, some companies do cover Viagra if there is an underlying medical need for it. Even then, though, most companies that I’ve looked at will only cover a small fraction of its cost. The coverage of birth control pills also varies, but in general it seems that most insurance companies cover it to some extent and some pay quite a bit of the cost. From what I can tell, anyone who complains about insurance companies favoring Viagra over birth control pills is full of crap.
Maybe what they mean is that their insurance company covers Viagra but not BCP for that individual. I imagine it would be an uphill struggle to convince your claims adjustor that they should pay both for your little blue pills and for your little multi-colored pills. I suppose working under the logic that if both of you are taking as many pills as possible, there’s no possible way a baby is going to make it out of there alive.
How much money are we talking about here? Being male, I wouldn’t know what birth control pills cost now. But 37 years ago I remember buying them for the wife and they were quite reasonable. Three bucks a month, I think.
From my personal experience in pharmacy, I have seen only a small fraction of companies cover Viagra/Cialis/Levitra, and only for a limited quantity. Typically 6 per 30 days, and at the highest copay available. I have only once seen a company reject birth control, normally it’s a situation where a particular expensive brand is not on their formulary and the company would prefer they switch to a cheaper type.
I’ve never seen any company outright reject birth control pills.
4. Talks about a specific insurance company that covers Viagra but not birth control.
Many of the articles you will find while googling are dated (from about 2002), but the discrepancy was there in the recent past. Now, it seems that at least half the states have passed laws mandating the coverage of birth control, in part because Viagra was covered. While it seems less true today, there are still many women who have to pay for their own birth control.
As a matter of fact I just got birth control pills for my wife yesterday. Almost completely covered by our insurance. (It cost about $2.50 for a month’s supply.)
brick, thanks for the articles. They seem long on anecdotal evidence and short on facts, though. The only one that tried to quantify the issue was from 1998 and had no footnotes, so I was unable to check to see if the statistics were true.
I’m not saying that some insurance companies exclude birth control pills and pay for Viagra. What I am saying is that when I have checked into it (and I have not made a full-scale study of it), the insurance companies I have looked at only cover Viagra needed for medical reasons (and these companies only paid a fraction of the cost) and they covered birth control to some extent (some subsidized it much more heavily than others). From what I can tell (and your articles do nothing to dissuade me of my belief), the notion that there is widespread coverage of Viagra along with widespread non-coverage of birth control is false.
Of course, that also gets us into the debate about what the proper role of health insurance should be. Insurance, no matter what kind, should really only cover high cost, low probability instances (like car insurance). It should not cover routine things. My opinion is that if you want birth control, you should pay for it yourself. If you want Viagra, you should pay for that, too. Neither of these should fall under the coverage of insurance. If they do, it’s not really “insurance,” it’s “making someone else subsidize your drug choices.” But that’s probably another debate. . .
Until someone with a more current stat comes along: 15 years ago they were around $25 a month, and my insurance covered only a little bit of it or not at all, I don’t remember. I just remember budgeting $25 a month for them out of pocket.
Another factor to keep in mind, it may not be the insurance company making the call. Large employers have a lot of discretion in what goes in the plan and what doesn’t.
I dunno, it can be a win-win for the insurance purchaser and the provider, since the insurance companies might not pay as much as the individual would for the drugs. Whether that’s the case here, I don’t know.
It’s a loss, of course, for the people who don’t need that coverage and are stuck with it as their only plan, but people who don’t want that coverage can choose another plan, sometimes.
Mine is $65 for 3 months worth and that’s with ok insurance. I don’t take a generic brand either though, so that may factor in to the cost.
At the university clinic, various forms of BC pills are available for $20 a month (my understanding is that the clinic is simultaneously covered in our tuition as well as by MediCal).
My same birth control seems to go for anywhere from $25-$35 a month on various online pharmacies. Then again, I’ve had friends that were told because of their age, insurance status, and combined household income (thanks, parents!), they needed to shell out almost $60 a month for 23 little pills.
My BC is $47/month if I pay for the whole thing, or $40 if I only have to pay the co-pay. So I suppose you could say that my insurance covers it.
For the hassle of using the insurance (mostly being limited to buying 1 month at a time) I’ve considered paying the other $7 and buying when/where I want.
Mine is about $35 a month, of which my insurance pays a little - I have a seperate pharmacy deductable and a low allowable amount, so it’s really pretty crappy. After I make the deductable it’s about $28.
I have never had insurance that covered BCPs, even when prescribed (as I take them) for hormone regulation rather than birth control. As of January they will be covered. My BCPs cost $20/cycle.
Fair enough, but the fact that dozens of state have enacted legislation to mandate insurance companies cover birth control proves the first part of the claim is/was true.
Ah, If you were only so reasonable in your first post.
No, they are not full of crap assuming they are/were complaining about a disparity that apparently existed to some extent. Here is another article from 2003 which states the following:
So there was a point, not too long ago, where it could reasonably be argued that insurance companies “favored” ED pills over BC. This up to date website states the following:
So the situation wrt employee insurance plans is much better now than at the time Viagra hit the market, but many women still fall through the cracks. While I am sure that the insurance companies that cover ED pills and not birth control are not the majority, it doesn’t mean they don’t exist, and it doesn’t mean someone who complains about them is full of crap. Especially since those same people were pushed for legislation mandating coverage of BC, thus eliminating the disparity that did exist at one time. A lot has changed in the last decade, so it is important view the complaints that were made in context, and understand that the claim did once have merit.
Looking at the cites, it seems you’re both right. Birth Control Pills, ie: Oral Contraceptives are covered under the majority of plans but other forms of birth control were poorly covered.