Questions? Call today.
Coverage Options

Birth Control and Health Insurance

Birth Control and Health Insurance

The refusal of so many health insurers to cover contraceptives for women is one of the oldest disparities in the health insurance industry. In what many women's rights advocates regard as an illogical inconsistency, more than half of prescriptions for the anti-impotence drug Viagra received health insurance coverage in 1998. A 2007 Mercer study of large employers revealed that only about 30% denied coverage for erectile dysfunction medications. By contrast, about half of all major health insurance plans do not provide routine contraceptive coverage for women. Though states have begun enacting legislation to rectify this inequality, affordable contraceptive backing remains out of reach for a large number of women with health insurance.

The Facts

Over half of the states in the U.S. have enacted legislation requiring insurers that provide prescription drug benefits to also offer some birth control support. In 1998, women's right proponents also won a major victory that required health insurance coverage for contraceptive drugs and devices for all federal employees. Many liken health insurers' reluctance to provision contraceptives to their former hesitation to cover prenatal care. In fact, health insurers did not begin covering prenatal care until about 25 years ago. Here are some other interesting facts on insurance safeguards for pregnancy prevention:

  • 49% of large group health plans do not routinely cover birth control
  • 97% of large group plans provision prescription drugs, but only 33% of those plans provision oral contraceptives, which are the most popular method of reversible female pregnancy prevention in the country
  • A paltry 15% of large group plans cover the five most common forms of birth control: oral contraceptives, diaphragms, IUDs, Depo Provera, and Norplant
  • Women age 15-44 pay 68% more for out-of-pocket healthcare costs than their male counterparts, largely due to the cost of reproductive healthcare

Why Offer Contraceptive Coverage

Advocates of full birth control coverage by health insurers contend that reimbursing women for the cost of pregnancy prevention, an average of about $30 per month, is much cheaper than paying for a unplanned pregnancy or an abortion down the line. Some analysts estimate the full coverage of contraceptives in large plans would only amount to about $16 extra per person. One of the most persuasive arguments for contraceptive coverage is the fact that the overwhelming majority of insurers will pay for drugs that treat impotence, but they refuse to pay for birth control pills. The fact that erections warrant insurance coverage but oral contraceptives for women don't is a sexist notion, in the view of some advocates.

The Opposition

Opponents of insurance coverage for family planning have two central arguments. One, the rise in premiums that would ensue if insurers covered all common forms of contraceptives is simply not worth the $30-per-month average cost of most birth control. Secondly, some insurers argue that pregnancy is not a medical condition, whereas erectile dysfunction is. Thus, protection is justified in the one case but not the other.

Next Step

Most Recent Articles

Other Products