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Female Finance: Birth Control Costs

April 8, 2008

If you are a nitpicker, you would notice that no health care costs are included in my budget. I have $70 pretax taken out of each check for my Health Savings Account (HSA) and my employer contributes about $30. I’d be shocked if I spend it all, and I pay for all health care costs with that money, which I sort of ignore in my budget. But today, I want to address my most expensive health care cost: preventing my body from spontaneously creating a new life.

I’ve never liked the idea of taking a pill, particularly a finicky one that insists I take it at the same time every day if I want it to really work. I know I can be spacey about that kind of thing whenever my routine is adjusted, and the NuvaRing sounded so nice an convenient at once a month. I signed up and have used it off and on for years. I don’t remember the original cost, but I got them for a reasonable price through the student pharmacy at my college, in the $20 range. Last year, I was paying around $42/mo (pre-tax money) for the NuvaRing. This past week, i noticed it had increased to $52. Really, I’ve had enough! I looked online to try to score a better deal, but no dice, even ordering from Canada (which may or may not be legit).

Part of this is my own choice of health plans, but let’s just leave that aside for now. I really don’t understand why birth control isn’t covered as a preventative drug. It prevents pregnancy, an arguably expensive condition (that results in an even more expensive child)! Probably because it would cost the insurance companies too much money to cover something that many women are almost required to take on a daily basis (or risk children they are not ready for).

What about condoms? They are cheap, right? Well, not cheap, but I’ll just admit that we have never spent $50/mo on condoms! Condoms are less effective, and T is hyper concerned about pregnancy. Using condoms as our sole form of protection really doesn’t appeal to me either. I have a nephew that resulted from that method!

The NuvaRing is becoming an unjustifiable expense in my budget and condoms do not provide enough protection (at least to ease my mind). What about the obvious answer, the Pill? Despite the annoyance of having to take it every day and be really diligent, I may end up switching to this less desirable (to me) method because of cost. But what is the cost? I don’t know yet. I estimate I can get at least some brand for $25/mo or so. Even with my income, planned parenthood will give them to me for about that. Walmart has a few brands for $4 or $9 (!) but that deal is not applicable for residents of some states, including mine. Besides, the walmarts around here are extra sketchy (so I’ve heard).

What about those student discounts? In the fall I will be getting a student ID (legitimately, as a part-time grad student), so can’t I get those discounts again? Nope! Turns out that trend is over. I can imagine this is impacting many young females on college campuses around the country.

One final option I’m going to discuss with my doctor is an IUD. It is non-hormonal and you put it in once and you are good for 10 years. You can take it out if you change your mind. There are some undesirable side effects and reasons they don’t recommend them for childless people, but this is not a women’s health blog, so you can find those elsewhere. I once heard the cost of insertion is $300, but I suspect it will be higher. (On a separate issue, I’ve found it really difficult to begin to select a doctor. I can get a list of doctors, but how do I know if I’ll like them? And do I need an OB-GYN or just a regular MD?) I know for sure that I don’t plan on having kids until T is done with grad school (at the earliest!) so that means at least 3 more years. It is something to consider, and I like the non-hormonal part. I was surprised that just 1.3% of women in the U.S. use it, while it is the most popular method in the world. I really like this idea, but I have a feeling that my doctor will talk me out of it, or the up front cost will be high.

To sum it up, here are the options I’ve come up with so far, all in pre-tax dollars:

  • Condoms: Maybe $150/yr, but not enough protection
  • NuvaRing: $600/yr
  • The Pill: Estimated $300/yr
  • IUD: ??? One time (per 10 yrs) cost of $300+
  • Abstinence: $0, but perhaps my happiness and/or my boyfriend

Gosh we women get ripped off. . . (Although any male paying $50/mo for condoms has my sympathy too.) Also, why aren’t feminine hygiene products eligible for my HSA spending but band-aids are? The sort of do the same thing. Ok, not at all, but still! I consider them a necessary health product but I guess they aren’t.

I missing any options regarding birth control expenses? What do you pay per a month?

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28 Comments leave one →
  1. April 8, 2008 9:14 am

    I recently switched to Seasonique, which has the extended 13-weeks of hormone pills, one week of sugar pills, and I’ve been very happy with it. HOWEVER, whereas my insurance used to cover my regular (brand name) pills with no restrictions, I am warned that they will not cover this after a year since it is a “long term medication”.

    Why the difference? Shouldn’t a prescription that only has to be refilled four times a year instead of twelve times be more cost effective? Why punish someone attempting to prevent bringing them more costs by getting pregnant unexpectedly?

