Should insurance be required to pay for ALL forms of contraception?

doreen, my plan, at least, considers fertility a medical condition that requires treatment, but only pays for two methods: oral contraceptives, and surgical sterilization. The same goes for every plan I’ve had in my thirteen years in the professional workforce. What kind of logical consistency does this have? One plan would even pay for abortion, but not contraception.

As for your argument about prescription vs. over-the-counter drugs: at least there is a certain logic to that one, and it is applied across the board. When Benadryl, the allergy medication, was a prescription drug, insurance paid for it. Now that it’s over the counter, insurance won’t pay for it. Same went for antifungal creams for yeast infections, ibuprofen in various dosages, and a host of other drugs which were once prescrition-only.

And I’ve seen the oral contraceptive non-coverage issue applied to a truly crazy extent. One of my co-workers had them prescribed to control her horrific case of extremely painful endometriosis, and it took years and many, many letters from her and her gyno (she is a lawyer, BTW, and writes a pretty convincing leter) to get them covered, and she had to make the argument all over again every year. This is stupid, IMO; if your insurance is going to cover one treament for a condition, they should cover all logical and FDA-approved treatments for that condition.

It may not be logically consistent (or even a good policy for an insurance company to have in terms of its own self-interest-20 years on the pill probably costs more than 20 years with an IUD) , but neither is it close to only paying for radiation when chemotherapy is more appropriate.
Way closer to partially covering Weight Watchers fee or gym memberships (as one of my HMOs did) but not covering liposuction.

And presumably she’s going through that because her coverage does not consider fertility a medical condition and doesn’t cover the pill when prescribed for contraceptive purposes.Wait! I’ve just thought of a logical reason for your company’s policy. Perhaps they cover the pill to avoid trying to sort out who’s using it for what reason and who’s lying about the reason to get it covered, After all, an IUD or diaphragm isn’t used for anything but birth control, but the pill is.

Well, if they think that her doctor is lying, why are they keeping him in the plan? Endometriosis isn’t only a fertility-related condition; it’s also a bonafide source of excruciating pain, which is normally covered!

P.S. Are there any health benefits at all to liposuction? I don’t think so. It’s purely cosmetic, and potentially dangerous, so why would insurance conceivably cover it? Not at all like the chemo/radiation analogy.

Not saying they think her doctor is lying at all, nor am I disputing that endometriosis is a source of pain and is normally covered. I’m saying they don’t know if he’s lying without checking.Look,a plan has 3 options for birth control pills.They can cover them for any reason they may be prescribed, exclude coverage for contraceptive purposes, or never cover them. The third option is pretty much out, as they are used for too many other conditions. The second option will cause some (perhaps many- and I’ve known of some personally) patients and doctors to lie about the reason for the prescription to obtain coverage. If the company accepts (or doesn’t even require) a simple statement from the doctor, they will in fact be covering pills prescribed for birth control, although not accounting for it in their premium rates. Therefore, they will demand proof of the reason for the prescription and varying amounts of wrangling to avoid paying for pills prescribed as contraceptives. However, if they set their rates and cover the pill when prescribed for contraceptive use, they will then have people claiming that they should be required to cover all forms of birth control as long as they cover one.Basically, if a plan doe not want to cover all contraceptives, either your co-worker has to jump through some hoops, or they cover all prescriptions for birth control pills , but not other methods . Can you think of a way where a plan could cover your co-workers prescription without any hassle at all and at the same time do an effective job of not paying for prescriptions for contraceptive use? I can’t.

Apparently, some plans do cover all contraceptives that must be prescribed by a doctor. Nothing prevents anyone from buying one or persuading their employer to offer one of them. But mandating that if they cover the pill without regard to the reason , they must cover IUDs and diaphragms will leave only two options-cover all prescription contraceptives, or make those who need the pill for other reasons fight . Some plans will choose the first and raise their rates to account for it. Others will choose the second. I will lose the option of choosing a plan that will cover pills prescribed for endometriosis without a hassle, but doesn’t charge me for coverage that I don’t want.

There are health benefits to losing weight, and liposuction causes weight loss. But no one expects insurance companies to cover every possible (or doctor-involved) method of losing weight just because they cover one.

Not saying they think her doctor is lying at all, nor am I disputing that endometriosis is a source of pain and is normally covered. I’m saying they don’t know if he’s lying without checking.Look,a plan has 3 options for birth control pills.They can cover them for any reason they may be prescribed, exclude coverage for contraceptive purposes, or never cover them. The third option is pretty much out, as they are used for too many other conditions. The second option will cause some (perhaps many- and I’ve known of some personally) patients and doctors to lie about the reason for the prescription to obtain coverage. If the company accepts (or doesn’t even require) a simple statement from the doctor, they will in fact be covering pills prescribed for birth control, although not accounting for it in their premium rates. Therefore, they will demand proof of the reason for the prescription and varying amounts of wrangling to avoid paying for pills prescribed as contraceptives. However, if they set their rates and cover the pill when prescribed for contraceptive use, they will then have people claiming that they should be required to cover all forms of birth control as long as they cover one.Basically, if a plan doe not want to cover all contraceptives, either your co-worker has to jump through some hoops, or they cover all prescriptions for birth control pills , but not other methods . Can you think of a way where a plan could cover your co-workers prescription without any hassle at all and at the same time do an effective job of not paying for prescriptions for contraceptive use? I can’t.

Apparently, some plans do cover all contraceptives that must be prescribed by a doctor. Nothing prevents anyone from buying one or persuading their employer to offer one of them. But mandating that if they cover the pill without regard to the reason , they must cover IUDs and diaphragms will leave only two options-cover all prescription contraceptives, or make those who need the pill for other reasons fight . Some plans will choose the first and raise their rates to account for it. Others will choose the second. I will lose the option of choosing a plan that will cover pills prescribed for endometriosis without a hassle, but doesn’t charge me for coverage that I don’t want.

There are health benefits to losing weight, and liposuction causes weight loss. But no one expects insurance companies to cover every possible (or doctor-involved) method of losing weight just because they cover one.