UPDATE: The open enrollment period for 2017 is over, but you may still be able to get coverage. Find out if you could be eligible for special enrollment.
By Sharon Levin of the National Women’s Law Center.
You’ve settled into your dorm room and checked out your classes, but there is one more thing you need to do to start the school year right: make sure you can get your birth control! Now that you’re back on campus, here are 6 questions to answer to make sure you’re covered.
1. Can I get birth control through my school?
If you have health insurance through your college or university, you may be able to get birth control through your student health plan. If your school has a student health center, you might be able to get birth control there too.
Find out if your school’s student health plan covers birth control.
The first step is to contact your student health plan and ask if they cover the type of birth control you use without cost-sharing. (That means you won't have any extra costs like copays or deductibles beyond what you paid for your insurance coverage.) If they do not, or if you can’t get a straight answer, contact the National Women’s Law Center’s hotline at Coverher.org—we may be able to help!
Here’s the background:
The Affordable Care Act (ACA for short, a.k.a. ObamaCare) requires all new health insurance plans—including student plans—to cover all FDA-approved methods of contraception (including emergency contraception) without any cost-sharing. To learn more, check out “Got health insurance? Hello, birth control options!”
There are some student plans, however, that the law does not apply to:
Self-funded student health plans—those administered by colleges and universities without third party insurers—do not have to comply with the preventive services requirement. It is estimated that there are approximately 200,000 students covered through self-funded student health plan arrangements.
Grandfathered health plans—although it is unlikely that a student plan will be “grandfathered,” those plans that existed before March 23, 2010, when the ACA was passed do not have to comply with the preventive services requirement.
If you attend a non-profit college or university that objects to covering contraception for students for religious reasons, you should still have your birth control covered through a process of the ACA that allows these schools to be “accommodated.” Under this process, the schools do not have to provide contraceptive coverage themselves—instead, the insurance companies provide it. If you attend one of these schools and are not getting your contraceptive coverage, contact Coverher.org.
Find out if your school provides birth control through student health services.
To find out your campus health center’s policy on providing birth control, you can check their website, call, or go there in person. Make sure to ask whether they provide the type of birth control that you need.
If your school doesn’t provide birth control at the student health center, check out Bedsider’s clinic locator to find clinics in your area.
2. What are my options if my school’s insurance plan doesn’t work for me?
If your school’s health insurance doesn’t provide birth control, you may still be able to get insurance that does cover it. Remember, under the ACA you must have health insurance or else you will be charged a penalty so it is very important if you don’t have insurance through your school that you get it another way.
You may be able to get or stay on your parents’ insurance: If you are 26 or younger, thanks to the ACA you can be covered by your parents’ insurance. Check with your parents to see if they have insurance and if they have you on their plan already. If they do, contact the plan to see if they cover your birth control method. If your parents have insurance but you are not currently on it, ask them to check with their human resources office (if they have an employment based plan) or with the insurance plan itself to find out if they can add you. Also, if you are going to school out of state, check to see if your parents’ plan places any limits on covering you that far out of network. If you’re considering this route, here’s some information about protecting your privacy while on your parents’ plan.
You may be able to get your birth control covered by Medicaid: In many states, Medicaid family planning coverage is available to many women who might not otherwise be eligible for Medicaid. Check the Medicaid website of the state where you live to see if you are eligible.
You may be able to get health insurance coverage through the Health Insurance Marketplace: Starting November 1, 2015, which is the first day of “open enrollment” period, you can buy an individual health insurance policy in your state’s health insurance marketplace. Or, under certain circumstances you might be able to get a policy sooner. You may even be eligible for a subsidy to make the policy more affordable. (Note that if you are a “dependent” on your parents or a spouse, their income will be included when your subsidy eligibility is considered.) Go to Healthcare.gov to learn more.
If you cannot get health insurance, or if your insurance doesn’t cover birth control, you may still be able to find free or low-cost birth control.
3. My insurance isn’t through my school—does my campus health system still take it?
This is a question for your campus health center and/or your insurance plan. Check with the health center to find out whether they take insurance other than the school plans. And check with your insurance plan to find out if your health center is in their network of health care providers—if it isn’t, the plan may not cover your birth control if you get it there. You should also ask what documents (photo i.d., copy of your parent’s insurance card) you will need when you go for your appointment in order to have the birth control and other services covered by your insurance.
4. If I need emergency contraception, do I have to pay for it? What about other over-the-counter birth control options?
Generally, health insurance does not cover over-the-counter birth control such as condoms, emergency contraception, or the sponge. However, if your medical provider gives you a prescription for the over-the-counter contraception your plan is required to cover it under the ACA.
Check with your campus health center to find out if they have emergency contraception or other forms of over-the-counter contraception on hand for students. If they do not, you should be able to get these at your nearest pharmacy or drug store.
5. What else should be covered by health insurance?
Well-woman visits: A well-woman visit is an appointment where you get your preventive care, like cervical cancer screenings, birth control counseling, and STI screenings. You can have as many of these visits you need in order to get all of your preventive care without cost-sharing.
Screening, counseling, and treatment for sexually transmitted infections (STIs)—including HIV: Under the ACA, screening and counseling for STIs including HIV must be covered by your health care plan without cost-sharing. The HPV vaccine must be covered as well for anyone in the recommended age range.
However, treatment of STIs and other health conditions is not required to be covered without cost-sharing. To find out what your plan covers and what you may have to pay out-of-pocket, you should check with your plan.
6. How do I know which birth control is right for me?
Under the ACA, contraceptive counseling should be fully covered by your insurance as part of your well-woman visits, so ask your health care provider to discuss your options with you. Discuss your health history, your past experiences with birth control, and other details of your life to determine which of the many birth control methods would be best for you and your circumstances. Bedsider has some tips for starting that conversation with your health care provider.
This conversation should also take place as your life and circumstances change. Here’s an example—you’ve been using the pill but are about to do a “Semester at Sea” and you won’t have many opportunities to get to a pharmacy. Maybe now’s the time to discuss changing to a long-acting contraceptive like an IUD.
Hopefully, your school year is off to a great start and you won’t have any problems getting your birth control or other sexual health services. However, if you have any problems with you insurance coverage, please contact the National Women’s Law Center’s Coverher.org website and we can assist you.
Sharon Levin is the Director of Federal Reproductive Policy at the National Women's Law Center. An attorney who has been working on women's issues for over 20 years, Sharon spends much of her spare time wondering how we can still have to fight to protect birth control access in the 21st Century.