Yet another barrier to pregnancy prevention
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Posts: 6,651
I'm so pissed!! :evil: Here's the story:
A co-worker of mine has been on the pill for 15 years. Recently, our employer (the 2nd-largest employer in the state) switched prescription insurance plans, requiring that we get new (hard copy) prescriptions and send in a bunch of paperwork to continue our prescriptions. It took awhile for my co-worker to get in with her doctor for a new prescription and she's been exceptionally busy lately so has fallen behind on getting the paperwork sent off. Also, we only get paid once a month and many of us run out of money at the end of the month. We've all been REALLY broke with the holidays. So she couldn't really afford to set up the new prescription plan just yet (we now have to pay for 3 months at a time). Given that she's single and hasn't had sex in nearly 2 years, she figured a month laps in her coverage shouldn't matter. Besides, if by some miracle she did get laid, there are always condoms and even emergency contraception. What are the chances?
Enter Some Miracle. So last night she hears from an old boyfriend who had moved away and was back in town. He comes over, they have sex. Of course she insisted (over his protests) that they use a condom. So they used a condom AND he pulled out. But she's fearful that he didn't put the condom on in a timely manner. And she noticed right after he pulled out that he didn't have it on. Did he take it off when he pulled out or sometime sooner? She doesn't know.
Being well-educated about reproductive health, she wants to be really responsible. She goes this morning to the pharmacy for emergency contraception (AKA Plan B or the morning after pill). She knows it's available without a prescription. But the pharmacist says it's $50 without a prescription. This month is tight, money-wise. We actually got paid right before Christmas & the paycheck has to last us until the end of January - nearly 6 weeks. She still has $50 in the bank, but not all her bills have cleared yet. She really can't afford it.
No problem. She works here in the clinic & has a friend (me) who can get a prescription called in for her right away. So that's what we do and it should be all good, right? Wrong. Apparently this new prescription plan - which is also MY prescription plan and the plan for most state employees - doesn't cover emergency contraception!! :evil:
What the fuck??? How can it not cover emergency contraception??? Presumably it's because it's available without a prescription. But that's irrelevant if people can't afford it without a prescription!! $50 is a lot of money! I bet they cover other pills, with prescriptions, that are also available without them. She wouldn't have had a lapse in her birth control coverage anyway if her plan hadn't been changed!
I'm not saying there's nothing this woman could have done to avoid being in this situation; obviously she could have not had sex. But I am saying that she acted reasonably and the system is just total bullshit! :evil: And we wonder how responsible women get pregnant in this world. :roll:
A co-worker of mine has been on the pill for 15 years. Recently, our employer (the 2nd-largest employer in the state) switched prescription insurance plans, requiring that we get new (hard copy) prescriptions and send in a bunch of paperwork to continue our prescriptions. It took awhile for my co-worker to get in with her doctor for a new prescription and she's been exceptionally busy lately so has fallen behind on getting the paperwork sent off. Also, we only get paid once a month and many of us run out of money at the end of the month. We've all been REALLY broke with the holidays. So she couldn't really afford to set up the new prescription plan just yet (we now have to pay for 3 months at a time). Given that she's single and hasn't had sex in nearly 2 years, she figured a month laps in her coverage shouldn't matter. Besides, if by some miracle she did get laid, there are always condoms and even emergency contraception. What are the chances?
Enter Some Miracle. So last night she hears from an old boyfriend who had moved away and was back in town. He comes over, they have sex. Of course she insisted (over his protests) that they use a condom. So they used a condom AND he pulled out. But she's fearful that he didn't put the condom on in a timely manner. And she noticed right after he pulled out that he didn't have it on. Did he take it off when he pulled out or sometime sooner? She doesn't know.
Being well-educated about reproductive health, she wants to be really responsible. She goes this morning to the pharmacy for emergency contraception (AKA Plan B or the morning after pill). She knows it's available without a prescription. But the pharmacist says it's $50 without a prescription. This month is tight, money-wise. We actually got paid right before Christmas & the paycheck has to last us until the end of January - nearly 6 weeks. She still has $50 in the bank, but not all her bills have cleared yet. She really can't afford it.
