Sunday, May 3, 2015

Is your health insurer following the rules?

There was an article the other day about how health insurers are finding loopholes and getting away with not providing required services, such as birth control with no co-pay.

Health Insurance Companies are Illegally Charging for Birth Control

My insurer is guilty of that, as the brand name birth control pill I take is free, but the generic is not.  So of course the doctor tends to want to write prescriptions for generics, because people usually want those, and if she doesn't the pharmacy substitutes, and then I have to have them all change it back because otherwise I get charged for something I'm supposed to be getting for free.

In two “State of Coverage” reports, which you can read here, the NWLC found that many major insurers are ignoring the ACA’s new rule that FDA-approved birth control methods should be covered without a co-pay. Insurers do things like putting all hormonal birth control methods together into one category, then pay for just one or two of them. Others don’t cover sterilization, although it’s an approved birth control method that some women might choose, or impose arbitrary age limits, refusing to cover birth control for women over 50. (Which raises the question: do they think women are continuing to take birth control after 50 for the hell of it? Presumably they’re doing it because they can still get pregnant and would rather not.)
 And then, infuriatingly:

Karen Ignagni, president of America’s Health Insurance Plans, an industry trade group, told the New York Times that actually women love paying for their birth control when they’re not supposed to have to anymore. Ignagni told the Times the report presented a “distorted” view of reality, adding, “Health plans provide access to care for millions of women each day and receive high marks in customer satisfaction surveys.”
Right, because people love paying their hard-earned money for things they're supposed to be getting for free.  Most likely 1) the women don't know their health plans are violating the rules, and 2) the surveys are biased as hell.

What about your health insurance plan?  Have you noticed you're not getting all the benefits you're supposed to be?

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