Ask Cheasty: Will All Contraception Be Free on Aug 1?

Dear Cheasty,

Under the ACA, will the August 1 no-copay rule for contraception apply to EXISTING health plans or just new ones? And do you know if IUDs will be covered?


Confused About the Contraception Rule


Dear Confused,

What a great question! There has been a lot of chatter about the August 1, 2012 start date at which all insurance plans must provide co-pay-free contraceptive coverage. Before diving in to an answer, Confused, let me give a little background information for those who haven’t heard about this yet.

No co-pay, you say? That’s right.

If you are insured and using contraceptives (and by “contraceptive” I mean every FDA-approved contraceptive, from the pill to the patch, to the ring, to the shots, to IUDs and even tubal ligation) as of August 1st of this year, you will no longer pay any out-of-pocket cost for this coverage. Why? Contraception is classified as preventive care (in this case meaning you are preventing an unintended pregnancy and all the associated medical costs), and under the Affordable Care Act (the health reform law), preventive care must be covered by insurers out of the cost of your premiums. No more co-pays. Click here for a complete list of preventive care offered to women under this new rule.

So, to answer your question. The rules for contraception apply to all health plans EXCEPT those that are grandfathered under the “keep your health care if you like it” provision in the ACA. Click here for a full explanation of how plans are grandfathered, but in sum, it goes like this: the grandfather clause states that any health insurance plan in existence on March 23, 2010 does not have to comply with rules like this one for contraception. UNLESS that plan makes (or has made) “meaningful” changes to its plan (i.e., raising costs or reducing benefits for beneficiaries), in which case it does then have to comply. On the other hand, all new plans, or recently altered plans must comply.  

My advice? Call your plan to find out whether they are grandfathered or whether they will comply with the regulation.

As for whether IUDs will be covered, yes. All IUDs (intra-uterine devices), both hormonal and non-hormonal, are FDA-approved contraceptives. They will be covered under this ACA rule. Go forth and save money, my friend!

To a well and healthy Texas,

Cheasty Anderson

Posted in The Texas Treatment|Tagged , , , , , |

4 responses to “Ask Cheasty: Will All Contraception Be Free on Aug 1?”

  1. Laura says:

    Thanks for this! Now I get to find out if my plan “existed” before March 23, 2010 even though I only signed up for it on July 1 of this year… Or does that even matter? The whole thing is so confusing! Blarg!

  2. Cheasty says:

    Laura, good news! If you purchased your plan after March 23, 2010, you are NOT GRANDFATHERED. You’ll have access to no-copay contraception, guaranteed.

    • Al says:

      I’m female, but I go by Al. I became a dependent (domestic partner status) on my boyfriend’s employer sponsored health plan 9/1/11 aafter I lost my job. He’s had this plan since 11/09 by himself until I joined. Do I get no copay contraceptives? I also heard that some plans aren’t implementing the no copay rule until the start of their new plan years. Is that true too? Also, when I 1st got on the plan it was an HMO, now it’s a cross between a PPO & an HMO. The employer & insurance company are the same & so is the ID & group#, which I will not disclose for my personal privacy reasons. The change happened at the beginning of this plan year (2012), and I’m still paying a copay on my birth control. I don’t know if that helps or makes sense.

  3. Callie says:

    Just a little (sad) clarification on the IUD front, no, they are not in fact totally covered by all insurers. I know, right? I just called by insurer, twice, to inquire about the Paragard IUD, and they are 100% covered AFTER you meet your deductible, which, if you’re like me, is probably higher than $1000. Mine will actually be $5000. Incredibly bummed out.

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