No problem. She works here in the clinic & has a friend (me) who can get a prescription called in for her right away. So that's what we do and it should be all good, right? Wrong. Apparently this new prescription plan - which is also MY prescription plan and the plan for most state employees - doesn't cover emergency contraception!! :evil:
What the fuck??? How can it not cover emergency contraception??? Presumably it's because it's available without a prescription. But that's irrelevant if people can't afford it without a prescription!! $50 is a lot of money! I bet they cover other pills, with prescriptions, that are also available without them. She wouldn't have had a lapse in her birth control coverage anyway if her plan hadn't been changed!
I'm not saying there's nothing this woman could have done to avoid being in this situation; obviously she could have not had sex. But I am saying that she acted reasonably and the system is just total bullshit! :evil: And we wonder how responsible women get pregnant in this world. :roll:
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Most smaller,non-chain type pharmacies will set up a tab for you and put you on a monthly billing cycle.
I have no idea what this means.
I have never heard of any pharmacies in town that will do this, and since I run our EC hotline I generally keep up on these things.
Well $50 vs paying for a child? Big difference.
Anyhow, plenty of personal responsibility (her and him) on this one, but it should be far easier for people to get the prescriptions that they have in a timely manner and without all the paperwork hassle for sure.
Clariton is over the counter and you can't get reimbursed for that.
It's easy to blame the insurance companies but usually with scripts it has to do with the drug manufacturer. Prices for prescriptions do vary by location and company. The same drug at A walmart may cost less than at a CVS
Except that it's not $50 vs paying for a child. It's $50 vs a very small chance that you'll get pregnant. If there were $100 odds that you'd get pregnant, that would be different.
I think there are plenty of drugs that insurance will pay for that are also available over without a prescription. 800 mg Iburophen, for example. And I know there are allergy meds, stomach meds, etc. as well.
And the UK has a lower rate of unintended pregnancy than the US. Coincidence? I don't think so.
Though it still has the highest rate of teenage pregnancy in Europe.... Education WITH free contraception... that would be even better!
Yes, education too would be ideal. Do the other countries in Europe have both free contraception & education?
I wonder what the UK teen pregnancy rate is compared with the US.
I'm guessing she's an educated adult...I really don't feel sorry for her in this situation...
I wouldn't say she had poor planning or unprotected sex. She used two methods of contraception: condoms and the withdrawal method. Most people would probably view this as a perfectly reasonable contraceptive effort. She's just trying to go the extra mile and be hyper-vigilant to decrease her risk even further, and the system doesn't allow for that.
EDIT: The system does allow for it - if you're wealthy.
Where I'm not ugly and you're lookin' at me
No, she's not sure. After having been on the pill for so long, she doesn't have a regular period. Regardless, I don't think she'd want to take the chance.
Not sure what the rate is (I could google...) but I know the US is much higher than the UK. Also, I don't know of all European countries, but certainly the ones I lived in do not offer free birth control. Education is key in those countries and girls are much better followed (thus lower rate of cervical cancer, etc.).
Perhaps your friend could call your emergency contraception hotline?
She did, by calling me. That's how I got involved & one reason I feel so frustrated about not being able to help her.
Another noteworthy point regarding emergency contraception: Normally one can just take extra regular birth control pills, but the insurance companies don't allow for that either. If you take extra pills, your pack runs out early. The insurance companies refuse to refill them before the date they SHOULD have run out. So that just leaves the person uncovered for a week or so at the beginning of the next cycle, creating a two-week (or more) window when they could get pregnant (right during ovulation time).
I just think it's bullshit that people's medical care/decisions should have to be based on insurance company policies rather than on what they & their doctor decide is best for their health. :(
how did the "system" disallow her from personally purchasing the morning after pill...?
For one thing, there's a difference between failing to allow for something and DISallowing it. I didn't say the system DISallowed it; I said it doesn't allow for it.
I'm saying that the system, whose purpose is to provide a means for people to get healthcare, doen't work. Instead, it doesn't cover all pregnancy prevention medication, leaving it available only for women with an extra $50 to spare. It should be FACILITATING pregnancy prevention - that's what it's there for. (Plus, it's just stupid to not cover all contraception when, if a woman gets pregnant, the cost to the insurance company will be even greater for pregnancy.) Instead, it can create a barrier. (If my co-worker didn't pay hundereds of dollars per month for health insurance, she would have had the money to pay $50 for this pill.)
