Managing the costs of women’s preventative healthcare
Insurance may not cover some of these basic women’s health services
By Madison Blancaflor | Published: September 6, 2018
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One in five women in the U.S. between the ages of 18 and 64 are uninsured. This means millions of women are having to choose between paying thousands of dollars in out-of-pocket costs and forgoing important preventative healthcare measures such as contraceptives, STD testing, cancer screenings and more.
Even women who are insured face uncertainty in coverage, higher premiums, greater out-of-pocket costs and occasionally outright discrimination.
The Trump administration is also still looking for ways to dismantle the Affordable Care Act (ACA), most recently rolling back the birth control mandate that previously required every employer to cover contraceptives for employees. The rollback allows companies to stop covering birth control for their employees if it goes against their “strongly held religious beliefs.”
While these new rules haven’t affected every woman in the U.S., the situation has reopened the debate on the role women’s healthcare plays in gender equality.
With insurance coverage for women’s healthcare a hit or miss depending on your location, insurance provider and employer, many women are wondering what the potential costs could be if they aren’t covered.
The cost of preventative healthcare for women
No matter your political opinions regarding the state of the U.S. healthcare system, no one can deny the astronomical costs associated with women’s preventative healthcare.
For women who are uninsured or have minimal insurance coverage, preventative healthcare such as contraceptives, STD testing, cancer screenings, and overall reproductive health care can cost hundreds or thousands of dollars out-of-pocket. This means many are unable to afford basic medical care for women-specific issues like effective birth control methods, genetic testing or fertility treatments.
Perhaps the most common (and most controversial) form of preventative women’s healthcare is birth control. Contraceptives are used for more than just pregnancy prevention; many abstinent women still utilize birth control to regulate their menstrual cycle and combat hormonal fluctuations.
With many options on the market, costs can vary widely depending on what method you choose.
Cheaper options such as oral contraceptives (commonly referred to as the Pill) or the Depo-Provera shot can cost between $200 and $600 per year without insurance. While many doctors recommend generic versions to help patients cut costs, those generic drugs can occasionally cause undesirable side effects.
Contraceptive implants and intrauterine devices (IUDs) run between $800 and $1,000 for those without an insurance provider that covers the device or procedure. These devices are typically more effective, have fewer side effects and usually last between three and five years, making them more cost-effective in the long term than some other options. The high upfront costs, however, can put a major financial strain on any budget.
Vaginal rings are actually the most expensive form of common contraceptive methods, with brands such as NuvaRing costing patients up to $1,000 per year.
These costs don’t even include what doctor’s offices or clinics may charge for appointments, tests or consultations that are often required for women seeking birth control.
Annual checkups, STD testing, and cancer screenings*
Typically, insurance covers annual checkups, STD testing, and cancer screenings. Under the ACA, yearly pelvic exams that often include Pap smears and cervical cancer screenings are fully covered by insurance.
However, for those without insurance or for those who have a plan predating the ACA that requires a high deductible before coverage kicks in, it can cost anywhere between $50 and $200 per exam, test, and screening. The costs vary depending on what state you live in and which doctor’s office you schedule an appointment with.
Coverage availability and out of pocket costs are varied for breast health checkups, screenings, and preventive measures.
Mammograms are almost always fully covered by insurance, but they cost $250 out of pocket on average for those without an insurance plan.
According to BreastCancer.org, testing for PALB2, BRCA1 and BRCA2 costs between $300 and $5,000, depending on where you go to get tested and how extensive the genetic test. Preventative surgeries for those with a high risk of breast cancer, determined through genetic testing or an evaluation of family history, can cost between $15,000 and $55,000 for those without insurance coverage.
Preventative surgeries such as mastectomies aren’t always fully covered by insurance, either. Even women with premium insurance plans can end up paying 20 percent or more of the overall cost for mastectomies and similar procedures. Others may have expensive deductibles to meet before insurance fully covers medical costs. Some insurance providers may not cover any of the costs if they deem that the surgery is not a medical necessity.
Many women turn to fertility clinics to help preserve their ability to have children when they are diagnosed with cancer or at risk for cancer. Fertility treatments such as freezing your eggs can be expensive whether or not you have insurance coverage.
According to National Public Radio, harvesting eggs costs around $10,000, freezing and storing your eggs costs approximately $500 per year and IVF treatments to become pregnant when you’re ready to unfreeze your eggs can cost $5,000. That is a huge financial undertaking for women without insurance, and even women who have insurance plans can end up covering a percentage of those costs themselves.
Hormonal therapy for postmenopausal women*
According to the Mayo Clinic, hormone replacement therapy for menopausal and postmenopausal women can help prevent bone loss and protect long-term health. However, insurance companies may not deem hormonal therapy a medical necessity, meaning even women with insurance coverage may end up paying for it out of pocket.
Costs associated with hormone therapy vary depending on the type of therapy you choose and the regimen your doctor recommends. On average, women can expect to spend $1,500 a year for consistent treatment.
Managing payment options for women’s healthcare
For unexpected or larger medical costs, some might consider using a credit card to help them afford costly medical expenses. However, using a credit card to pay for large medical expenses can harm your credit score and cost you more in the long-term because of higher interest rates.
While small monthly costs such as The Pill might make sense to charge, there are other options available for paying for preventative healthcare measures out of pocket.
If your employer offers health plans, you probably have access to an FSA. Patients can contribute up to $2,650 each year to pay for copayments, deductibles, and other healthcare costs. Some employers also contribute to employee accounts.
This money is not taxed, helping patients save money on healthcare.
Planned Parenthood offers affordable women’s health care, including wellness visits, contraception, STD testing, cancer screenings and more. If you don’t have insurance, Planned Parenthood may have alternative payment plans available to you. Many women also qualify for free for low-cost services at Planned Parenthood centers.
Medical credit cards offer a payment plan option for patients by offering “no-interest” promotional periods based on how much you charge. For example, if you charge a $1,000 IUD on a medical credit card with a six-month promotional period, you could pay off the debt interest-free for less than $200 a month.
However, for those who don’t pay off their debt within the promotional timeframe, deferred interest, and higher APRs can end up costing patients.
If your yearly income is at or below 250 percent of the federal poverty level, your insurance doesn’t cover screening exams or you meet certain age requirements, you might qualify for free to low-cost healthcare services from the Centers for Disease Control (CDC).
Local NBCCEDP programs offer services such as:
- Breast exams
- Pap Smears
- Pelvic exams
- HPV screenings
- Diagnostic testing
- Referrals for treatment