Story No. 451: Patient from Illinois

I switched my health insurance for 2018, and at the time of my switch I was taking an oral contraceptive that was listed as covered under what would soon be my new health insurance plan.

However, when I went to pick up my prescription in January 2018, my co-pay was now $55/month. I called my health insurance company and spoke with a representative, who told me that each oral contraceptive had a different co-pay, and gave me a website where I could type in the name of the contraceptive to find out what the co-pay would be.

So, I spent approximately four hours typing in over 100 brands to discover that all forms of Yaz and Generic Yaz had been removed from the coverage list, and that there was a new list for 2018 that no one had informed me of, including the multiple people I had spoken with over the phone.

I was provided with the suggestion to switch to a different brand of oral contraceptive; however, that would mean changing the hormones that go into my body and affecting the reason that I was actually taking an oral contraceptive in the first place. It was something I was not comfortable with and also something that I don’t feel my health insurance should be dictating over my physician.

As a result, I made a plan to meet with my doctor regarding an IUD placement, which was covered under my plan (again, it is my health insurance dictating my health care versus me making a decision about how my body will be treated). However, due to appointment time frames and the need to wait for placement of the device, I had to go three months without birth control. During this time, I had a need for an emergency contraceptive. Again, under my new plan, only one emergency contraceptive is covered, and this one requires a physician’s prescription. I spent the next 48 hours feeling very anxious, nervous, and scared as I attempted to get a hold of my physician to get an order to obtain the emergency contraceptive pill to be used in the recommended 72 hours. In the end, it felt as though the whole system wanted me to get pregnant.

Throughout the whole process, I felt as though the people dictating the rules for health care coverage do not care about the coverage itself or providing safe preventative health care for women. To have removed an entire version of an oral contraceptive, one that helps for many more things than just preventing unwanted pregnancy, made it feel as though they did not care about my physical or mental health. I am an educated, middle class female who works in health care and has access to many resources and support systems; and still I felt frustrated, confused, and alone in the system. I cannot imagine the struggles others face who are placed in similar situations without the experience or support that I have.

Thank you for listening to my story.