The Affordable Care Act, also known as Obamacare, has been the law of the land since 2010, but some people are still parsing out exactly what it all means—and overlooking some of the happy benefits (like no co-pays for birth control!). Some branches of CVS Health may have forgotten that particular amendment—or at least, their computer system has. The pharmacy recently admitted to charging approximately 11,000 women co-pays for their birth control prescriptions when they should have been covered by the ACA. A spokesperson for CVS told The Hill that this was a coding glitch that affected women who were enrolled in a certain health plan that CVS works with.
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Luckily, these women have a congresswoman on their side. Rep. Jackie Speier (D-Calif.) wrote a letter to Larry J. Merlo, the CEO of CVS Health, to express her dismay after one of her own staffers was charged a $20 co-pay when picking up birth control in Washington, DC. CVS responded immediately that the coding error will be fixed, and all of the women who were illegally charged will be reimbursed by October 1.
“Although my staff member’s issue was eventually resolved a week and numerous phone calls and pharmacy visits later, I am concerned that most women who are likely not as familiar with their rights under the ACA may go without this essential family planning service that is supposed to be guaranteed to them under law," wrote Speier in her letter to Merlo.
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She's right: Despite the fact that ACA has been around for years now, it's still not as widely understood as we would hope. But here's the thing: All FDA-approved methods of birth control are covered at no cost (unless your health insurance comes from an employer with a religious exemption to the contraceptive coverage). However, your insurance company may limit which brands or methods are covered and which still charge a co-pay. (For instance, they might cover generic prescriptions but not name brand ones, unless your doctor specifically requests it for you).
That said, if your pharmacy tries to charge you a co-pay for birth control, call your insurance company ASAP to see if it should actually be covered at no cost to you. And if you are a customer at CVS Health with benefits covered by the Pharmacy Benefit Manager CVS Caremark and you think you may have been charged, Speier suggests calling 1-800-704-6589 and asking to speak with a Tier 2 representative or supervisor about the birth control illegal co-pay charge.
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