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Old 10-02-2003, 10:17 AM
dzandiloo dzandiloo is offline
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Join Date: Mar 2002
Location: TX
Posts: 1,152
Well, I'm currently uninsured, but I used to work for an insurance company & let me explain the justification I often heard with respect to this issue (NOTE: I am not agreeing or disagreeing with this stance-I am just sharing the insurance company's point of view):

1. Most prescription plans only cover medications that are medically necessary for the treatment of a medical condition. Technically, if a doctor writes a prescription for Viagra, it is intended to be used for the treatment of erectile disfunction-a medical condition.

2. Most women who use BCP are using them for birth control purposes only. As far as the insurance company is concerned, it is not medically necessary to avoid being pregnant. HOWEVER, almost every insurance plan I know of that exludes BCP for purposes of birth control does provide an exception in the event that the pill is being prescribed for treatment of some other condition, like lessening the symptoms of endometriosis, and in extreme cases, acne. Getting approval in these cases is almost always a huge PITA, b/c volumes of medical information has to be provided.

Its also a matter of cost. Insurance premiums are insane & prescription drugs are said by many to be the number one culprit--its a matter of deciding what prescriptions will hurt the bottom line the least: in this case, the percentage of men needing (or even pursuing) Viagra is fractional compared to the percentage of women who would use BCP's if they were available to them. This is one reason why the same plans that won't pay for BCP's will often pay for elective abortions--they know not many women will take advantage of the benefit, and even if they do, the cost of an abortion to an insurance company is drastically less than the cost of a full-term healthy or complicated pregnancy....(I know that comparison is offensive to some, but believe me, it is considered when benefit plans are written and premiums are set).

I suppose the so-called "double standard" question stems from the question of how medically necessary is it for a man to be able to engage in sexual activities? Hmmm....and then there are those who argue that the only reason that Viagra is covered is because men run the insurance companies (I don't buy that, but who knows for sure???)
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