How College Students Can Access Contraception Without Cost-Sharing
Earlier this month, a regulation that implements part of the Affordable Care Act took effect, ensuring that women have coverage without cost sharing for a wide range of recommended preventive services. Many of these services are especially important to improve women’s health, especially young women. The Department of Health and Human Services estimates that 47 million women with private health insurance will receive these recommended services without cost sharing.
The requirement applies to both group and individual new health insurance plans, and because student health plans are categorized under the Affordable Care Act as a type of individual health insurance, these plans will be subject to the requirement. The preventive services requirement, which includes contraception, says that insurance companies will have to cover preventive services with no cost-sharing for plan years that start on or after Aug. 1, 2012. Because college health insurance plan years tend to start in August—as opposed to employer-sponsored plans, which often begin in January—students will be among the first beneficiaries of this requirement.
Due to limited regulation of student health plans, each institution operates differently. So while guidelines are offered below, check with your university to find out exactly how your student health plan operates.
What can I get without cost sharing? (Services with * will be available without cost-sharing for new plans beginning on or after Aug. 1, 2012. Services without * were already available without a co-pay under Obamacare.
- Cervical cancer screenings, which are conducted with either a pap smear or HPV test
- Chlamydia screening
- Gonorrhea screening for women at higher risk
- Syphilis screening for women at increased risk
- Smoking and alcohol cessation programs
- Depression screening
- All FDA-approved methods of contraception, including emergency contraception, and contraceptive counseling*
- Domestic violence screening and counseling*
- HIV screening and counseling*
- Well-woman visits*
- Sexually Transmitted Infections counseling*
- HPV DNA testing for women 30 and older*
- Gestational diabetes screening for pregnant women*
- Lactation supports and counseling for nursing women*
How do I access these preventive services?
- All screenings can be conducted during your well-woman visit with a gynecologist at your campus health center, including STI screenings and HIV testing.
- In the case that your health center is unable to provide you with services required under this provision, they should refer you to another health provider. Your school-sponsored insurance will still be required to cover any services received “out of network” if they are not available “in network.”
- The provision covers all FDA-approved contraceptive methods, sterilization procedures, and family planning-related patient education and counseling. In your well-woman visit, you and your gynecologist can discuss what contraceptive method might work best for you.
- The oral contraceptive pill, the patch, NuvaRings©, diaphragms, the Depo Provera shot©, cervical caps, intrauterine devices, implantable rods, tubal ligation, and sterilization implants will all be covered without cost-sharing to beneficiaries. However, your insurance is allowed to cover only generic brands if they are available and equally effective. For more information about contraceptive methods and procedures click here.
- These methods, which include long-acting reversible methods as well as sterilization procedures, might not all be available at your college health center. In that case, you will need a referral to see another medical provider to obtain these services. Again, your school-sponsored insurance is required to cover these services if they are provided out-of-network if they are not available in-network.
- Emergency contraception will also be covered by your college health plan and may be available at your college health center. Plan B is available without a prescription if you are 17 or older, but you will need a prescription for Ella, another brand of emergency contraception.
What if I am refused birth control, emergency contraception, or other preventive services without cost-sharing?
- Look up your college or university’s student health insurance policy to see if it mentions the requirement. As each institution operates differently, the only way to find out exactly what is covered by your plan and whether it is in compliance with federal law is to refer directly to your plan documents. To begin, try entering “[College or university] student health plan” into a search engine. If you attend a secular institution, they are required to cover these services, but might be unaware. If you attend a religiously-affiliated institution, they might have taken an optional year-long waiver with regard to contraceptive coverage and those benefits will not go into effect until after Aug. 1, 2013.
- If your school’s health center refuses to cover preventive services, approach the administrators responsible for overseeing students’ health insurance or a student advocate (sometimes referred to as an ombudsperson). Also consider writing a letter or email to the administrators responsible, so that there is documentation of the lack of services provided.
- Are there faculty members who do research on these issues and are fluent on these policies? If so, see if they can help you and your fellow students receive these important services without cost-sharing.
- Address your grievances to your state insurance commissioner. Click here to find out who your state insurance commissioner is.
Note: You are also eligible to stay on a parent’s health insurance plan until you are 26 thanks to the Affordable Care Act. However, if your parents are opposed to contraception or you’d rather they not know what services you are receiving, keep in mind that your privacy may not be protected in billing statements or other insurance documents. Also, students will be eligible to purchase insurance in the new state-based health insurance markets known as exchanges beginning in 2014. For more information, click here.
Elizabeth Rich is an intern with the Center for American Progress, our parent organization.
For more information, visit the links below:
- Contraceptive Coverage Rule Is a Big Win for Students: http://www.americanprogress.org/issues/2012/01/college_contraception.html
- Young Women and Reproductive Health Care: http://www.americanprogress.org/issues/2012/07/youngwomen_contraception.html
- Young Americans: What No-Cost Contraception Means to Us: http://www.americanprogress.org/issues/2012/07/contraception_youth.html
- How To Find Out If and When Your Health Plan Will Begin Covering Women’s Preventive Services with No Co-Pay: http://www.nwlc.org/resource/how-find-out-if-and-when-your-health-plan-will-begin-covering-women%E2%80%99s-preventive-services-n
- Preventive services FAQ: http://www.nwlc.org/resource/access-preventive-health-care-women-health-care-law-frequently-asked-questions
- Contraceptive coverage FAQ: http://www.nwlc.org/sites/default/files/pdfs/contraceptive_coverage_faq_11.9.11.pdf
- Information on how emergency contraception works: http://www.nirhealth.org/sections/publications/documents/EC-One-Pager-3_15.pdf
More information on the preventive services required under the Affordable Care Act: http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html; http://healthreform.kff.org/notes-on-health-insurance-and-reform/2012/february/insurance-coverage-of-contraceptives.aspx; http://www.hhs.gov/news/press/2011pres/08/20110801b.html/
 Health plans that existed before the Affordable Care Act was passed are grandfathered under the law and not subject to this requirement. Check with your plan to find out if it is grandfathered.
 Only students at secular schools will be guaranteed no-cost coverage for contraception this year. Because religiously-affiliated colleges and universities that object to contraception can opt for a one-year waiver, students at schools that take the waiver will have to wait until August 1, 2013, after which point they will receive coverage for birth control directly from the insurer.