  2. April 8, 2008 9:19 am

    Ick. Reproductive health is such a frustrating issue I think.
    I’ve heard bad things about the IUD–but I have no idea if any of them are true or just hearsay. I think with something like birth control its important to do what is going to be most effective / useful for you. A friend of mine who is currently on the pill has a daily reminder set on her phone so she will remember to take it, and that works for her.
    When I was on the pill I discovered that (for some weird co-pay type reason) it was actually cheaper to buy it 6 months or more at a time, if the insurance company was willing to sign off on it(after much prodding from my doctor they finally did–I think she finally said I was doing the whole no-period-at-all thing)that was strange but it did work–my insurance company’s web site listed all of the pricing stuff, which is how I figured that out–you might check and see what yours says. I always took it when I put in my contacts in the morning, that made it easy for me to remember.

  3. amy permalink
    April 8, 2008 9:25 am

    If you go with the pill, you may have to try a few before you find one that you and your body like. I was on one and it made me super sad the week before – told my doc, off that one, on to another one. I’m on Kariva. It has a similar hormone level all through out the entire 28 days. (my body can’t handle the up and down one). I’ve been on it for almost a year and really like it. I have no issues and pain is down and best – NO BABIES!!

    But above all, listen to your body and research and talk to your doc. Ask ladies at your work what doc they like. I did and found a great one.

    My doc is a reg doc / family doc, so I go to her for everything.

  4. karen permalink
    April 8, 2008 9:38 am

    It depends on your insurance/company. My Depo is covered; I pay less than $10 for it (maybe around $65-70 per dose without. However, it’s not for long term use as it can cause bone density loss. I’ve used it for years with some breaks in between).
    Also, my company has the mail order prescription plan that you have to get long term medicines in bulk, like the BC, 3 months at a time (or something. My Depo isn’t required to be bought through the mail order so I’m fuzzy on the particulars).
    Birth control are eligible FSA Health Care Expenses; not sure about HSA, if there is a difference.

  5. April 8, 2008 11:10 am

    If I had my way, birth control in all its forms would be free and available without a prescription whenever possible. I’m SO with you on the feminine hygiene products–also, there is sales tax on these in most states, which is absolutely ridiculous!

    I’m not crazy about the Pill…my periods have gotten a bit weird and I kind of don’t like the idea of being on it for years and years…but like you and T, we’re not comfortable relying solely on condoms.

  6. LJK permalink
    April 8, 2008 11:13 am

    I’m on Yaz and because I have the high deductible plan with an HSA now, I was able to get a 3 month supply from my local pharmacy. I’m not sure if I got a multi-month discount or if the negotiated price was lower than it was with my old insurance, but it came out about $5 cheaper per month. For $150 and some odd cents I got a 3 month supply.

    Also, when I mentioned to my nurse practitioner at my last annual that I’m now on a HDHP, she gave me 3 months worth of samples. I wont have to buy BC again until the fall!

  7. April 8, 2008 11:28 am

    I think men should have to pay for birth control too!! lol. I’m only half kidding (hey, it’d be nice, right?) With my mail-in prescription plan I get a 3 month supply of OTC-lo for $100. It sucks compared to the $10 packs I used to get at my school’s clinic, but if I bought it per month it would be $50 each.

    I would try the generic pills, but my sister mentioned to me that she started having huge mood swings on those, so I’m a little scared to, but I suppose everyone reacts differently.

    This is one of those things I don’t really skimp on. (This, and my eyes) I think that cutting costs may not be worth it if it will be interfering with your quality of life (meaning mood swings, unfavorable changes in your body….or accidental pregnancy!!) Go with what you’re most comfortable with and will give you peace of mind.

    I’ll be very excited when that male birth control pill comes out though!! ;-)
    (lol. Actually, I’m not sure I could trust my boyfriend to take a pill every day at the same time…)

  8. Janet permalink
    April 8, 2008 1:23 pm

    I totally hear you. Can I add my own personal pet peeve? The mail order pharmacies are set up to give you a “90 day supply” for a set price. But with the pill, it’s not 90 days per 3 months, it is 84 days. I get cheated out of a month almost every year and have to pay for that “hidden” month.
    Also, quarterlifegirl, as long as the generic has the exact same chemical names and dosage, it should be the same, but be mindful of substituting desogestrel for levonorgestrel, (or other substitutions).
    There is Ortho-Evra, the patch which only needs replacing once week but it is more expensive and I would be concerned because it may deliver more estrogen than necessary. BTW, I am also on Kariva.

  9. April 8, 2008 2:06 pm

    You definitely need to see an OBGYBN who will be more familiar with all the costs and side effects of the various methods. And FYI I spend $54/mo on birth control pills (Yasmin), and that’s after my Blue Cross discount (without it they’re $65/mo).

    My other BC pill (ortho-tri-cylen) was also around $50/mo. Sure, you can just go for the cheapest one, but that might very well be the one that F’s with your hormones the most, causing unpleasant side effects such as weight gain, acne, and raging anger/depression/panic.

