HMOs exclude cost-effective birth control, study says Misplaced cost concerns blamed for omission

December 18, 1998|By KNIGHT RIDDER/TRIBUNE

While contraceptives might seem readily available almost anywhere today, many health insurance plans actually do not include coverage of birth control, or neglect to give information about the coverage they provide.

A new study says managed care organizations frequently offer no such coverage out of a misplaced concern about costs.

"It's undeniable that for an insurer to pay for pregnancy is many, many, many times more expensive than paying for contraception," said Rachel Gold, a researcher with the Alan Guttmacher Institute, a family planning research and advocacy organization that sponsored the study.

But when asked why they don't include contraception in basic coverage, managed care representatives typically said the costs are too high, according to the study.

But Gold said research indicates that basic contraceptive care would cost employers about $17 per employee per year, less than the cost of a one-month supply of birth control pills. "The cost savings come from preventing pregnancies," said Katie Reinisch, vice president of public affairs for Planned Parenthood in Denver.

According to the study, 21 percent of managed care organizations surveyed in five states offer little or no contraceptive coverage, and fewer than half of the plans informed recipients of whether they provide the coverage. Furthermore, only one in four managed care organizations have involved family planning agencies in their networks, and more than half of these agencies have no contracts with managed care firms.

The Alan Guttmacher Institute, based in New York, is an offshoot of Planned Parenthood, which operates many of those clinics that would like to hook up with managed care.

"Certainly access to effective and affordable birth control is the most important component in pregnancy prevention, and when almost half the pregnancies are unintended, it is shameful and short-sighted that insurance companies do not include contraceptives as part of their basic benefits package," Reinisch said.

HMO Colorado, a subsidiary of Blue Cross Blue Shield of Colorado, offers contraception as a standard benefit, says Neil Westergaard, Blue Cross media relations director. Its parent Blue Cross organization, however, offers the coverage only as an add-on to the standard benefit package, costing between $1 and $2 per month.

Pub Date: 12/18/98

Baltimore Sun Articles
|
|
|
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.