An investigation by the Guardian has shown how murky the current system had become in the US: riddled with inconsistencies in the price women pay at the pharmacy counter
New provisions in the Affordable Care Act mean that women in the United States who have health insurance will have better access to healthcare services – notably cheaper birth control.
But even though the government estimates that 47 million women will benefit by the end of the year, experts say the new rules could take up to two years to take full effect. For many women, the inequalities of the current system will endure for some time yet.
An investigation by the Guardian has shown how murky the current system had become – the price women pay for contraception at the pharmacy counter is riddled with inconsistencies. The advice given by medical practitioners too, varies widely.
One service, though, was provided cheaply or for free across the board: sterilization.
Loise Geddes, 36, was one of more than 100 women who responded to a reader call-out asking for information about contraception costs; Geddes opted for permanent sterilization after months of “nonsense” and surprises at the pharmacy counter.
Geddes, who lives in New York, said: “On more than one occasion, I discovered that my payment had changed while at the pharmacy counter, which would then necessitate a call to the insurance company, who would suggest an appeal as a means of getting the medication covered.”
In other cases, women were paying different amounts for the same prescription, even while on the same insurance plan and with the same pharmacy chain filling the prescription.
Judy Waxman, vice-president for health and reproductive rights at the National Women’s Law Center, mentioned several other reasons why the pay scale for contraception is so varied, including insurers that negotiate contracts regionally and different negotiation processes with employers.
“Wherever you go, wherever you live it’s a totally different story,” Waxman said. “That’s what the new law’s going to do. Bring some uniformity to the situation.”
Usha Ranji, associate director for women’s health policy at the Henry J Kaiser Family Foundation, said contraception is the most talked-about provision of the new healthcare guidelines, but that the new policy will allow health experts to learn more about other services.
“Well woman visits, breast feeding, domestic violence screening … that’s where we don’t have a ton of data on what was covered before.”
View our findings on the map below, and share your #ContraceptionCosts with us by filling out this form:
#ContraceptionCosts around the country:
Birth control more expensive and difficult to access in rural areas
“Four years ago I moved to a very rural part of Montana and was suddenly in the position of needing to stockpile BC because of the distance to get the prescription filled and shocking price increase. So I could pay more once a month (15 miles away) or buy several months worth at a city clinic (75 miles away) – neither situation was financially palatable. I eventually stopped using BC and figured condoms would have to be good enough.” – Jennifer (Blue Cross Blue Shield), Billings, Montana
Regular checkups are major contributors to overall cost of contraception
“Affording birth control pills themselves isn’t the main issue when it comes to preventing pregnancy for me – it’s the appointments that follow. I am uninsured so I pay for my healthcare on a sliding scale based on income. From my calculations, I am spending $2,500-2,800 a year on birth control pills and routine checkups that I need to have in order to maintain a prescription for birth control pills.” – Hannah (Uninsured, taking Lutera), Wilton, Maine
Religiously affiliated insurance companies causing problems accessing birth control
“My birth control is not covered by my insurance due to the fact my insurance is through my mothers work (catholic hospital) it has been difficult to obtain.” – Tori (Keystone, taking Oxytricyclean), Folsom, Pennsylvania
“My husband works for a Catholic hospital group. We were told that I could get coverage for my birth control if my gynecologist filled in a form and faxed it to CVS Caremark explaining that I need the hormones from the birth control to treat my hormone imbalance and control the cysts on my ovaries. She told me she did not believe that would make any difference and gave me a card from the pill distributor for a discount. The discount only takes off $10 a month from the price of the pill. Needless to say paying for birth control is a hefty chunk of my budget.” – Rachel Sherman (Blue Cross/CVS Caremark, taking) LoLoestrin, Ferndale, Michigan
Unpredictable price increases the norm
“My birth control co-pay was just increased as of this month from $10 to $30 after taking it for eight years. My insurance provider has now deemed it as a ‘higher tier’ birth control. It’s very frustrating because they tripled the price and it is a generic pill. I can purchase it without insurance for $50 so it’s not much of a savings to have insurance.” – Renee, (United Health Care, taking Kariva) Henderson, Nevada
“It used to be $4 then went up to $20 … So happy it will be free, as a struggling college grad, that will be $20 more in my pocket every month. $240 dollars a year!” – Krystin (Aetna, taking Trivora) Howell, New Jersey
“I have been watching the cost of my birth control steadily climbing for the last five years and it used to be $30 cheaper” – Natalie (Allegis Group, using NuvaRing), Auburn Hills, Michigan
Vasectomies and sterilization easier and cheaper to obtain than birth control
“I used to take the pill and the nuva ring through my current provider. I paid $13 co-pay for prescription at the time. We had zero co-pay on my husband’s vasectomy. All of our birth control options have been very reasonable.” – Axli (Tricare) Killeen, Texas
“Over the past year, and as I have switched insurance, moving between United and Empire, the price and availability of birth control has fluctuated wildly. My birth control cost $100 dollars per month, which was unsustainable for me, even though I have a stable, well-paid job. Eventually, I was told that sterilization was available and covered by my insurance, as a married mother-of-two, it seemed the more practical – and more affordable – option.” – Louise (United) New York, New York