If you're one of the 62 million American women of childbearing age, we have a question for you: How much do you pay for birth control? Did you know you might be able to save perhaps hundreds of dollars on your contraceptive method, just by asking? Let's back up. We've reached the halfway point in our PriceCheck project.
We're shining a light on notoriously opaque and highly variable health care costs. We're asking you, the members of our community, to share what you've paid for common procedures including mammograms and back MRIs. We found that both screening mammograms and back MRIs could vary in price ten-fold. Now we're moving on to a new health care service: IUDs.
We're asking you to share what you paid for your IUD. The two most widely-used IUDs are Mirena (a hormonally-based IUD) and ParaGard (a non-hormonal product). Both are more than 99 percent effective in preventing pregnancy. Our PriceCheck partner, ClearHealthCosts.com, has surveyed health care providers and lists cash prices for these IUDs in our PriceCheck database.
We've already found that if you're not insured and are paying out-of-pocket for an IUD, these cash prices in the Bay Area range from about $600 to about $1,200. But we also know that what insurers pay for health care tests and treatments varies widely. We're asking you to share what your insurer paid -- and what your copay was.
Right about now you might be thinking that IUDs are supposed to be covered at no copay under rules established by the Affordable Care Act. Isn't that right?
That would be both yes -- and no.
Yes, the Affordable Care Act mandates coverage of birth contraceptive methods for all women. On healthcare.gov, it says that plans on the health insurance marketplace, which would include Covered California, "must cover the services without charging a copayment, coinsurance, or deductible when they are provided by an in-network provider."
Yet, just 1.4 million of California's 38 million residents are insured through Covered California. While other people with private insurance should get the same benefit, it won't be true for everyone. That's because many people are in so-called "grandfathered" plans -- plans that have been around since before the ACA was signed into law in March, 2010, and so do not have to follow all the regulations required by the ACA. You've also probably heard of the Hobby Lobby case allowing some businesses to file a religious objection to providing contraceptives. Some religious nonprofits may also be exempt.
In addition, some plans cover some, but not all, of all the FDA-approved contraceptive services. If you want to know what specific methods are covered under your plan, you call call the member services number on the back of your insurance card.
The National Women's Law Center provides this extremely helpful phone guide for you to use, to help make sure you're getting all the answers you need. ClearHealthCosts details some early submissions we've already received from women who shared the cost of their IUD. Despite having insurance, one woman paid the entire $730 cost of her IUD because she had not yet met her deductible.Another woman was charged $2.24, but will also have to pay $197 for the six-week follow up appointment. A third woman says the entire cost of her IUD was paid by insurance.
The more women who shared what they paid, the more it helps other women be informed consumers. We invite you to share what you paid. It’s helpful if you have your “explanation of benefits” from your insurance company (Find out more about EOBs here.) Then visit PriceCheck and share.
Help us make health costs transparent in California!