DWQA QuestionsCategory: Women's HealthI have employer-based coverage and I know my plan is not "grandfathered". Yet, when I recently filled my prescription for birth control pills, I was charged a co-payment. Aren’t those plans required to cover all contraceptives without cost sharing now?
HealthTNHealthTN Staff asked 5 years ago

I have employer-based coverage and I know my plan is not “grandfathered”. Yet, when I recently filled my prescription for birth control pills, I was charged a co-payment. Aren’t those plans required to cover all contraceptives without cost sharing now?

1 Answers
HealthTNHealthTN Staff answered 5 years ago

Yes, all non-grandfathered plans (plans that started or made changes after March 23, 2010) must provide contraception with no cost sharing. If there is a generic alternative to your birth control pills, you can be charged a co-payment for the brand name pill. Check with your provider if there is a generic birth control pill available that will work for you. If your birth control pills are already a generic then contact your insurer and request coverage with no co-payment. If there is a medical reason you need to use a brand name birth control pill, ask your doctor to help you request a “waiver” from the insurance company. The “waiver” would allow you to use the brand name drug with no co-payment.

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