dear senator, congressman, and/or mr president,

i pretty much want to throw up as i read through my health benefit plan options for 2013.

here are a few examples of one plan’s changes from last year.

We now provide benefits in full for certain contraceptive services and voluntary sterilization procedures for women when the services are performed by a Preferred provider. Previously, these services were subject to member cost-share.

We now provide benefits in full for generic contraceptive drugs and devices for women purchased at a Preferred retail or internet pharmacy, or, for Standard Option only, obtained through the Mail Service Prescription Drug Program. Previously, these items were subject to member cost-share.

We now provide benefits in full for over-the-counter (OTC) contraceptive drugs and devices for women only, when the contraceptives meet FDA standards for OTC products, and only when they are purchased at a Preferred retail pharmacy with a physician’s prescription. Previously, these items were not covered. 

and from another plan.

The Plan covers all FDA approved contraceptive services with a physician’s prescription with no patient cost-sharing in network.

last year, my plan only covered 85-90% of the cost of oral contraceptives. but i can now count on not having to pay for any contraceptives. those can be free. i could even voluntarily sterilize myself for free.

all in the name of protecting women’s reproductive rights. am i getting that right? that’s why contraceptives are free now? 85-90% coverage wasn’t good enough. having to pay anything was a violation of our rights as women. is that what sandra fluck was fighting for?

is anyone fighting for the other side? do i, as a woman, also have reproductive rights when trying to conceive as opposed to when i’m trying to prevent pregnancy? what would those be? and where can i find proof of them in my health benefit options? 

as i look at one plan, i see that there might be hope. under the heading “infertility services” i read that i only have to pay 15% of the plan allowance for preferred providers of “Diagnosis and treatment of infertility, except as shown in Not covered.”

here’s what “not covered” means. 

 Not covered:
• Assisted reproductive technology (ART) and assisted insemination procedures, including but not limited to:
– Artificial insemination (AI)
– In vitro fertilization (IVF)
– Embryo transfer and Gamete Intrafallopian Transfer (GIFT)
– Zygote Intrafallopian Transfer (ZIFT)
– Intravaginal insemination (IVI)
– Intracervical insemination (ICI)
– Intracytoplasmic sperm injection (ICSI)
– Intrauterine insemination (IUI)
• Services and supplies related to ART and assisted insemination procedures
• Cryopreservation or storage of sperm (sperm banking), eggs, or embryos
• Infertility drugs used in conjunction with ART and assisted insemination procedures

here’s what “not covered” means in another plan.

 Not covered:
• Infertility services after voluntary sterilizations
• Fertility drugs
• Genetic counseling and genetic screening
• Preimplantation genetic diagnosis (PGD)
• Assisted reproductive technology (ART) procedures, such as:
– Artificial insemination
– In vitro fertilization
– Embryo transfer and gamete intrafallopian transfer (GIFT)
– Intravaginal insemination (IVI)
– Intracervical insemination (ICI)
– Intrauterine insemination (IUI)
• Services and supplies related to ART procedures
• Cost of donor sperm
• Cost of donor egg

now, i admit that i don’t know every possible treatment that might be out there for infertility. but those lists look to me as though everything i’ve ever heard of fits nicely into “not covered.” the inclusion of “but not limited to” in the first list is especially convenient.

i’m not asking that (in)fertility services be covered in full. but it would be nice if they were covered at all. but i also don’t think that contraceptives should be covered to the extent that they are. i mean, does it make sense to you, my elected leader(s), that pregnancy prevention gets a green light and assisted baby creation does not?

do you think we could ask all the women in america who are using contraceptives as a means of exercising their reproductive freedoms to loosen their purse strings? would they be willing, in the name of women’s reproductive rights, to shoulder some of the cost, so that those of us who need help trying to get pregnant might have a slightly lower medical bill?

or should i be thinking even bigger? should i be asking questions about our society and what it values?

i am one of the lucky ones. i have a good job. my husband has a good job. we have been able to pay for these “not covered” treatments. but i have more than one friend whose job situation/income gives them little or no hope of ever affording them.

does that seem right to you?

sincerely,

alyce

p.s. there’s more to say about this. and perhaps i’ll say more later. perhaps i’ll really send a letter like this to my elected officials. do you think i could get a radio or tv talk show host (from the right or the left, i don’t care) to call me names? do you think the media would pick up my story and help get this message out there?

p.p.s. in case you’re thinking that i should be lodging my complaint at insurance companies, allow me to remind you that the patient protection and affordable care act (aka obamacare) mandates full coverage of contraceptives in all insurance plans as of august 2012. so yeah, my elected leaders need to hear about this.