NWR: Health insurance rant/ BC help needed

theartistformerlyknownas · October 2014

melbenso said:

I was on the NuvaRing for a couple of years and switched back to the pill about a year ago. I use Ortho Tricyclen Lo. It's the lowest hormone dose available in the pill. (Aside from the ease of use of the NuvaRing, lots of people like it because it is a low hormone dose.) But honestly, my best advice would be to make an appointment at Planned Parenthood and talk to a doctor/nurse practitioner there about your birth control options. They are pretty much the experts, and if you are having problems with insurance, their birth control is all low cost or free.

Brought to you by your friendly neighborhood Planned Parenthood Volunteer Community Council Member.

loro929 said:

Yes, I agree with this. I also use the NuvaRing and it is not covered in my insurance and I pay $30.00/ month, which seems much more reasonable than what you have to pay with insurance "covering it".

That likely is covered by insurance. Mine was about $20/month with my insurance.It was much more without it before my insurance covered it. Despite the ACA's free birth control rule, not all health insurance plans are required to provide completely free birth control. Some plans like mine, especially for small companies, have been grandfathered in. So I still have to pay $20/month for it. Boo.

Yeah the $30 was likely the co-pay for the second tier of covered drugs, or at least after an insurance discount. Mine was technically "covered," but it was in the $45 a month tier, which I couldn't afford. The full retail prices without insurance as posted here: http://www.truemedcost.com/nuvaring-price/

$297 a month is still way high though - JC are you sure that wasn't the 3-mo price? How'd your appt go? Any luck with the samples?

JCbride2015 · October 2014

melbenso said:

I was on the NuvaRing for a couple of years and switched back to the pill about a year ago. I use Ortho Tricyclen Lo. It's the lowest hormone dose available in the pill. (Aside from the ease of use of the NuvaRing, lots of people like it because it is a low hormone dose.) But honestly, my best advice would be to make an appointment at Planned Parenthood and talk to a doctor/nurse practitioner there about your birth control options. They are pretty much the experts, and if you are having problems with insurance, their birth control is all low cost or free.

Brought to you by your friendly neighborhood Planned Parenthood Volunteer Community Council Member.

loro929 said:

Yes, I agree with this. I also use the NuvaRing and it is not covered in my insurance and I pay $30.00/ month, which seems much more reasonable than what you have to pay with insurance "covering it".

That likely is covered by insurance. Mine was about $20/month with my insurance.It was much more without it before my insurance covered it. Despite the ACA's free birth control rule, not all health insurance plans are required to provide completely free birth control. Some plans like mine, especially for small companies, have been grandfathered in. So I still have to pay $20/month for it. Boo.

^^ I was going to say this-- that lower cost is at least subsidized by insurance even though not "covered."

JCbride2015 · October 2014

lolo883 said:

melbenso said:

I was on the NuvaRing for a couple of years and switched back to the pill about a year ago. I use Ortho Tricyclen Lo. It's the lowest hormone dose available in the pill. (Aside from the ease of use of the NuvaRing, lots of people like it because it is a low hormone dose.) But honestly, my best advice would be to make an appointment at Planned Parenthood and talk to a doctor/nurse practitioner there about your birth control options. They are pretty much the experts, and if you are having problems with insurance, their birth control is all low cost or free.

Brought to you by your friendly neighborhood Planned Parenthood Volunteer Community Council Member.

loro929 said:

Yes, I agree with this. I also use the NuvaRing and it is not covered in my insurance and I pay $30.00/ month, which seems much more reasonable than what you have to pay with insurance "covering it".

That likely is covered by insurance. Mine was about $20/month with my insurance.It was much more without it before my insurance covered it. Despite the ACA's free birth control rule, not all health insurance plans are required to provide completely free birth control. Some plans like mine, especially for small companies, have been grandfathered in. So I still have to pay $20/month for it. Boo.

