Question

I went to the pharmacy last week seeking Plan B, but I was told I would have to pay for it. I thought my insurance covered emergency contraception, how can I fight this?

Answer

Plan B is one of nearly two-dozen brands of emergency contraceptives in the United States. Emergency contraception is used to prevent an unplanned pregnancy that may occur due to failed contraceptive methods or sex without a condom. Plan B should be taken as soon as possible, within 72 hours of having sex, in order to be most effective. The cost of Plan B is about $40 - $50 and the generic brands range from $35 - $45.

In 2013, the FDA approved Plan B for over-the-counter (OTC) sale with no age restrictions. This means you don’t need to show any form of ID when purchasing emergency contraception. Insurance companies, however, are not required to cover OTC contraceptives if your doctor does not prescribe them. As a result, if you buy Plan B without a prescription, you will have to pay full price (some states are working on changing this and Maryland recently passed a law that would require insurance coverage of OTC contraceptive products).

There are ways to get Plan B and other emergency contraception without having to pay for it. Your insurance will cover the cost completely if a doctor prescribes the emergency contraceptive. If you obtain a prescription and your insurance still refuses to cover your emergency contraceptive costs, you can call your insurance company to dispute the charge, or the National Women’s Law Center hotline. Additionally, contacting your local health department or local Planned Parenthood may result in reduced costs for emergency contraceptives if you qualify based on your income.

For more information about emergency contraceptives, see these sources:

Quick facts about emergency contraceptives - https://www.nwhn.org/emergency-contraception/

Types of emergency contraceptives and how they work - http://kff.org/womens-health-policy/fact-sheet/emergency-contraception/

Birth control coverage under the ACA - https://bitchmedia.org/post/how-will-the-affordable-care-act-affect-my-birth-control-coverage-on-october-1st

Common questions about emergency contraceptives - http://ec.princeton.edu/questions/dose.html

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