Insurance won't cover The Pill -

You guys will like this.... .

Our insurace co. has deeee-cided it will no longer cover The Pill; of course, insurance would cover the Fruit likely to appear if we elected not to buy The Pill on our own dime (don't worry, we would buy The Pill even if it cost us huge bucks!).

This has to be oen of the most twisted health insurance "decisions" I have come across. They'd rather we produced a Fruit - which would entail thousands of dollar of costs (even if the kid is perfectly healthy) during its first year alone. But a couple hundred bucks (maybe) for birth control?

Nahhhhh.

That's "wasteful," apparently.

That is fucked up! Thank dog I live in Quebec and my health insurance covers everything, no questions asked. I only have a mere 25$ to pay the first time of the year when I use it for medication or anything.

That's total bullshit.

I can't get started on this topic again because I'll get all overheated.

I'm sure the troll will be by any second to offer his/her valued opinion and reasoning on the topic..................

Are you talking about me?

Sorry to hear your insurance carrier seems to have changed policy. It seems like a strange time to be making that decision especially when most carriers are either offering it willingly or being mandated by state laws. It's cheap with proven health benefits.

I would be willing to bet that if your carrier isn't covering something that really is as cost effective as contraceptives, then there's probably a lot of other health benefits that are being cut out. That is likely thanks to your employer.

Do you work for a small company? Unless you are self-insured, your employer dictates what they are willing to pay for in your coverage. The smaller the company, the less coverage you tend to get.

It might be worth it to give your insurance carrier a call and see whether it's them stopping the coverage or your employer. If it's your employer, you might be able to add additional coverage for prescription contraception. Most carriers will allow this and its usually affordable.

Also, not that I'm suggesting you lie...but even for carriers that don't provide coverage, if your doctor is able to provide a medical reason for you to require contraception, then you'd have a pretty good chance for a carrier to prescribe it as a medical benefit, rather than contraception. Like endo or a condition which may make pregnancy dangerous for you.

Ok, sorry so long.

That is complete crap. Some people, myself included, take the pill for reasons other than birth control. For example, if I stop taking the pill, my skin breaks out in horrible infections (sorry for the TMI) and it can be painful. The pill keeps my hormones in check. I consider it medically necessary. Oooh, that makes me so mad!!

Weak. My snip was fully covered, save for the $25 co-pay. I guess most insurance companies know birth control is a lot cheaper than repugnancy and the subsequent visits to the doctor every time Brattley has a sniffle.

Ketchup Wrote:
-------------------------------------------------------
> That is complete crap. Some people, myself
> included, take the pill for reasons other than
> birth control. For example, if I stop taking the
> pill, my skin breaks out in horrible infections
> (sorry for the TMI) and it can be painful. The
> pill keeps my hormones in check. I consider it
> medically necessary. Oooh, that makes me so mad!!

Don't even justify WHY you take the Pill. I do not understand WHY women must feel they have to say, "I do not do this for birth control reasons..." There is no reason to make justifications for your choices. Same goes for abortion. A man never justifies why he buys a box of rubbers. He just does it and has no shame as he planks the box down on the counter. As for Blank, why would any company prefer to pay the huge costs for maternity and then post-natal care along with the baby than for contraception? Oh...I forgo...women are meant for nothing more than crapping out babies. Most of the herd are pretty fucking retarded when it comes to this shit. No wonder we have not gotten that far when it comes to securing reproductive rights. It is 2008 and women still have to fucking beg. At least Blue Cross covered my tubal. No wonder their costs are more manageable as they are willing to pay for a snip rather than have to cover all of these preggos.

Eric, why do I suspect that your insurance company will continue to cover Viagra and Cialis?

What gets me is that medical insurance companies will claim to be dropping the Pill because it's not "essential" in terms of life and death or treating debilitating disease or injury. What a load. No one dies from not being able to get it up, either, but they'll still cover the impotence drugs. And these, unlike birth control pills, generally have no other accepted medical use.

Many insurance companies in the US will not cover sterilization either, on the grounds that it's an elective procedure akin to a facelift. Seems as if all these decisions are meant to enable sprogs at all costs by discouraging other options, even at great potential expense to the company from pregnancy and child health care. I can't understand this "logic".

Eric--My insurance is the same way. Luckily, it will cover the pill if there is another medical reason that it is needed for--like severe menstrual cramps and especially heavy periods. Maybe if your wife went to another doctor complaining of period problems your insurance will cover the pill. That's how I get it paid for. I don't feel a bit bad about doing it that way. It is absolutely ridiculous that they will pay enormous amounts for pregnancy, birth, and the kid until it is 25, but not pay for part of the pill. Insurance Companies are pigs.

