Many Illinois women paying for birth control pills, shots or patches are now able to pocket more prescription money. A law that took affect Jan. 1 forces state-regulated insurance companies that offer prescription drug benefits to cover contraceptives.
Kate McAdams, a 21-year-old student at Northeastern Illinois University, will save about $20 a month on her birth control pills.
It’s about time, she says. “It made me angry that something like Viagra can be covered and not birth control.”
McAdams’ parents were paying for the prescription, which was not covered by her father’s medical insurance, but as of this month, “I’m going to start paying for it, because it’s more reasonable,” she says.
Under the law, signed by Gov. Rod Blagojevich in July, coverage begins when the company renews its insurance policy–typically Jan. 1, although that’s not always the case.
“Some companies renew in different months of the year. When they renew [in 2004], women will [then] start to receive coverage for prescription contraception and office visits,” says Pam Sutherland, president of the Illinois Planned Parenthood Council.
About 40 percent of female workers in Illinois–about 1 million women–are expected to benefit from the law and may save up to $750 a year, Sutherland says. Because the law applies to insurers–not employers–not all workers in the state are covered. Companies that do not offer prescription drug benefits and those that are self-insured with custom policies are not required to provide contraception coverage. More than 30 percent of Illinois companies are self-insured, which means they are assuming the insurance risk for only their employees and are therefore exempt from the state law, according to a 2003 survey by the Management Association of Illinois.
The only way to find out if your employer is self-insured is to ask your human resources manager.
The law does not force the hand of those with religious objections, either. Through the Illinois Healthcare Right of Conscious Act, four religiously affiliated Illinois insurance companies also are not required to provide coverage, Sutherland says.
Advocates hope that the state law will encourage more self-insured companies to include coverage of contraceptives in their plans.
Coverage extends to all FDA-approved contraceptive drugs and devices, as well as the costs arising from related doctor’s visits–everything from birth control pills to cervical caps to hormone injections that require outpatient services.
The morning-after pill–the emergency contraceptive taken after intercourse–is included too.
Although some business leaders opposed the bill and claimed it would inflate costs, Denise Vuilleumier with the Management Association of Illinois says its membership of human resource executives have not called the help hotline with compliance concerns. “It hasn’t come up on our radar screens,” she says. “We haven’t heard of companies having problems dealing with this new law.”
Illinois is the 21st state to require private insurance companies to cover contraceptives. It’s a move that Sutherland says Illinois women should celebrate.
“Sometime during the year, 40 percent [of female workers] are going to receive contraceptive coverage they weren’t receiving before,” she says.
Beyond the pill
In the last few years, a growing number of birth control options have hit the shelves.
What’s new? What’s ahead? Here are some of the latest choices for both men and women:
Seasonale
An oral contraceptive with a 91-day regimen. Women take it in three-month cycles, reducing their total periods per year to four. Other birth control pills can be used similarly.
Failure rate: 1 percent (same as other birth control pills)
Downside: As with all such pills, it must be taken daily. Side effects include nausea, spotting and weight change.
Cost: $110 for three months (about $36 a month)
NuvaRing
A flexible ring inserted into the vagina for three weeks, then
removed for one week. The ring, which is about two inches in diameter, releases a combined dose of hormones.
Failure rate: 1 percent
Downside: Some women may find it
awkward to insert. Side effects similar
to other hormone methods.
Cost: $45
Lunelle
A hormone injection given once a month into a woman’s arm, thigh or butt. Delivers smaller dose of hormones than Depo-Provera.
Failure rate: Less than 1 percent
Downside: Requires monthly visits to the doctor.
Cost: $27
Ovcon 35
A chewable, spearmint-flavored version of a pill already on the market. May be swallowed whole, as well. Available only as a 28-day regimen.
Failure rate: 1 percent
Downside: Side effects similar to other oral contraceptives.
Cost: $35
Ortho-Evra
A patch, approved last year, which releases hormones into the blood through the skin. Women apply a new patch for three weeks, then allow a gap week for menstruation.
Failure rate: 1 percent
Downside: May not want to wear something visible. Only available in pink flesh-toned color so it doesn’t blend in with darker skin. Side effects similar to oral contraceptives.
Cost: $40 for 3 patches
(one a week)
Implanon
A new hormonal implant due out later this year. Unlike the old
Norplant system, Implanon contains only one tube (instead of six). Also, its stays implanted for three years instead of five.
Failure rate: In studies, not one woman became pregnant,
although no method of
contraception is 100 percent
effective.
Downside: Side effects similar to other hormone methods.
Cost: Not yet published
Lea’s Shield
A one-size-fits-all cervical cap. The barrier device may be reused for about a year.
Failure rate: Cervical caps have a 17 percent failure rate, when used with spermicide.
Downside: Can be difficult to insert, messy
Cost: $65
CycleBeads
Women move a rubber ring across a bead each day. White beads mean a window of fertility, brown beads mean pregnancy is unlikely.
Failure rate: 5 percent
Downside: A 12-day window that requires abstinence or another form of contraception
Cost: $11-$13
Male injections and birth control pills
Researchers are testing pills, injections and other forms of
contraception for men, although they won’t show up in the
marketplace for at least five years. Hormone-based methods reduce the sperm count to levels where pregnancy is unlikely. A study in Australia recently reported positive results: 55 men were
injected with hormones; none of the women got pregnant over the yearlong trial.
Alison Neumer, RedEye.
BY THE NUMBERS
– 38.6 million women use birth control
– American women will spend $2.8 billion on birth control pills this year
– One out of four couples rely on modern methods of birth control
– 85 percent of women who don’t use any contraceptives during intercourse become pregnant each year
