Dear Curious,

Most students, understandably, are looking for actual costs when considering their contraception options. However, the short answer is that cost of birth control may vary by student, depending on whether s/he has Columbia or alternate insurance, what level of insurance coverage s/he has, and what brand (or generic) birth control s/he uses. Following are some key points that will help students who are covered by the Columbia Student Medical Insurance Plan determine the cost of contraception (students at Barnard or covered by insurance through their parents, spouses, partners, or an employer will need to contact that insurance plan directly for information on costs).

The Columbia plan does cover prescription contraceptive devices and medications. Contraception that is available over-the-counter (such as condoms, spermicide, the sponge, and as of 2006, emergency contraception) are not covered by insurance. Health Services at Columbia provides free condoms to all students.

Specifically, the Columbia insurance plan covers the pill, the ring, the shot (a.k.a. Depo Provera), Implanon, the patch, IUDs, and diaphragms. The out-of-pocket cost to students will vary based on:

• The type of contraception (i.e. brand name or generic medication)
• Whether there will be a co-pay for an in-office procedure (like with IUD insertion)
• Whether the student is on the basic or comprehensive level of Columbia's insurance plan (the comprehensive level covers a higher total dollar amount for prescriptions)
• Whether the student fills their prescription at an Aetna "preferred" pharmacy

Ok, let's get down to some numbers.

Co-Pays
Students covered by Columbia's insurance plan have a co-pay for prescription drugs (most insurance plans in the United States have a similar co-pay system). On the Columbia plan, prescription co-pays range from $5 to $40 for a one month supply of birth control, depending on the brand (see a chart explaining co-pay amounts in further detail). A prescription co-pay is the amount that you'll pay to the pharmacist when you pick up your medications. The cost of the co-pay depends on what "tier" of drug you are prescribed; generally brand name drugs have a higher co-pay than generics. Insurance companies (Aetna, in the case of the Columbia plan) determine which drugs fall into which tier.

Basic or Comprehensive Level of the Columbia Insurance Plan
At the beginning of each school year students on the Columbia plan select either the basic or comprehensive level of insurance coverage. The basic level has a maximum prescription benefit of $1500 total per year, after which students pay out-of-pocket the full cost of prescriptions. For this reason, Columbia recommends that any student who has one or more regular prescriptions choose the comprehensive level of insurance (which has a $7500 per year total prescription benefit). For either level, once a student reaches the annual maximum, it's still a good idea to fill prescriptions at an Aetna participating pharmacy in order to take advantage of the discounted rate. 

In-Office Procedures (IUD, Implanon)
Certain contraceptive methods may require an office visit to a provider outside of Columbia, for example to have an IUD inserted. For these office visits, students would pay a co-pay for their visit to a health care provider within the Aetna network (keep in mind this would be a one-time co-pay, since with these methods there is no monthly prescription).

Preferred Pharmacies
Aetna has a large network of "preferred" pharmacies where Columbia students can fill prescriptions at the lowest cost. Most major pharmacy chains are included; you can verify whether yours through Aetna's DocFind feature. Students can also fill prescriptions outside the "preferred" network, however they are required to pay in full at the pharmacy and submit a claim for reimbursement to Aetna Pharmacy Management and Health Services' insurance office.

Whew. That's a lot of financial information to consider, on top of deciding which method of contraception is right for you. If you are concerned about the costs of birth control, it would be a good idea to speak with your health care provider about the methods that would best suit your medical needs and your pocket book. Columbia students can make an appointment at Primary Care Medical Services by logging on through Open Communicator or by calling x4-2284.

Best of luck making a decision,

Alice

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