Here's Why You're Still Getting Charged For Birth Control
Some insurance plans still aren't complying with the Affordable Care Act. Here's what to do if you're getting charged at the pharmacy.
You probably know that birth control is free without a co-pay under the Affordable Care Act (ACA).
But some people are still getting charged for their birth control when they should be getting it for free.
1. Find out if you’re on a grandfathered plan.
2. Find out if your plan has a religious exemption.
3. Check if how you're getting your birth control affects the cost.
4. STILL getting charged? Call up your insurance company and ask why your method isn’t covered without a co-pay — and if other methods are free.
5. If your plan says they don't cover certain methods — like the IUD, implant, or ring — fight it.
- Be prepared when you call your insurance company. The number is on the back of your insurance card. Keep your card handy, since they're going to ask for your plan number, your group number, and if you're the primary policy holder.
- TAKE NOTES when talking to anyone at your insurance agency or in the benefits department. Like, really good notes, suggests Gandal-Powers. It's rare that something like this will be resolved in one phone call (sorry), so those notes will be really helpful.
- If you're not getting anywhere, hang up and call back. Yes, you may have to wait on hold again, but you could also be connected to someone more helpful. They might confirm what you already heard or give you totally different information, which is frustrating, but will help you out in the end. If you're still getting nowhere, ask to speak to a supervisor.
- Be patient and polite. This simple tip will get you farther than you realize, says Gandal-Powers. Customer service representatives will be more inclined to help you figure something out when you're not snapping at them over the phone.
- If your insurance company isn't complying with the ACA (and they should be), file an appeal. You can find instructions and even appeal letter templates at CoverHer. You can also check with your doctor or employer to see if they might be able to help you with your appeal or get it expedited in any way. Insurance companies are required to respond to appeals, but it may take a month or more, so be patient. If they reject your appeal, they'll give you information on how to submit a second-level appeal. If that also gets rejected, you can file a complaint with the government agency that oversees that plan, says Gandal-Powers.
- Contact the CoverHer hotline at any point for one-on-one help. You can email or call them here.