So, my health insurance doesn't cover prescriptions

[xmas74]

I have a separate plan for my prescription coverage (Medco). I'm wondering if my health insurance will have to cover birth control prescriptions or if I'll still have to use my prescription coverage.

Right now I'm on a progestin only pill (mini pill) for menstrual irregularities. As of this time, my insurance company (Cigna), while covering well woman exams with no copay, does not include birth control. My pills right now through Medco will jump up to $20 a month, according to a recent letter from them. Not bad but isn't is supposed to eventually be covered or can they decide what forms of bc will or will not be covered, especially since mine are not specifically for bc?

Anyone have an answer or anyone going through something similar?

[GobBluth]

1. So sorry, I have not gone through something similar, but

while talking to some of my friends, they were able to get the mirena IUD at their health department (Florida) for about $400. I have one, and hated the first 6 months, but now am LOVING IT. I need the hormones, and this helps alot with my problems. If you are using hormonal therapy (sorry, that's what it is to ME), for birth control, it is good for 5 years and very cost effective if you aren't planning on having children in that time frame.

oh just realized you said yours aren't specifically for birth control. What BCP are you taking? I was taking Orthotryclene (Sp?!) and then the nuva ring to help, but the Mirena has been awesome (after the first six months like I said above, seems to be common).

[xmas74]

4. I'm on Jolivette for the moment

but that could change if my cycles change for the worse. The doctor wanted to try pills first, figuring they would be the cheapest and the easiest way to start.

I have one child, almost a teenager, and have no plans for any more. The only reason I'm on it at all is to regulate everything. I'm too young to be entering any stage of menopause and the decision was made by my doctor to put me on hormones to prevent me from entering too soon.

[NashvilleLefty]

2. well, according to Evangelicals

your only purpose in life is to be a brood-mare. So, if you cannot produce children you should just die.

Personally, I don't think that way. I don't have any suggestions to help your issue, but I hope you find an answer. In the meantime, I am sending out good vibes to you - rather than praying you just die.

[xmas74]

5. Thank you.

I can afford to pay for it but I'm wondering if I'll be eligible since it's not for birth control. Right now it is birth control that will be considered preventative so I can see the insurance companies trying to pull a fast one.

If they do my doctor will just change the script, stating it's for birth control, so it's all covered under preventative.

[haele]

3. Medco should cover the progesterone, even if it's for something else.

It's part of our insurance package, also. They covered the kidlet's BC pills for menstrual irregularities up until her periods settled down. Laz takes methetrexate for his arthritis, and that's a cancer drug. Medco's got a good rep for being politically neutral when it comes to prescription medicine. I'm sure that as soon as medical cannabis is legalized and insurance companies start covering it along with some of the naturalpathic meds they currently allow, they'll start carrying prescription capsules or edibles.
So long as it's not experimental or totally out of irresponsible-land (something like using vicodin to treat high blood pressure), and it's a reputable doctor that's accepted by your insurance plan that's making the prescription, Medco will cover it - and some OTC's if you look at their site.

Haele

[xmas74]

7. They cover it

I receive it through them now (reminds me-need to place an order soon!). What I wonder if it will eventually go to the no copay through them as a preventative, even though they are not technically a health insurance company. I also wonder if I will be covered under the preventative, since my script is not actually for birth control, thereby making it not technically a preventative service.

This will be interesting to watch over time.

[NNN0LHI]

6. If this is employer paid insurance it is not the insurance companies fault

It is your employers fault.

Your employer decides what is and is not covered. Insurance only pays what your employer tells them is covered.

Don

[xmas74]

8. What I'm wondering if it will be covered as a preventative.

Birth control is supposed to fall under preventative care soon. Technically, it's birth control but my prescription isn't written for birth control-it's written for menstrual irregularities.

I just wonder if this is something that will fall in the cracks.

[NNN0LHI]

9. It is up to your employer to decide whether it will be covered or not. Preventative or otherwise

I personally wouldn't depend on something falling through the cracks.

Don

[xmas74]

10. I thought it was to the insurance company and not the employer to

decide on birth control. I thought that was the go-around so that faith-based businesses didn't actually have to pay for birth control coverage-the insurance had to provide it.

I'm on birth control but it's not for birth control. It's for problems with my period. It's birth control, which will eventually be covered as a preventative service with no copay. The difference is that my prescription isn't actually for birth control, which means it could possibly still demand a copay, since it's no longer a preventative.

[NNN0LHI]

13. That is a misconception that many people have

[xmas74]

14. According to heathcare.gov

It's the insurance company that has to provide bc, not the employer.

[guneydomuz]

11. Medco Sucks the big one

If you can afford it, seek other options for your meds, try PP for BC, it may be cheaper.

My experience with Medco is that they will harass your Dr with paper work every month to get them to change your meds to something cheaper even if you are paying $10 a month for it, they will also try and force you to go mail order from them on all your meds.

I was always battling them, I was with them for 2 years through my work plan then the company dropped them because a VP was getting sick of the harassment too, despite monthly complaints from the serfs. If it were not for a VP getting crap service, we would still be stuck with it.

[xmas74]

12. It's the only way I can afford the insurance.

Cigna is my health but Medco is my prescription and yes, I do have to go mail order or else I won't get the big discounts. (If I didn't go mail order it would actually be cheaper for me to buy it without prescription insurance!)

My script is the generic and my doctor refuses to move any further down the list. We'll see where it goes. I do suspect that, once bc is considered preventative, that they'll refuse to offer it w/o the copay because my script isn't for bc-it's for my periods.

[javier_andrade789]

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