(Closed) Insurance Company Won't Pay for my Birth Control After They Said They Would.VENT

posted 5 years ago in Wellness
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  • Post # 2
    Member
    6262 posts
    Bee Keeper
    • Wedding: August 2013 - The Liberty House

    What type of insurance plan do you have? What is your deductible supposed to be?

    Post # 3
    Member
    4424 posts
    Honey bee
    • Wedding: December 2013

    View original reply
    PBeeWriter:  Hmmm…this doesn’t sound right. If your insurance was enacted after the ACA was put into effect, then yes birth control should be covered 100% regardless of if the deductible has been met. Now, I’m not going to claim to know totally about the IUD as there has been some isues with certain methods of BC and the ACA…but, in my experience (and in my insurance) birth control is completely paid for even if I haven’t met my $1200 deductible for the year.

    Post # 4
    Member
    47427 posts
    Honey Beekeeper
    • Wedding: November 1999

    View original reply
    PBeeWriter:  Many plans have an annual deductible before they start paying. Does your plan have a deductible? If so, have you already paid it for this year?

    My understanding is that plans are not required to cover ALL types of birth control, but must offer at least one type with full coverage

    ObamaCare Birth Control

    Post # 5
    Member
    1305 posts
    Bumble bee

    From the way you are describing, you don’t understand what a high deductible health care plan is, and possibly didn’t read over/understand the plan before you took it on.  I recommend asking your HR department or calling customer service with the insurane provider to send you something again and going over it until you understand.

    I also wonder if you have an HSA or FSA that you didn’t utilize as well.

    I could be wrong, but I don’t believe insurance covers ALL types of BC.  But then again, I could be wrong.  I have been on the pill for the past ten years so I haven’t researched this to death.

    • This reply was modified 5 years, 5 months ago by  doglover89.
    Post # 6
    Member
    1565 posts
    Bumble bee
    • Wedding: May 2016

    Ugh! I’m so sorry you’re having to jump through hoops just so you DON’T get knocked up and your insurance company has to pay for medical care for both pregnant you and your offspring. It’s so stupid. I tried to switch from birth control that was making me fat, moody, and is probably going to cause osteoperosis down the line to the pill. Whatever pill my doc prescribed apparently isn’t covered by my insurance company because it’s sometimes prescribed for something other than birth control, so they classify it as a “Tier 2” medication, one that isn’t preventative. I was shocked when I went to pick it up and they were going to charge me $43 for 30 pills. I’m back to my free but annoying birth control for now thanks to the stupid insurance company. I know I’m not making you feel any better but I wanted to vent too because crap like this shouldn’t be such a hassle for us women!

    Post # 7
    Member
    18628 posts
    Honey Beekeeper
    • Wedding: June 2009

    Ugh that’s annoying.  I have heard of some plans not covering all BC types and still being in compliance with ACA.  I think as long as they have options available, they don’t have to offer all types of pill for examply to be in compliance.

    That super sucks that they counted it toward your deductible!  I had mine put in the year before ACA took effect so I have to pay the majority of it myself and thought that I was still saving money instead of $40 a month for BC.  But still sucks that they didn’t explain your benefits and cost to you beforehand.

    Post # 8
    Member
    2051 posts
    Buzzing bee
    • Wedding: May 2013

    This doesn’t really surprise me, most insurance plans have a deductible you have to spend before insurance coverage starts.

    View original reply
    KatiePi:  maybe the Mirena itself is covered, but the procedure / doctors time might not be?

    Post # 9
    Member
    9388 posts
    Buzzing Beekeeper
    • Wedding: July 2016

    View original reply
    PBeeWriter:  Ouch.  🙁

    I wish I had something more useful to say, but I don’t.  I really hope something works out–it’s so immoral for them to have TOLD you it was covered when it isn’t.  It’s one thing for you to ASSUME it is and be wrong, but a whole nother thing if they actually said go ahead and get it inserted and we’ll pay.

    My only advice is never call insurance companies–always email.  Get it in writing!

    Post # 10
    Member
    4424 posts
    Honey bee
    • Wedding: December 2013

    View original reply
    CityBearBride:  Maybe. If that’s the case, that totally sucks. I have a bit of pregnancy brain and didn’t even think of that aspect of it.

    OP, I would call your insurance directly (again) and ask them specifically why you are being charged this money and have them talk you through it.

    Post # 12
    Member
    690 posts
    Busy bee
    • Wedding: October 2014

    I don’t think this is legal.  Doesn’t sound in compliance with Obama care. 

    Post # 14
    Member
    3470 posts
    Sugar bee
    • Wedding: July 2012 - The Gables Inn, Santa Rosa, CA

    View original reply
    KatiePi:  Birth control is only 100% paid for pre-deductible if you’re on a method that has a generic available.  I fought with this for my nuva ring before we were TTC.  

    View original reply
    PBeeWriter:  That really sucks, but unfortunately they absolutely can get away with that.  For example, my deductable is NORAMALLY $250, but for certain medications that aren’t generic yet, I have to pay a lot more because of the way my blue cross plan is structured.  Also, deductables aren’t as simple as a single dollar amount, you can have different deductables for different coverage, for example, when I give birth if it’s natural/vaginal my deductable will be $4,000 but if I have a C-section, that counts as surgery, so my deductable is $6,000.  It’s all a tangled mess! 

    Post # 15
    Member
    3695 posts
    Sugar bee
    • Wedding: May 2012

    Seems like it would be easier.  Like, they would want to avoid paying the $250k in medical bills we’ve had so far this year due to pregnancy, pre-term childbirth, and a NICU stay.  After I paid our out of pocket max for all that though, my Mirena was free.  

    The topic ‘Insurance Company Won't Pay for my Birth Control After They Said They Would.VENT’ is closed to new replies.

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