Amethusos, I'm not sure why you seemed to direct so much of your comment at me when I merely replied as someone who works in the insurance industry. Although the cost some things are not as high as you would think.

Why any particular carrier would choose to deny this coverage? I don't know. Which is why I assume either that whoever has made the decision, either the employer or the actual carrier, has also decided to stop or deny coverage for other cost effective treatments, basic or not.

It's pretty well felt in the carrier industry that providing coverage for hormonal contraception is very cost effective for what it's meant to do. Even in states where coverage ISN'T mandated, most carriers still provide coverage because it costs next to nothing.

Denial of coverage wouldn't make sense to me, and I would encourage the OP to investigate the matter further, and find out WHY and specifically WHO is denying coverage.

First off, I have to say the obvious--not covering birth control, whether it's the Pill, diaphragm, cervical cap, IUD, patch, etc. is ridiculous when you consider the monetary implications (birth control vs. possible complications associated with pregnancy/birth). If nothing else, I would think that competition would dictate otherwise; many insurance companies DO cover oral contraceptives. I'm on a cheap-as HMO, and I still get mine paid for, no questions asked.

If you put the question to an insurance company, you'd probably get a pat answer that sounds something like this: "We cover medical conditions. Pregnancy is a medical condition. Erectile dysfunction is a medical condition. Not wanting to have babies, however, is not a medical condition."

However, oral contraceptives DO ligitimately treat many medical conditions such as endometriosis, acne, anemia and dysmenorrhea. Eric, I think if your wife tells the doctor she has extremely heavy periods complete with debilitating cramps every single month without exception, he/she would be well within reason to prescribe the Pill. Particularly when dysmenorrhea is a symptom of endometriosis, and the only way to diagnose endometriosis is with surgery (which is expensive, and is a risk factor for ovarian cancer, and, infertility).

Reply Quote

Off topic:

Ok, I am back to ask: Blank, why are you here? Are you childfree or are you only here to feed us your so-called bullshit expertise on health/insurance issues of importance to childfree people? What's really going on?

I don't have children, not now, probably not ever. I don't necessarily declare myself as childfree the same way I refuse to make actual declarations about my religious beliefs.

I don't want children, but I don't consider it a lifestyle choice, I consider it my choice.

Anyway, I don't post to "bullshit" anyone. I lurk on this board and a few other childfree boards as well as some random other boards around the internet. My personal life choices don't really seem to fit in with most of the people at any of the boards I lurk at, so usually I don't bother to post. I see its the same here.

I posted on these two forums because I work in outcome studies for a major insurance carrier. I basically do research on how coverage of certain medications or conditions affects outcomes, such as long term outcome, short term results, and the impact on lifestyle, overall health; basically the impact of providing coverage separate from the money involved. I don't work in any of the financial areas, but I know the basic idea. I thought my responses would be helpful and at least, somewhat educational.

blank: it's not that your input isn't welcomed, but if you're not SURE kids aren't for you, and there's a chance you MIGHT pro-create, then you're really not CF.

I'm not childfree, I'm someone who doesn't want children. I don't do labels, not for myself or others. I said probably because I have a long way to go in my life, and I try to never say never to anything.

I also respect other people's life choices, even those that may conflict with my own beliefs about things. As long as my quality of life isn't affect, the personal choices of others don't bother me. It's part of why I really only lurk in so many places, I don't fit in with many of the attitudes or beliefs that others have.

Anyway, I only responded to the posts I did because I know something about the information in them. But I'm not really sure I would want to post on anything else.

If I may say though, there are probably a lot of people out there who are on the fence or unsure about the choice to have or not have children, for whatever reason and come here to gain insight or support for a decision they may feel shaky about. If they're being told they're not really childfree or that they don't quite belong here, you're essentially pushing them away from this kind of community.

OK, I'm excuse me while I chow down on my own words here. The real "pat answer" is even lamer than the one I came up with. I just found this article: http://www.pbs.org/newshour/bb/health/july-dec02/birthcontrol_8-13.html

It's a transcript of an old pbs program on this subject. Granted, it's about six years old, but I'm sure the basic concept still holds true. A few choice quotes:

JAMES REED Insurance Industry Consultant: "These drugs cost $21 to $32 locally per month. I mean, that's the cost of a movie and a dinner out once a month. It's a small amount of money to pay. If they're concerned about the pregnancy, they're buying it out of their own pockets already."

HUH??!!

