The health care law (the Affordable Care Act) requires certain women’s preventive health services and screenings, including birth control, to be covered in new health insurance plans without out-of-pocket costs. This is a major victory for women, who now have insurance coverage for the full range of FDA-approved birth control without being charged a co-payment or coinsurance or having the costs of birth control applied to their deductible. Yet, some employers (both non-profit and for-profit), colleges, and universities have religious objections to including birth control in the employer- or school-based health insurance plan. If you work for an objecting employer or attend school at an objecting university, here’s what you need to know about your access to birth control without out-of-pocket costs.
If You Work for an Employer or Attend a School that Has Religious Objections to Including Birth Control in the Employer- or School-Based Health Insurance Plan:
Don’t worry, in most cases you should still have access to birth control without out-of-pocket costs, as guaranteed by the health care law. Your birth control will just come directly from the insurance plan (or another third party), rather than your employer or school.
What you need to know:
- If you work for a non-profit employer or attend a school with religious objections to birth control, you should already have access to birth control without out-of-pocket costs. There are some exceptions, so call your insurance plan directly to find out if you should be receiving the birth control benefit.
- If you work for a closely-held for-profit employer and the owner has religious objections to birth control, you should already have access to birth control without out-of-pocket costs. Call your insurance plan directly to find out how to get the birth control directly from your health insurance company.
- You should receive notice about your birth control benefit directly from your health insurance company and it should arrive around the same time as other insurance information. It should include contact information if you have any questions or concerns. Be sure to take a close look at any letters or documents you receive regarding your health insurance, particularly in the months leading up to your new health plan year. If you don’t receive information about the birth control benefit, call your insurance company.
- Your coverage should be seamless. Simply schedule the appointments or visit the pharmacy as you usually would, and you should not face any co-payments or other out-of-pocket costs. The insurance company or third party simply arranges for payment of the birth control without you taking additional steps. If you have any problems or have to take extra steps to access your birth control coverage, contact our hotline at 1-866-745-5487 or [email protected].
- When you get your birth control benefit, you should be able to access all FDA-approved contraceptive methods for women, including pills, the Ring, the Patch, injectables (the Shot), implants, intrauterine devices (IUDs), and sterilization procedures. Discuss with your health care provider which birth control method is right for you, and verify that you have access to it without out-of-pocket costs.
- You should already be receiving coverage of the other women’s preventive services, like mammograms and well-woman visits, without out-of-pocket costs.
Contact our hotline at 1-866-745-5487 or [email protected] for free help if you work for an employer with objections and are not getting the birth control benefit.
If You Work for a House of Worship:
Churches and other houses of worship do not have to provide insurance coverage of birth control without out-of-pocket costs. This means that if you work for a church, church auxiliary, or other house of worship and get your health insurance through your employer, you will not get the health care law’s birth control benefit if your employer objects to it.
But remember, you should be receiving coverage of the other women’s preventive services, like mammograms and well-woman visits, without out-of-pocket costs.
Contact our hotline at 1-866-745-5487 or [email protected] for assistance. We can help you identify other resources to access birth control.
You Were Told You Cannot Get Birth Control Without Cost-Sharing. Why?
- You work for a house of worship or church auxiliary. Churches and other houses of worship do not have to provide the birth control benefit, but they must meet a certain definition in order to qualify. If you have any questions about this, contact our hotline at 1-866-745-5487 or [email protected].
- You work for a for-profit company with religious objections to providing this coverage and your plan is grandfathered. If you have any questions about this, contact our hotline at 1-866-745-5487 or [email protected].
- You work for a non-profit organization or attend a college or university that is suing to stop the benefit. Some non-profit organizations that object to birth control coverage have filed lawsuits so that their employees or students don’t receive the benefit. These lawsuits are ongoing. However, the federal government has indicated that where it has information about the insurance company that would arrange to pay for birth control, it will notify the insurance company that it should ensure women can access birth control without out-of-pocket costs immediately. If you have any questions about whether your employer or school is allowed to do this, contact our hotline at 1-866-745-5487 or [email protected].
- You are a student in a “self-funded” plan. A small number of universities are completely exempt from the health care law because their health insurance plans are “self-funded.” This means that these plans do not have to provide coverage of birth control without cost-sharing. Call your insurance company or contact a school administrator to find out if your student health plan is “self-funded.” If the plan is self-funded, unfortunately the health care law does not apply to your plan.
If you do not fit into the above categories, are getting conflicting answers or confusing information, or need assistance, contact our hotline at 1-866-745-5487 or [email protected] for free help or visit www.CoverHer.org for information on how to appeal any co-pays or deductibles you’ve been charged and to demand compliance with the law.