If you like it then you shoulda put a NuvaRing on it
March 14, 2014 1:00 PM   Subscribe

What's the most efficient way to get non-condom birth control without health insurance?

It's that time of the relationship where No More Condoms is on the table. I'm up for going back on hormonal birth control, but I don't have health insurance.

How do I do this?

Ideally, I would go to Planned Parenthood (or similar cheap clinic?), and they would write me a prescription for monthly hormonal birth control, which I would pay out of pocket for. But is there a better way? A cheaper way? A faster way (in terms of scheduling appointments and such)? Is it possible to get a birth control prescription without a well woman exam?

Also, since I'll be out of pocket, what's the cheapest option for birth control prescriptions? Am I correct in assuming that I'm looking at going on the pill as opposed to NuvaRing? Is "the shot" still a thing?

I am not interested in an IUD at this point, for various well-considered reasons.

I'm in the US, in the LA area if anyone has specific recommendations of a clinic to go to or nonprofit to call, or particular tips about LA Planned Parenthood.

(I have weighed out all the options and am 100% sure that I don't care about hormonal birth control messing with my precious lady rhythms or whatnot. Please do not answer this question with "hormonal birth control is bad because..." That is not what I'm asking about.)
posted by Sara C. to Health & Fitness (26 answers total) 2 users marked this as a favorite
Are you going to have health insurance in two weeks when the deadline for the penalties kick in? Because under the ACA birth control is free: our copay for the pill is $0, we just pick it up from the pharmacy every month.
posted by Oktober at 1:02 PM on March 14, 2014 [3 favorites]

Is getting health insurance off the table?
posted by gingerbeer at 1:02 PM on March 14, 2014

It looks like I'm going to be eligible for a work related health plan that is much better and cheaper than ACA within the next few months, so for right now the ACA is not on the table.
posted by Sara C. at 1:05 PM on March 14, 2014

By far, I've found planned parenthood is the cheapest for birth control. It was sometime seven cheaper than my totally legit health insurance, back when insurance didn't have to cover most Bc options. Plus they were totally cool with listening to me and switching up whatever I was using for something that worked better. I tried a variety of pills, the patch and depo before settling on the ring. Give them a try.
posted by stormygrey at 1:06 PM on March 14, 2014 [1 favorite]

You may qualify for PACT. When I went to the Planned Parenthood in Hollywood (highly recommended), they had screening questions for eligibility and were able to issue me a card same-day. (This was a few years ago.)
posted by kagredon at 1:07 PM on March 14, 2014

Yes, the shot is still a thing, and if you're paying out of pocket it's comparatively cost effective.
posted by Ms Vegetable at 1:14 PM on March 14, 2014

Without health insurance you have three options:

1) Go to a regular doctor and just pay out of pocket. You will probably get some sort of cash discount, but this is definitely your most expensive option.

2) Go to a community or free clinic. Here's the association for LA. They can work out a cost for you based on your income.

3) Planned Parenthood. This, I think, is by far still your best option. It will have the best expense vs. quality of care ratio.
posted by Lutoslawski at 1:20 PM on March 14, 2014 [3 favorites]

Definitely try Planned Parenthood. When I went in 2011 they just gave me some card that made my visit and birth control free. I kept trying to tell them I couldn't possibly be eligible but they said I was. It was some kind of medicaid program, maybe PACT mentioned above. I've had insurance through my work for two years now so I don't know if it's still a program.
posted by carolr at 1:27 PM on March 14, 2014 [1 favorite]

Not to belabor the point but I think you can get health insurance now through the ACA to cover you until you're eligible for your work plan. When you become eligible for the new plan, you just cancel the old one. I could be totally wrong but I'm pretty sure that's how it works.

