Can someone explain Obamacare and BC coverage to me

[Deleted]

My mirena is about to expire. 

Apparently it isn't covered according to my insurance co. BCBS. It is going to be $800 OOP to have this sucker replaced. Much cheaper than a baby, but I'm now pissed because I would have had it removed and replaced in December if I had known because I had already met my deductible for the year. 

[Deleted]

FWIW we switched insurance carriers 1/1/13

[Deleted]

No idea on Obamacare but maybe see how much planned parenthood will charge.

[msmerymac]

All I can tell you is that there's a list of BC pills that ACA is supposed to cover outright, and my old insurance company still wasn't covering mine, despite being on the list. AND my policy renewed in October.

I have new insurance now with a $0 copay, so we'll see what exactly that means.

[Deleted]

Some insurance contracts are grandfathered too. Mine still requires a copay for annual visits and birth control.

[Deleted]

but this is a brand new contract that went into effect 1/1

[Deleted]

Is it a new contract that your company just negotiated? Or did you simply switch options that your company had?

Disclaimer--I'm not in HR or in the insurance field any more. I just know as employees we can switch every November, with the new policy choice effective Jan 1. But the actual contract between our company and the insurance company is grandfathered, so it makes no difference if I just joined this policy Jan 1, it is still grandfathered (if that makes any sense).

[Deleted]

Mar 15, 2013 11:02:01 GMT -5 @historychick79 said:

Is it a new contract that your company just negotiated? Or did you simply switch options that your company had?

Disclaimer--I'm not in HR or in the insurance field any more. I just know as employees we can switch every November, with the new policy choice effective Jan 1. But the actual contract between our company and the insurance company is grandfathered, so it makes no difference if I just joined this policy Jan 1, it is still grandfathered (if that makes any sense).

brand new contract. we changed insurers. 

[Deleted]

Well, then that sucks. Maybe your HR can double check if it is supposed to be covered and the rep at BCBS is clueless? One can always hope, right?

[SusanBAnthony]

Mine was 700 something. Then I got my gynecological oncologist to write a letter that I needed it for endometrial cancer risk reduction so they covered it all.

So possibly you could acquire a genetic risk of lady-parts cancer and then they would cover it?

[Melissa W.]

Mar 15, 2013 9:59:28 GMT -5 @septimus said:

My mirena is about to expire. 

Apparently it isn't covered according to my insurance co. BCBS. It is going to be $800 OOP to have this sucker replaced. Much cheaper than a baby, but I'm now pissed because I would have had it removed and replaced in December if I had known because I had already met my deductible for the year. 

I just had mine put in January. We've had the same insurance company (BCBS) forever. They covered it completely. I was surprised at the cost though.

The OB ran the following through my insurance:
-Surgery-$400
-Mirena- $800
-U/S- $270
-Lab- $20

Then there was a Quest charge for $191.

Total cost was $1,681. I don't think there was anything special about the procedure for me. 

[EllieArroway]

BCBS just covered my mirena 100% in January.

[MrsAxilla]

Ditto Habs on Planned Parenthood. They put in an IUD for me when my OB couldn't get my in soon enough. I think it was about $100, but I'm completely sure. They'll charge you on a sliding scale anyway.

[gault]

From what I can recall, MOST bc is covered completely. There's still a list of brands and preferred names, etc.

I'm sorry, that sucks.

[Bad Dingo]

Mar 15, 2013 12:34:07 GMT -5 gault said:

From what I can recall, MOST bc is covered completely. There's still a list of brands and preferred names, etc.

I'm sorry, that sucks.

This.  Your insurance has to cover something, but not necessarily the brand or device that you are using.

[PinkSquirrel]

Insurance companies are sucking wind at following the Obamacare regulations with regards to preventative care ie we paid $80 for flu shots that had to be reimbursed and a lot of people are being charged for the pill when they go to pick it up only to call their insurance company to complain and the insurance company says send your receipts we should be reimbursing.

So, just because that's what's showing up in the systems doesn't necessarily mean that's what you should be getting quoted. Have you talked to BCBS directly and asked them specifically why this isn't covered under ACA?