THE HEALTHCARE SYSTEM DOESN'T WORK PROPERLY. That's my point.
Can you just unsubscribe to the thread or something?
so this person does not send the paperwork in to get an updated prescription...she runs out of money because she can't budget....figured a month laps in her coverage shouldn't matter...she can't afford $50 for a plan B pill...and the "system" is at fault...
ok... :roll:
How did so many in this society seem to lose such a sense of personal responsibility?
was like a picture
of a sunny day
“We can complain because rose bushes have thorns, or rejoice because thorn bushes have roses.”
― Abraham Lincoln
No one is allowed to fail anymore, be it banks of kids in school, failure is not an option. Without failure, how is anyone supposed to learn from their mistakes? They don't.
If this actually worked, then great. But it won't. This whole system will FAIL if the people of this country keep giving their silent permission for these practices to continue.
No, she depended on the her partner to use a condom and pull out. If he was wearing a condom during the entire process, she would not have had to worry if he pulled out or not. So, I'm thinking she had to be aware at some point that a condom was not being used and took her chances based on the availability that she could get a morning after pill.
I have to agree with inmytree on this one. Her poor planning, her fault. Hopefully, it was just a bad scare and she's learned a valuable lesson for when the next 'miracle' comes along.
I think you're completely missing my point (and I'm starting to realize why people are so out of touch with reality around here). My point is not to place blame or remove personal responsibility. My point is to explain the reality of reproductive healthcare.
Whether or not you think it's reasonable for a woman who's not sexually active to think a short lapse in birth control coverage will not be a big deal, and to prioritize other expenses over this one, the point is that this type of contraception is meant to prevent pregnancy in just this type of situation, and yet it's not affordable and accessible, even to someone who's totally knowledgable about how to get it.
I very seriously doubt, by the way, that any of you guys would have made more "responsible" choices than she did. She continued to take & pay for birth control even when she wasn't sexually active, which most people think isn't necessary. She made sure the guy used a condom, which most people feel is all the contraception that's needed. (Do you all refuse sex with a woman who's not on the pill, or do you think a condom is protection enough?) My most societal & medical accounts, she was responsible and made sure to practice safe sex and probably doesn't even need EC, so how she came to need EC is not the point.
The point is that, when a woman needs/wants it, it's not accessible to anyone without extra cash laying around (which isn't the same as failing to budget, by the way). This is reality. Of course all of you still want to do the same old thing you always do and just blame the woman, complain about the problem of unintended pregnancy, and act like there's nothing we can do to help aleviate it. :roll:
Except that's not the case. She's just paranoid about pregnancy & trying to be extra responsible because of where we work. Plus, it doesn't change the fact that EC should be available to women who need/want it.
A woman with health insurance but without $50 extra bucks has sex and uses a condom. She wants to "back up her birth control" with EC. She can't get it.
How is the insurance company refusing to cover this kind of birth control any different than if they had refused to cover any other form of birth control? (The only difference I see is that people are more quick to judge women who use this kind of birth control.)
And why do people on here always complain about women having too many children or having abortions & yet refuse to acknowledge what our healthcare system can do about the problem?
Also, getting paid every 6 weeks? It sounds like the both of you have some things to iron out with your employer... For one, maybe you can opt out of your company's plan (or is it the state you work for?) and receive that money to put towards a plan of your choosing where the insurance company will cover everything you want it to? Best of luck with that... You may get EC, but maybe cancer treatment may be absent?
The lapse between plans that your friend had, when you think about it, opened her up to not being able to afford injuries from a slip and fall, or a malignant tumor, etc... things that could be harder to deal with financially speaking, than a mere $50.
I agree with you, it's bullshit. I don't know that EC should be covered or not if the insurance company is already providing one means of contraception in the plan, but I do know that none of this stuff should cost what it costs. Lawyers, politicians, and insurance companies drive up the price of EVERYTHING. Thank them all for working together to legislating their own power. It's long past due for a separation of corporation and state.