“It’s not up to the insurance company whether to cover that method; it’s up to the provider,” said Adam Sonfield, executive editor for policy analysis at the Guttmacher Institute, a research and advocacy organization focused on women’s reproductive health.
But according to the National Women’s Law Center report, many insurers, patients and their providers aren’t aware of the requirement, and state agencies don’t enforce these so-called exceptions policies.
If patients run into trouble getting the method they want, “we typically recommend filing an appeal with their insurance provider,” said Gretchen Borchelt, vice president for reproductive rights and health at the National Women’s Law Center.
Stephanie Force said she was unaware of any process she could have used to get the NuvaRing covered without cost sharing. Neither her health care provider nor the insurer mentioned the possibility.
She recently had an appointment with a new provider, who she hopes will be a better advocate for her. ——— (KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.) ___ Distributed by Tribune Content Agency, LLC.