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Is Plan B covered by health insurance?

A brief overview...
  • Services for the reproductive health of women have been improved with healthcare reform
  • Expanded mandated women’s health services include contraceptive methods at no charge, even without satisfying the annual deductible.
  • A prescription is all that is needed to have a healthcare policy cover the costs of emergency contraceptives, even if you work for an exempt company, or organization
  • Plan B prevents pregnancy, rather than causing a medicinal abortion
  • Plan B can be taken along with standard birth control pills, as often as needed at no cost to women with minimum healthcare coverage

Change in healthcare law did more than offer idle promises of allowing services to those individuals that have been unable to afford them in the past, but it has opened an avenue for the ongoing reproductive health of women in all age brackets. They can now easily access well-woman checks, mammograms, HPV and HIV screenings and much more.

The attempts to make available medical services from the start of the reproductive years, until the grand finale of menopause had been consistently thwarted until ACA legislation.

The goal is to reduce the rates of sexually transmitted disease, unwanted pregnancies, PMS symptoms, reproductive cancers, breast cancer and other life-threatening conditions. Early detection is often what makes the difference in having the best chance of survival.

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The Mandate for Expanded Services for Women

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Many health insurance offerings before the Affordable Healthcare Act limited, or omitted pregnancy coverage. In fact, statistics show that less than 12 percent of women had pregnancy coverage. Plans must now offer at least bare bones structures for the health and wellness of women, throughout their reproductive years, at no cost, including deductible. This is proving beneficial for the entire health insurance industry.

With more single women earning higher wages, a new avenue for insurance has opened.

One of the biggest changes is mandated access to contraceptive methods that are FDA approved. Health professionals must also offer contraceptive education and counseling to women of all reproductive ages, without restriction.

There have been health insurance policies in place for many years that provided for these services, but the breadth of how well the coverage options were had to be explored. Now it is required, but there are still differences in coverage levels.

Contraception Options

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There are 18 separate categories of contraception methods that have to be offered to patients with new healthcare rules and regulations. The covered individual has the option of using one method from the list to control unwanted pregnancies and help with planning family growth.

Below are the generalized categories of covered services and products:

  • Barrier contraception methods such as diaphragms and sponges
  • Implants like intrauterine devices
  • Hormonal controls such as birth control pills and vaginal rings
  • Sterilization
  • Emergency contraception products like Plan B and Ella
  • Contraceptive education and counseling

The Conservative Fight Against Plan B

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The political climate has turned inexplicably cold when it comes to methods of birth control and abortion, no matter the circumstance. The view of some politicians strongly veers from the statistics of their constituents.

A 2011 poll  showed that a mere 10 percent of registered voters were behind the ban of abortion in all cases, including incest and rape. This was the largest poll taken in regards to this controversial subject.

Unfortunately, contraceptive methods like IUD’s and Step B have undergone the heaviest attack. This is because they are considered a combination of the services that conservatives detest: abortion and birth control. Depending on the individual views of when life begins, both sides of the equation feel they have the absolute answer. All this has served to do is alienate women needing services for perfectly legal contraceptive options.

Depending on the individual views of when life begins, both sides of the equation feel they have the absolute answer. All this has served to do is alienate women needing services for perfectly legal contraceptive options.

How do I get Plan B?

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The first step in getting Plan B is to make an appointment with your primary care physician. You will need to get a prescription for this emergency contraceptive in order to have a health insurance plan cover the cost.

You may want to investigate the options available as you shop for plans if this is a critical coverage for you. Once you have the prescription, you can pick up the product at any pharmacy.

What if I work for an exempted company or organization?

There are exemptions for religious-affiliated companies and organizations when it comes to being involved in providing contraceptives, education, and counseling to female employees. You still have the ability to get these services, but you will have to contact the insurance company directly and they will cover the cost of these services and products. They will handle all of the details, which leaves the company out of the process.

It is the plan developed that allows women to get needed legal contraceptive services that respect the religious beliefs of exempted employers. An exempt employer must qualify by:

  • Being an organized religious non-profit agency
  • Qualifying they object to contraception due to religious beliefs
  • Self-certifying they are religiously-affiliated

Differences Between Emergency Contraception and the Abortion Pill Question mark on notepad

Although there is a lot of controversy that tries to swirl around emergency contraceptive products like Plan B, the actions of the abortion pill are much different and not covered by health insurance. Taking Plan B in a timely fashion is what makes the product effective.

Ideally, Plan B should be taken within 36 to 72 hours of having unprotected sex. The infusion of hormones helps deter ovulation, which means you will not become pregnant in the first place.

An abortion pill does not necessarily have to be taken right away. It will eliminate any fertilized egg that decides to attach to the wall of the uterus. This quality is what gives it the moniker “abortion pill.”

On the other hand, the “morning after pill,” or Plan B, shuts down the possibility of getting pregnant, making it a much-preferred method of ensuring against unwanted pregnancies.

Can I take Plan B if I already take birth control pills?

One of the major reasons a woman finds a need for emergency contraception is from having unprotected sex and missing regular doses of birth control pills. Missing doses early and late in the pack place you at higher risk than at any other time.

You should use Plan B if you have missed one, or more of these critical doses, or have missed numerous doses of birth control.

Plan B will not interact badly with the ingredients of birth control pills, but many other brands can. You can safely use Plan B while on a daily routine of birth control, but it needs to be taken within 72 hours to be the most effective. Plan to discuss other methods of birth control with your doctor if you miss doses of the pill often.

How many times can I use Plan B safely?

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There are no real safety concerns with taking Plan B as often as needed. The instructions for a product like Ella state to not take more than one time per cycle, but there are no such warnings with Plan B. It is a hormone boost product that might offer mild nausea after ingestion, but should offer little-to-no other side effects.

The real problem behind frequent use of emergency contraception is the obvious need to find a method of birth control that is effective and relieves you of some of the worry about unwanted pregnancy. Your time and resources might be better spent in discussing the various methods with your primary care doctor.

How much of the cost of Plan B will my health insurance cover?

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As long as a woman has a health insurance plan that offers the minimum of care required, all costs related to Plan B are covered. Your doctor may want to discuss other forms of birth control if there is a frequent use of this emergency contraceptive.

There are no real major health risks or cost prohibitions that make it necessary to curb the use, as needed. Progestin-only oral contraceptives, like Plan B, are on the list of 18 acceptable and fully-covered birth control methods.

The need for emergency contraceptive products have been an item that many women have had to bear without much assistance from health insurance coverage. There is now an increased importance placed on the overall reproductive health for women of all ages.

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