That said, nth-ing Planned Parenthood. I don't think most doctors will write you a prescription for hormonal birth control without an exam. This might help you pay for the NuvaRing. I tried it before and didn't like it - it made me gain weight - but I've never been on the pill so YMMV. I read the Vanity Fair article before and found it scare-mongery. But again, YMMV.
posted by kat518 at 1:32 PM on March 14, 2014 [5 favorites]

I have an IUD and love it, so I'm a big proponent of the set-it-and-forget-it style of birth control. Since you're not interested in IUDs, maybe check out the implant? That review mentions that it was about $100 without insurance at Planned Parenthood, and that's a pretty huge savings in time and effort compared to the pill or ring.
posted by MsMolly at 1:38 PM on March 14, 2014 [1 favorite]

In terms of convenience, I think PP will give you three months' worth of birth control at a time. I am pretty sure they'll want to do an exam, as it's a) a good idea to get that once a year, and b) their due diligence.
posted by radioamy at 1:46 PM on March 14, 2014

The Planned Parenthood in my city offers birth control without a pelvic exam, seeing patients on a walk-in basis a certain number of afternoons a week. They call this the H.O.P.E. plan (hormonal option without pelvic exam). Yours may, too- call and ask. This can be a help both in terms of scheduling and in terms of of hassle.

This is not a good option if you haven't had a pap in a while or are complicated medically for other reasons, obviously.
posted by charmedimsure at 1:47 PM on March 14, 2014 [1 favorite]

A number of pharmacies have hormonal birth control in their discounted generic list, although typically birth control is $9/month, $24/90 days rather than $4/$10. If you prefer a specific brand it might not be available but most have ortho tri-cyclen.
posted by ChrisHartley at 2:01 PM on March 14, 2014

I had this dilemma a few months ago and went to Planned Parenthood. Mine was actually not super-nice-and-accepting - the lady was actually quite brusque and borderline rude - but it was way cheaper than I expected ($45 for a 3-month supply of generic pills). They didn't require a pelvic exam since I stated I had one done within the last 3 years, which I guess is the current recommendation for women under whatever-age. I think it was $40 for the initial consult and they'll give you a ton of refills so it will just be the pill cost after that.

I'm sure the cost varies from city to city, just as a datapoint/anecdote for reference.
posted by celtalitha at 2:01 PM on March 14, 2014 [1 favorite]

When I was in the Bay Area and low-income I went to a city-run Public Health Clinic who confirmed that I was eligible for PACT and issued me a card. For the time when I had zero income, it completely covered a well-woman check-up, lab work, and NuvaRings which they dispensed right at the clinic. The one annoyance was that for a refill I had to go in during certain hours for a very brief appt. for the Dr. to look at my chart but then they would give me 4 months worth. I got my first 3 rings during my very first appointment. Maybe there is something similiar in LA.

If you've had a well-woman/pelvic exam in the past three years, they should hopefully not require one to dispense but they might want to call or get records from the office where you went.
posted by dahliachewswell at 2:09 PM on March 14, 2014

Yeah, you can get ACA insurance for the few months until the employment insurance kicks in. Please consider it; it sounds like you have a bunch of projects you want to do, and you should be protected from financial and health disasters.

Of course your circumstances are your own, but it could make your life a lot easier. And it would solve this question.
posted by amtho at 3:32 PM on March 14, 2014

Not exactly legal, but I ordered mine from inhouse pharmacy and paid out of pocket. I wanted a progesterone-only pill (Cerazette) that's not available in the US anyway. (If I had wanted a pill containing estrogen I would have gotten my blood pressure checked before using the pill and continued to check it while on it.) It worked great, no hassles, no regrets. If I ever need birth control again that is absolutely the way I will do it, but I'm a firm believer that the pill should be OTC.

You absolutely do not need a well-woman exam for the pill; it has nothing at all with whether it's safe for you to use it. The only screening needed for hormonal birth control is a blood-pressure check and making sure your family history doesn't include excessive stroke risk.
posted by Violet Hour at 3:43 PM on March 14, 2014

Just to head off the ACA derail once and for all, I can't afford an ACA plan and likely won't be subject to the penalty (the cheapest plan I'm eligible for is more than 8% of my income).

I haven't had health insurance since 2009, so from where I'm sitting paying about $1000 to have virtually worthless coverage for a few months is a total nonstarter.

