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Health Insurance & Affordable Care Act

Consumers Expecting Free 'Preventive' Care Sometimes Surprised By Charges

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But according to a study by the Guttmacher Institute, a number of plans appear to be excluding the contraceptive ring and patch from coverage without cost sharing

"They're claiming that it's the same hormones as the pills, so it's the same method," says Adam Sonfield, a senior public policy associate at Guttmacher who authored the report. 

"The pill, the ring and the patch are different types of hormonal methods," said an HHS official in an e-mail. "It is not permissible to cover only the pill, but not the ring or the patch." 

The health law does permit plans to apply medical management techniques to "control costs and promote efficient delivery of care." So, for example, a plan may charge a co-pay for a brand-name contraceptive if a generic version of the same drug is available at no charge.

Implementing the preventive services provisions will require constant monitoring, "and not just through complaints," Pollitz says. "Because for every person who complains, there's a whole lot more who don't complain or don't even get the service."

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.

Fri, Jan 17 2014

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