Hi all, I recently had my old IUD removed, new one inserted. I did my annual check up at the same time with my OBGYN. My Aetna CVS Health Bronze HMO 8700 ACA plan is now covering only $500 of the $2000 cost. I called before to Aetna and was told the IUD would be covered 100% due to ACA rules.
I’m preparing for my first written appeal after resubmission had the same result, Aetna says their interpretation of Texas law regarding birth control means that the birth control is covered but it is going toward my deductible first, hence the $1500 charge.
Aren’t the free birth control rules set federally by the ACA, superseding Texas laws? I’ve read the ACA covers birth control 100%, no deductible, for any related charges, and medically necessary selection of a specific device (I tried three others previously).
For my previous ACA plan in Texas, it was covered 100%, no deductible. Are there federal or Texas laws that I can refer to in my appeal? Thanks for any help!
TLDR: Aetna CVS Health Texas Marketplace plan covered 25% rather than 100% of IUD removal/insertion, trying to prepare for appeal.
78724, 33 Female
submitted by /u/lump322
[link] [comments]Hi all, I recently had my old IUD removed, new one inserted. I did my annual check up at the same time with my OBGYN. My Aetna CVS Health Bronze HMO 8700 ACA plan is now covering only $500 of the $2000 cost. I called before to Aetna and was told the IUD would be covered 100% due to ACA rules. I’m preparing for my first written appeal after resubmission had the same result, Aetna says their interpretation of Texas law regarding birth control means that the birth control is covered but it is going toward my deductible first, hence the $1500 charge. Aren’t the free birth control rules set federally by the ACA, superseding Texas laws? I’ve read the ACA covers birth control 100%, no deductible, for any related charges, and medically necessary selection of a specific device (I tried three others previously). For my previous ACA plan in Texas, it was covered 100%, no deductible. Are there federal or Texas laws that I can refer to in my appeal? Thanks for any help! TLDR: Aetna CVS Health Texas Marketplace plan covered 25% rather than 100% of IUD removal/insertion, trying to prepare for appeal. 78724, 33 Female submitted by /u/lump322 [link] [comments]Read Morer/HealthInsurance