Yeah the $30 was likely the co-pay for the second tier of covered drugs, or at least after an insurance discount. Mine was technically "covered," but it was in the $45 a month tier, which I couldn't afford. The full retail prices without insurance as posted here: http://www.truemedcost.com/nuvaring-price/

$297 a month is still way high though - JC are you sure that wasn't the 3-mo price? How'd your appt go? Any luck with the samples?

@Lolo883 That $297 might have been for three months-- even so, way more than I'm willing to pay! I hope it was for three months actually because for one month would be crazy.

You saved the day with the samples! I asked my dr. and she remembered another branch which used to have samples, and they still do! So I am going to use a sample this month, which will give me some time to get an appointment for an IUD. I really prefer not to take a pill every day and the IUD is free with my insurance.

@Melbenso Thanks for the PP tip. I used to go there and loved it. I sort of don't want to take away their services from those who are in financial need-- I have the capacity to pay for BC, I just don't want to pay so much, you know what I mean? If I can't get an appointment soon for an IUD though, I will look into going there for sure.

theartistformerlyknownas · October 2014

Yay! I'm so glad it worked out!

hellosweetie1015 · October 2014

littlemushroom said:

hellosweetie1015 said:

littlemushroom said:

@hellosweetie1015‌ I am on Sprintec and it is $9/mo without insurance at Walmart. Maybe that brings it back into affordability range?

REALLY IT IS THAT MUCH CHEAPER? Yes, that's closer to affordable. I'll be moving my prescription today if my walmart's price is the same as yours.

ETA @littlemushroom you are the BEST.

Aw, thanks! I really hope your Walmart has the same price. Shop around if they don't. I know Schnucks has a $4 prescription thing that covers different things than Walmart, so you might have a store near you that has it on their cheap prescriptions list. Walmart just happens to be the most convenient to me, so I haven't shopped around much.

It does have the same price! Walmart is kind of way out of the way, but the pharmacy in my grocery store is more expensive than the CVS I've been at, so it'll be worth it. Plus - with the exception of meat and fresh produce - I can get groceries there. One stop, cheap BC... I'm down for a few extra minutes of driving.

slothiegal · October 2014

MagicInk said:

I'm just impressed you're brave enough to post about BC again considering what happened last time.

That's the whole reason I clicked on this thread

I'm so glad everything worked out, JC!

JCbride2015 · October 2014

slothiegal said:

MagicInk said:

I'm just impressed you're brave enough to post about BC again considering what happened last time.

That's the whole reason I clicked on this thread

I'm so glad everything worked out, JC!

Bahhhh hahahaha I had the same thought before I posted!!

JennyColada · October 2014

JCbride2015 said:

@Melbenso Thanks for the PP tip. I used to go there and loved it. I sort of don't want to take away their services from those who are in financial need-- I have the capacity to pay for BC, I just don't want to pay so much, you know what I mean? If I can't get an appointment soon for an IUD though, I will look into going there for sure.

You can still go to PP and pay. Generally it's only free if you make under a certain amount. I haven't been able to have free PP visits for like 5 years, but I still used to go just because it was so convenient. They don't take much insurance, but the prices still seem much more affordable than the average retail prices. So it's worth looking into anyway, and don't feel bad!

mrs4everhart · October 2014

I haven't read through the other responses, so this may have been brought up already, but can your doctor call them and prove this is medically necessary? (I'm not asking that bc I want you to answer the question on the Internet to a stranger you don't even like, it just helps build the rest).

If so, that could help tremendously. If your physician is particularly sympathetic s/he may be willing to use legally "scary" language such as "patient safety."

My Mom is battling cancer. She's also run operating and recovery rooms for 30+ years. When she started running up against insurance company bullshit she started using language that she (and her doctor) knew would, "persuade" her insurance company to do the right thing. Possible malpractice is pretty motivating. You're a lawyer. I bet if your doc is on your side you can get what you need cover, even if through slight, polite intimidation.

I get that time is of the essence but if they find in your favor they likely will reimburse you the money you had to pay out of pocket.

NWR: Health insurance rant/ BC help needed

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