And then theres: JAMES REED: "Most women could budget for this. The purpose of insurance is to cover events that are random, that are not budgetable, that you're... that you have little or no control over. When you buy car insurance and you're buying it for accidents, but you're not usually buying your car insurance to change your oil, and so it's the same analogy." Right. So if I don't "budget" and therefore don't get birth control and end up pregnant, is that considered planned or unplanned? By your logic I guess it's considered planned. So would you not cover my pregnancy expenses?

I do see your point, and as I stated in my previous post, I felt the insurance information you contributed was very informative.

But folks like you who are still not 100% sure whether or not you want children fall in the 'fence-sitter' category. There's nothing wrong with being a fence-sitter. But that is what you are. I have always been 100% sure I never wanted children ever since I was a kid. I divorced my first husband because HE changed his mind, and I would not waiver on this most critical decision. I am almost 40 now and happily married for over 10 years to a wonderful child free man. I am child-free, always have been, always will be, and that has never wavered.

Don't be so insulted by 'labels', they're not a big deal. Milk is milk and eggs are eggs - they're labeled . I do hope you stay, I think your insights are good.

I a NOT afraid to label myself "childfree-by-choice". What was said sort of reminds me of women who say, "I am not really a feminist...," while reaping the benefits of what the early feminists fought for such as the right to credit without a man's signature, same to rent or buy, reproductive freedom, a harassment-free workplace, and so forth. Many people do not want 'labels' because they still want societal approval. But...that is their business. However, no one should get into our faces here or anywhere else. Blank, please do not offer suggestions how the community should be run if you are not posting anywhere else on the site. After all, you just got here. We do not need your advice.

This isn't really a community - it's a rant board. You can come here and post anonymously. Given the strong feelings people who post here have about being CF and CF issues, I wouldn't say this is a place for fencesitters. If you're a fencesitter, I'd say go hang out at Positively Childfree or CF Debate on livejournal.

Oh...I see.... Blank, you're a fence sitter and you're basically a lurker who is posting your "insurance knowledge" just to entertain yourself? Ok, now I get it.

As far as insurance information, if I need it, I'll call up BCBS or Michael Moore. LOL

Ok....on with the show!

amethusos* Wrote:
-------------------------------------------------------
> I a NOT afraid to label myself
> "childfree-by-choice". What was said sort of
> reminds me of women who say, "I am not really a
> feminist...," while reaping the benefits of what
> the early feminists fought for such as the right
> to credit without a man's signature, same to rent
> or buy, reproductive freedom, a harassment-free
> workplace, and so forth. Many people do not want
> 'labels' because they still want societal
> approval. But...that is their business. However,
> no one should get into our faces here or anywhere
> else. Blank, please do not offer suggestions how
> the community should be run if you are not posting
> anywhere else on the site. After all, you just got
> here. We do not need your advice.


Totally agree....especially with the part in bold. "I'm not childfree, and I don't like to be called childfree. I just don't know whether or not I want kids....but if I don't mention that, and post on CF boards, then I'll be looked upon as childfree anyway and accepted into the CF community as such!" GTFOOHWTBS!!

Mean Person posted: "So if I don't 'budget' and therefore don't get birth control and end up pregnant, is that considered planned or unplanned? By your logic I guess it's considered planned. So would you not cover my pregnancy expenses?"

That used to be true. They wouldn't. Until the late 1970s, when the federal government passed a law requiring medical insurance companies to cover pregnancy and childbirth, the insurance companies used just that same logic: having a child was "planned" (elective) and therefore not covered. Coverage was for unforeseen diseases and accidents. That was the companies' logic.

I still think it's downright stupid to cover impotence medications but not the Pill when used for birth control. Getting a boner is optional, in other words "elective", especially at the ages of men typically taking the impotence drugs. And I'm a middle-aged man saying this.

VLM Wrote:
-------------------------------------------------------
> Oh...I see.... Blank, you're a fence sitter and
> you're basically a lurker who is posting your
> "insurance knowledge" just to entertain yourself?
> Ok, now I get it.
>
> As far as insurance information, if I need it,
> I'll call up BCBS or Michael Moore. LOL
>
> Ok....on with the show!

Dittos on that one. I would not go to someone named, "Blank", for insurance advice. In JAX, FL, there is a BCBS office downtown...

Jesus Christ people, it's just blanks' experience regarding insurance company's policies. I see y'alls point, because there are so many different insurance companies out there, one SHOULD consult their own co. for what is covered and what is not, but it was just one persons experience.

Blank is a fence-sitter who happens to be a little more on the conservative side of things but, whether she likes it or not, she's a fence-sitter - labeled!

Relax and enjoy the back-n-forth banter.