This is, likely, a stupid question, and I apologize. I’m a rather naive college freshman who feels, indeed, very stupid asking this.
Say, hypothetically, I see the nurse on campus for a medical issue. She writes me a prescription for something which is not at all important to my health, but will make me more comfortable. It’s not like antibiotics for an infection or insulin or anything: nothing will change in my health if I don’t take these. In other words, they’re non-vital, sort of extraneous.
Typically, is stuff like that covered under insurance plans, or would I have to pay out-of-pocket? I know some drugs can be staggeringly expensive.
Say insurance does cover it. I’m sort of covered under two seperate plans right now, because when I left for college my dad’s employment wasn’t certain, so my parents got the cheap-ass bare-bones insurance through the school. My parents are the ones who pay the insurance bills: I never see anything they send, it all goes straight to the folks at home.
Would there be anything my parents would see that would indicate that I even had a prescription filled? Would it say what it was? I know this all probably varies from company to company - I know the school insurance I’m under is Bollinger, and I have no idea who the ‘real’ one through my dad’s employer is.
Most insurance plans don’t cover the entire cost of prescription drugs. Either a co-payment or deductible or both will be applicable, and you will have to pay something.
The insurance company sends a statement to the payor of the insurance, disclosing what it paid to the provider directly, what the deductible is, and what the co-payment is.
I’ve had about six different insurers in the last 7 years or so (fickle employers). I don’t believe I have ever seen a listing of prescriptions on any of my insurance statements–only office visits and procedures like X-rays.
If it is birth control pills, they might be covered. Mine are under, and the co-pay is low because I can take a generic. If you buy them at full price, expect to pay upwards of $30 per month.
If you’re talking about birth control, head to your local Planned Parenthood. They will take care of you, within your budget. They’re really good that way.
BC pills are largely not covered under health insurance. Vasectomy is.
And I’ve never heard of the actual drug name appearing on a statement of benefits, or even any mention at all. All the SOB (heh) gives is a coded description of the procedure, for instance: “Birth Control Consultation”
well…you’d at least know who was ready for a commitment.
Planned Parenthood has strict confidentiality rules if that’s a concern. And while I’m not quite broke enough to get their deep-discount pills, their standard rate is still about ten dollars less than getting them through a pharmacy. I’ve been going to them for a couple of years now and have been quite happy.
I know it sounds like we’re all assuming you mean birth control, but I can’t think of anything else you’d be wondering about that wasn’t strictly medically necessary that you wouldn’t want your parents to know about (and it sounds like you wouldn’t want them to know). I bet your school health clinic has some sort of a program where you can get birth control without your parents’ knowledge, especially since insurance normally doesn’t cover this sort of thing.
My apologies to NinjaChick for starting the avalanche of birth control pill talk. I thought a better answer would arise if more specifics were known, and BC pills seemed a good guess. In retrospect I think NinjaChick should have been the one to offer the specifics.
It is birth control, yes. It’s not because I’m sexually active - I’m not, nor do I plan for that to change anytime soon. It’s to try to deal with severe PMS issues, which is why I didn’t think to check out anything like Planned Parenthood. The problem is that if my parents saw that on a bill or something, they’d automatically assume I’m sleeping around. Conversations that are anything but fun would ensue, and they also get sent my tuition bill, so…they generally win.
Lots of doctors prescribe birth control pills for reasons other than birth control. Regular cycles, reduced cramps, control acne, etc. When the pills are for a medical reason like this, they are covered for insurance like any other prescription would be to treat the same condition. Some acne responds to antibiotics, some to BCPs. The insurance coverage is based on the condition being treated, not the medicine being used.
You might want to see if your doctor/nurse would have a conference call with your mom “I’m treating Ninja Chick for serious cramps, want to use BCPs b/c they give good results. We wanted to make sure you were comfortable w/ that and understood what was up when you saw it on the insurance.”
Maybe not the world’s funnest conversation, but the nurse should be able to keep it medical for ya.
Regardless of the reason for the prescription, some insurance companies will cover birth control pills and some will not. (Many more, however, cover Viagra.)
If the ins. co. has a prescription pay provision, the claim for that is often submitted separately or through the pharmacy, who may handle the submission of the necessary documents. I’ve never seen the cost of the medicine itself listed on the doctor’s bill, but YMMV.
I’m thinking you might want to bite the bullet and let at least your mom know why you want the pills, like Harriet the Spry said. Your mom is 90% likely to understand. I went to Planned Parenthood for my chemical alteration and for reasons much less moral than yours. My mom understood when she found out later and was actually glad that I’d taken precaution. And, once you get her on your side, it will be easier to sooth your dad. My dad’s still not comfortable with me dating (even though it’s been with one and only one guy for the last 8 years) but he did agree that he didn’t want unexpected kids screwing up my school. Since your reasons for wanting BC are much less scandalous, the reveal is more likely to turn out well, and then you won’t have to hide.
PS: I only put 90% in case your mom is really weird. Like avoids walking past the house of an anthiest weird, or accuses people of witchcraft weird. Odds are much better if she’s not that weird.
Weird in that she believes PMS is never anywhere near debilitating, and that I’m just making it up when I spend a day or two essentially confined to bed and in incredible pain? Yeah. She is. :rolleyes: My dad’s actually not the problem: the conversation turns remotely femine and he runs.
Planned Parenthood provides the full range of reproductive/women’s health services, not just contraception, so no matter what your reason for wanting BC pills, they shold be able to advise you. They saved my butt more than once when I was uninsured. I was always very impressed with the professionalism of their staff, sometimes more so than with the private OB/GYN I had later on. If you’re at all uncomfortable with having your parents in on this, I highly recommend giving them a try.
I’ve been lucky that my cramps were never beyond the control of meds, but if she doesn’t believe that women experience things differently, direct her to This Thread.
I’ve been in your situation, and here’s what I’ve done:
-When I was in college, I went to the university clinic. I didn’t give them my insurance information because a)though I was covered by my parents’ plan (and they were in town) I didn’t have that info at hand and b)I really didn’t feel like telling them.
I paid for everything out-of-pocket. I think the exam was only $30 or so.
The pharmacy associated with it had a super sweet deal on most drugs, including BC pills. I think mine were something like $4.50 a pack (way more than what I pay now under my employer’s plan).
-After I graduated but before I had a job, I went to Planned Parenthood. Because I was unemployed and because my year-to-date income was below a certain threshold, I qualified for some low-income program run by the county and my exam and pills were free. A month later I got my job, but they weren’t on the “preferred provider” list of pharmacies, so I started getting my pills someplace else.
Even if you weren’t getting pills, you could justify the exam to your parents because young women should have an annual pap smear (until you have so many clean ones, then I think it’s every other year).
I have never gotten any paperwork from my insurance company regarding payment for medications, and I’ve been with three different companies since getting out of school. We get statements showing what we’ve had done at the doctor or the hospital, but never the pharmacy. So depending on the company, your parents might never be notified about what you get at the pharmacy.
Also, our student health plan covered birth control at a ridiculously low cost. Insured or no, if you were a student, you could get your pills at the school pharmacy for $6/month. So you might not even need to use your insurance.
Some plans cover BCs, some don’t. But if yours does, many insurance companies are now starting to send a “Statement of Benefits” to the insured (in this case, your parents), listing the medications that were paid for in the last month. This is to make sure the pharmacy isn’t billing the wrong person, etc.
I agree with everyone who has said that if this is an issue, you should try checking with your school’s hospital or clinic… they probably have the BCs at a very reduced rate.