    You’ll need to be prepared to try and potentially switch from one medication to the next before you find the best one for your body – which could take a year or more since you really should stay on one pill for at least 3 cycles to get used to it and see how it really affects you.

    It sucks, but it’s better than having a baby prematurely!

  10. April 8, 2008 10:07 pm

    Well this stinks. No one had a magical solution for me??? You know, free, won’t mess with me/my body, won’t allow a baby to form (yet).

    Hmph.

  11. April 9, 2008 4:15 am

    You said the school isn’t offering discounts anymore? In college I got 12 month supplies of pills for $5 a pack. (I’m was on desogen, one of those with the same level of hormones). It was great. Then my insurance was $5 a pack for a while, but now is $10 (for generic, Aprii). I don’t really mind the double in price.

    I don’t really like being on it for so long (3 years now) but I haven’t had any ill effects. I found that taking it at the same time wasn’t really hard, just find something you do at the same time (or close) every day, like lunch or dinner or watching the news, and pair it with that.

    I also agree, talk to your GYN about the options. I’d rather take a pill than insert something, but each has risks.

  12. Carol permalink
    April 9, 2008 8:42 am

    If you go with the pill, be sure to ask your doctor (whichever one you pick) about samples. I was able to get a 3-month supply of each one I tried for free.

    I finally settled on just returning to the NuvaRing (which I’d previously dropped because of the cost). I’m now paying $13.97/mo after my insurance (it’s $60/mo originally here, I think).

  13. April 9, 2008 9:54 am

    It’s outrageous that most insurance doesn’t cover birth control for its normal uses. My birth control is covered, actually, but that’s probably because I take it under the aegis of my polycystic ovarian syndrome, which requires hormonal intervention. I use the NuvaRing, & like it lots.

    At my college, they used to sell packs of pills or patches or the ring to students for $5 a pop. I’m not sure how they managed to do that–selling samples? eating the cost difference?–but it sure made my life (and my friends’ lives) much easier.

    Anyway, my sympathies. I might also advise looking into this with your doctor: is there any way s/he could shoehorn in birth control under some other medical rubric, so that it would be covered by insurance?

  14. Velocitygrl permalink
    April 9, 2008 1:23 pm

    I’m going through the same thing. I have been on Nuvaring for several years and love it. I’ve decided just to stick with Nuvaring for now. I have been shopping around, and it pays to look around. I found a $15 price difference between the different chain pharmacies in my town, and many of them price match competitors. The best deal I found here was Sam’s Club at $45.88/month, and they say you don’t need to be a member to get pharmacy stuff.

    I agree w/ PP- birth control should be free and freely available.

    I just left grad school, and the reason for the change in the birth control being cheap was that before, the companies would give the university a deal where the BC was just pennies, in order to win some young customers. Unfortunately, there was a ruling on some federal government medical programs that if the companies give a deal to one agency (the University), they must give it to all government agencies (i.e. medicaid, medicare (though they probably don’t need it)). As a result, the companies started charging the Universities much higher prices, and the Universities had no choice but to pass that on to students. However, my Nuvaring was still far cheaper than in the public markets- something like $33 vs somewhere between $45-$60). I think they sold it at cost there.

    One other tip- you can also try getting gift cards ($20-$25) by transferring your prescriptions to a new pharmacy (I found some of these for Walgreens, Rite-Aid, CVS). I learned about this recently, and some pharmacies will honor each other’s coupons too. Unfortunately, the Target near my house doesn’t honor competitor’s coupons, so that is a bummer, but some pharmacies do. You could get some gift cards towards some other stuff this way.

    Let us know how much you end up paying! I may have to re-evaluate whether my Nuvaring is still worth it.

  15. April 9, 2008 2:41 pm

    You should call your gyno first. Sometimes they have TONS of samples of these. Last time, my gyno gave me six.

    Years ago I got Nuvaring at Costco for $35/month. My student insurance wanted a $40 copay, so I just got it there.

  16. April 10, 2008 7:07 am

    When I was in college I went to planned parenthood and was able to get 12 month supply of pills for FREE! I still have some of those left over but I’ve stopped taking them because I think they made my face break out like crazy (as you can see my priorities are great .. clear skin vs. pregnancy?)

    Anyway, I started taking Yasmin, I have a $250 deductible with my insurance that I haven’t reached yet, so its about $60 for 3 months, or $20 a month.

  17. April 14, 2008 6:09 am

    Wow. it’s covered under Canadian healthcare

    Linessa was about $150 for 6 months
    Yasmin was about $55 for 3 months

    And I just pay 10% of whatever I buy

  18. April 16, 2008 4:25 pm

    You should probably see a gyno. They will have more detailed info on the range of options and possible side effects.

