Insurance companies cannot demand co-pays for birth control

As of January of 2013, no health insurance company can charge co-pays for birth control medication. Image from Wikimedia Commons.

As part of health care reform legislation, no insurance company can require that anyone have any co-pays whatsoever for birth control medication. In other words, any woman on a birth control regimen that has health insurance has to pay a dime for her prescription.

Getting birth control will no longer be a financial bitter pill

Part of the Affordable Care Act, the health care reforms laws which are often referred to pejoratively as “Obamacare,” gave the government authority to regulate what health care insurance companies could charge their customers in co-pays for birth control medication. The Obama administration has just announced new guidelines on co-pay charges for birth control, according to the New York Times. The decision fell to the Department of Health and Human Services to determine the policy. HHS Secretary Kathleen Sebelius, after receiving recommendations from the National Academy of Sciences, has just released the new guidelines. As of January 1, 2013, no insurance company can ask for a co-pay or reimbursement of any kind for birth control medications.

Women’s healthcare a major focus

Part of the Affordable Care Act focused on increasing the use of preventative care, especially preventative care for women. The new guidelines includes mammograms, DNA screening for the human papillomavirus as part of testing for cervical cancer, prenatal exams and, according to WebMD, sexual transmitted disease tests including tests for HIV and AIDS and medical tests for domestic abuse. All of these preventative procedures will become fully covered by health care insurance companies; no woman with health insurance will pay for these services, once the law takes effect in 2013. All insurance plans that begin on August 1, 2012 must adhere to these guidelines. All Food and Drug Administration-approved contraceptives will be covered including the “morning after pill,” though religious organizations offering health insurance to employees can opt out of covering contraceptives via a religious exemption clause. However, insurance companies can charge a co-pay if a patient is being prescribed a brand name form of birth control, if a patient wishes to not use the generic equivalent.

Lean years ahead for Big Pharma

The health care industry is set for some heavy losses in coming years. Besides insurance companies having to fully cover all birth control and other portions of the health care reform laws, the pharmaceutical industry is bracing itself for massive losses as many of the world’s most profitable drugs are going off-patent, and exact generic copies will be available for much less money. Merck, according to BNET, recently announced the pending layoffs of 13,000 employees ahead of losing the patent on its asthma drug, Singulair, which made the company $1.3 billion per quarter. Pfizer is set to lose the patent on Lipitor, the single most best-selling drug in the world, in November of this year, according to ABC. That drug is an $11 billion per year industry all its own.


New York Times





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