I am not actually a stupid idiot who has never heard of the ACA.

I wish people would just answer the question I asked.
posted by Sara C. at 3:44 PM on March 14, 2014

My employer is exempt from providing birth control coverage (though I have great coverage for my exams and whatnot). I buy my Nuvaring (only form that works for me without significant weight gain and crazymaking) in 3 month supply from Canada via Birthcontrolbuzz.com for about $75 including shipping (so $25/mo).
posted by rinosaur at 3:44 PM on March 14, 2014

A friend of mine just visited Planned Parenthood in Hollywood. She's in a similar situation as yours health insurance-wise (and sexual activity-wise). Here's what she said:

Pricing depends on your income. If your income is below the poverty line, services are free or severely reduced. She was not below the poverty income level and paid ~$200 for her appointment, which also included full STD and AIDS screening. She also said they sold her HBC at ~$25/pack.

Because it's so dependent upon your income level, she recommended that you visit the PP website and even call the office you plan to visit beforehand so they can inform you about the pricing schemes.
posted by saguaro at 4:10 PM on March 14, 2014 [2 favorites]

Nthing Planned Parenthood. In California it's really easy to get the green card that lets you have birth control and related health care visits for free, or at least it was several years ago when I used it last. It's funded by Medicaid, but is administered separately. They'll do the paperwork with you at PP almost automatically, and it's just you stating your income.

You might want to call a few different offices to see if one is less busy and can get you in faster.
posted by apricot at 4:12 PM on March 14, 2014

Oh yeah ChrisHartley is right - I totally forgot about pharmacy prescription discount plans. All the big chains have them, and usually have the lists on their website. The prices are about what you'd pay for a generic on insurance ($10-$30 approx). Of course you still need the prescription but at least you'd be able to get it filled conveniently.
posted by radioamy at 4:17 PM on March 14, 2014

Nthing Planned Parenthood! A few years ago when I was without health insurance I was able to get the special green card that gave me free visits and birth control. In fact, I had no idea the card or program even existed before I went to planned parenthood and I was so shocked at the end of the visit when they told me that everything was covered (this included std and aids testing as well as prescription for birth control) that i promptly donated 20 bucks to them. The card that they issued me right then enabled me to go to my local pharmacy and pick up my birth control for free for the next year (or however long the doctor there wrote a refill prescription for me, i cannot remember). It was extremely easy. The hard part was getting an appointment in the first place.
posted by ruhroh at 4:40 PM on March 14, 2014

In a bit of a rush so I confess I haven't read all the answers, but:

Generic birth control is cheap. I've been paying $25/month for generic ortho tricyclen without insurance. Don't bother with planned parenthood if you don't have to. Your income is (I'm assuming) high enough that you'll end up paying a decent chunk of change for bc pills, and you will have to wait a million years for it because LA planned parenthoods are all overburdened and understaffed.

Seriously. I was ineligible for the free stuff green card when I was working as a PA because I was making too much money. ($2,000/month, more or less)

In terms I getting a prescription, though, you might want to go to planned parenthood for the exam if you don't have an ob/gyn. But it might be only slightly more money and a lot less hassle to just go to an ob/gyn and pay cash.
posted by ablazingsaddle at 5:30 PM on March 14, 2014 [1 favorite]

if you can show you are at a low income level (tax return from last year? pay stubs?) i think you can get a free exam or low cost exam and pills at planned parenthood. when i was unemployed i showed them my UI form from the state, and they had this paperwork ready to go for someone with low income. i filled it out, the exam was paid for by the state (including a blood test for HIV) and they got me hooked up with a low cost birth control pill. i had heard from my roommate that they have some pill packs that are free that they give away there at the clinic, but for me they wanted to continue the type i was already on so they gave me a generic version of it - Sprintec. it costs $9 per pack.
posted by cristinacristinacristina at 6:57 PM on March 14, 2014

As a side note, you can still get health care as of today through Covered California. Then you can use whatever birth control with your insurance.
posted by klangklangston at 9:12 AM on March 15, 2014

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