I thought health insurance had to cover birth control, but my plan doesn’t pay for the pill I’m on. Is that legal?

23 Jun I thought health insurance had to cover birth control, but my plan doesn’t pay for the pill I’m on. Is that legal?

Thanks to the Affordable Care Act, new insurance plans must fully cover birth control, including pills, rings, IUDs and more. (Even female condoms are covered, but your doctor has to write a prescription for them for you to get reimbursed.) Your plan might be grandfathered, though, meaning it existed before the law passed, so the new rules don’t apply. (Insurance plans will continue to lose this status, so it’s likely a matter of time before yours changes.) There’s a catch, however: Even for new plans, insurers are required to pay for at least one type of each method, but they don’t have to cover every product in all categories. They might completely cover a generic version of your pill but require a co-pay for the brand-name one, for example.

Still, that doesn’t mean you’re stuck. Plans will pay for a specific product if there’s a medical reason you need it. Your doc can help you request a waiver explaining why the pill you want is the best choice.