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Insurers find loopholes around covering contraceptives

Some moving generic pills from zero tier to more costly tiers

Some insurers are using federal regulations to their advantage to exclude generic versions of contraception from free coverage, reported Kaiser Health News.

Back in 2012, the Department of Health and Human Services mandated that most health plans offer free prescription contraceptives, including all methods approved by the Food and Drug Administration, without co-payments or deductibles.

Under these regulations, a health plan is allowed to charge for a brand-name contraceptive should an equivalent, generic drug be available, free of charge. What's not clear in the guidelines is that a plan can "charge for most generics as long as it offers some for free," Adam Sonfield, a senior public policy associate at the Guttmacher Institute, told KHN.

Some insurers are now moving generic birth control pills from the zero co-payment tier into a higher tier, forcing a monthly payment, as was the case with a reader who wrote into KHN.

As of late, insurers have been reluctant to cover contraceptive methods such as the patch or vaginal ring, claiming these preventive measures use the same hormones as birth control pills and are therefore the same contraceptive method, the article added. Yet a large majority of Americans--69 percent--believes insurers should have to include contraception coverage in all health plans.

Rep. Jackie Speier (D-Calif.) is taking steps to do just that. She introduced a bill this week that would give women in the armed forces access to birth control with no co-pay, reported The Hill. Female service members often have difficulty accessing contraceptives and family planning services when deployed overseas, Speier said.

For more:
- here's the KHN story
- check out The Hill article

Related Articles:
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Majority of Americans support mandated contraception coverage
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How does contraception ruling impact insurers?