    Looking for a new doctor is a pain that I’ve been putting off for some time now so I have no suggestions. The last office I went to charged everything as outpatient visits, which my insurance then didn’t cover…

    A few others have mentioned it, but the 3 month mail order thing is great. A few years ago I saved approx $40 every 3 months by ordering this way. Check with your insurance and also with a few local pharmacies.

  19. April 16, 2008 7:46 pm

    Planned Parenthood has a sliding-scale fee basis, so you might be able to get whatever birth control you choose a little cheaper there. Though they usually require you to have you annual on file there, too.

    That birth control is so expensive in the US is a freaking crime.

  20. Bonnie permalink
    April 17, 2008 4:52 am

    I take Yaz (one of the new-generation BC pills); it costs me $25/month. (I do have insurance–who knows what it would cost otherwise.) Do you think that boyfriends/partners should have to chip in on the cost? My boyfriend has never offered, and I find that somewhat frustrating. Thankfully, my dermatologist gives me a few boxes of samples every time I see her. But I still end up paying quite a bit each year.

  21. Donna permalink
    April 18, 2008 9:14 am

    I discovered that if I use a mail order pharmacy (in the US) I can get 3 months worth of pills for the cost of one co-pay.

  22. Margo permalink
    April 20, 2008 7:28 pm

    I also save by using mail-order. My co-pay is $20, but I get 3 months for the price of 2 if I mail-order.

    For anyone who’s complaining about the cost — be thankful that you’re with someone and therefore you have the need ;) The alternative is to save the pill money and blow it on going out trying to meet someone new.

  23. Johanna permalink
    April 21, 2008 8:52 am

    Without going into too much detail, I’ll just point out that abstaining from procreative activities does not mean abstaining from everything. There’s plenty of things you can still do. I realize that’s not the option for everyone, though.

    As for feminine hygiene products, I highly recommend the Diva Cup. As a one-time expense, it’s a little pricey (~$40 when I bought mine five years ago) but when you think about how it means no more pads or tampons, ever, it’s totally worth it.

  24. Cate permalink
    April 23, 2008 2:29 pm

    I take Yaz and HAVE insurance, but my insurance won’t cover it (because you know, pregnancy prevention isn’t important). It costs $70 a month. I wish I didn’t love it so much (keeps acne away, I never have weird hormonal mood swings) because it’s so expensive, but everything else I’ve tried just hasn’t been as good.

  25. doublejen permalink
    May 5, 2008 8:53 am

    I know this is a late arrival, but I had an IUD for a year and a half after my son was born, and I freakin’ loved it. I also used to work at Planned Parenthood, and lots of my colleagues had it (many of whom have never had children). It’s a fabulous option.

  26. Kate permalink
    May 5, 2008 10:07 am

    I’m also late to the post, but, much like doublejen, I used to work at Planned Parenthood. After weighing my options for a couple months, I decided to get an IUD (the Mirena, the one with hormones). I’ve never had children. A co-worker of mine got one and loved it. I knew I was going to be quitting PP and therefore be without insurance, and didn’t want to pay the cost of pills each month. I had been on some form of birth control pill for at LEAST 5 years (for wicked mood swings and cramps at first, birth control later), my favorite being Seasonale, which I was on the longest. I continued to take the pills and skipped the placebos. It was about $90 for 3 months, with insurance. While at PP, I had pretty good insurance that would cover the insertion and cost of the IUD, which ended up being about $700 total, with the insurance discount. I was charged for the office visit, a pregnancy test (always done before an IUD is inserted), the “surgery” of the insertion, and the actual IUD. Getting an IUD is a large upfront cost, no doubt, but over the 5 or 10 year period that they are effective (depending on which one you get), it ends up being MUCH cheaper. It was very painful for me to have inserted (the pain varies for different people), but am very glad I got it. I tended to forget to take the pills at the same time, sometimes even would skip days on accident. I feel much more confident with an IUD. Also, it is one of the most effective forms of birth control, short of abstinence.
    I’d recommend this website as a starting point for information about different kinds of birth control: http://www.birth-control-comparison.info/
    If you have any questions about IUDs, feel free to email me — one of the most helpful things for me when deciding was having someone who had one to talk to and ask them questions.
    Good luck!

  27. Maria permalink
    May 5, 2008 11:07 am

    I’ve had the hormonal IUD in for about nine months now, and I agree with doublejen it’s a fabulous option. I’m a student in British Columbia, so between my provincial and university health plans, I only paid $82 for it and the insertion. Rather, I paid half that, my boyfriend covered the other half.

  28. Courtney permalink
    May 12, 2009 6:22 pm

    I say go with the IUD.

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