Pills (and other hormonal contraceptives) By Post May Save Your Hide

In a new round of horrific developments in the Trump administration and GOP-controlled Congress, yesterday, on May 4th, the House voted 217 to 213 in favor of repealing the Affordable Care Act ("Obamacare") and replacing it with what they're calling the American Health Care Act. Any time there is an attempt to make major changes to the U.S.'s healthcare system there's cause for concern, but this new bill is particularly worrisome, and, for some of us, outright terrifying. It would especially negatively impact women, people with disabilities, people of lower income, folks with pre-existing conditions, those who are dependent on social services such as Medicaid, anyone who uses Planned Parenthood's many services, and anyone who relies on insurance coverage for contraception. While it still needs to be approved in the Republican-controlled Senate with at least 51 votes to pass -- it's not law yet, so take a breath -- and would take even more time to actually implement, we feel it's much better to be prepared, and better to be safe than sorry.

As well, an Executive Order Trump signed on the same day (if the Trump administration and most of the GOP gets their way, May 4th may truly be remembered as a horrible day in American history) may lead us backwards on contraceptive access. It could give pharmacists and others legal protections to refuse to fill prescriptions or sell over-the-counter contraceptives if they say their refusal is based in their religious beliefs.

So, a lot of folks in the United States are understandably worried and wondering: what can I do to secure my prescription contraceptive methods for the foreseeable future? And what might I do if I lose access to contraceptives at the in-person pharmacies or shops I can get to?

MAIL-ORDER CONTRACEPTIVES TO THE RESCUE!

what they are

Hormonal contraceptives - usually in pill, patch, and/or ring form, as well as emergency contraception (EC) - that you can get online, often for no or low cost (depending on whether or not you have insurance) that you can order online and have mailed to you every month. Listed below are the various mail-order pharmacies and the types of services they provide. These are bonafide and safe pharmacies and services and have been created expressly to provide people with contraception, so you don't have to worry about refusals.

where to get'em

  • Nurx
    • Types provided: Pills, patch, ring, EC
    • States available: CA, FL, IL, MI,  MN, MO, NY, PA, VA, WA, D.C.
    • Accepts health insurance
    • Approximate price per month's supply with insurance: $0
    • Approximate price per month's supply without insurance: As low as $15
    • Can provide a prescription for contraceptives if you need one
    • Other good things: They carry a wide variety of pill brands.
  • PRJCT RUBY
    • Types provided: Pills, EC
    • States available: Every state but AR, IA, MS, NC, LA
    • Does not accept health insurance
    • Approximate price per month's supply: $20
    • Can provide a prescription for contraceptives if you need one
    • Other good things: Available through Android/iPhone app, donates to a fantastic reproductive access nonprofit for each purchase.
  • The Pill Club
    • Types provided: Pills, ring, patch, EC
    • States available: AZ, CA, FL, MS, NV, NY, OH, WA
    • Accepts health insurance
    • Approximate price per month's supply with insurance: $0
    • Approximate price per month's supply without insurance: As low as $5
    • Can provide a prescription for contraceptives without insurance for $30
    • Other good things: Each pill pack comes with chocolate and product samples!
  • PillPack
    • Types provided: Pills, ring, patch, EC
    • States available: Every U.S. state besides Hawaii
    • Accepts health insurance
    • Approximate price per month's supply with insurance: $0 or regular copay
    • Price per month without insurance varies by medication
    • Other good things: You can add any prescription medication to these customizable pill packs, uses iPhone app.
  • Planned Parenthood Care App
    • Types provided: Pills, ring, patch
    • States available: AK, HI, ID, MN, WA
    • Accepts health insurance
    • Approximate price per month's supply with insurance: $0 or regular copay
    • Price per month without insurance varies by medication
    • Can provide a prescription via video chat for $25
    • Other good things: Uses iPhone and Android app.

why?

There are a lot of reasons why someone might want to use a mail-order pharmacy for accessing birth control, separate from this particular crisis - you don't have to pay, travel, or take time to go to a doctor's office or pharmacy; you don't have to have any face-to-face conversations with a provider about sexual history (although you may have to do it via survey or video chat!); filling things out online can be less anxiety-inducing for some folks than making an appointment and going into a doctors office, and so on.

The reason we're putting this out now is because there is a chance that you may not have access to birth control soon - depending on whether or not this bill passes, and this executive order is allowed to stand, or if you think you might lose your healthcare coverage, using a mail-order pharmacy can be an easy way to "stock up" on hormonal contraceptives for the foreseeable future. It's a good standard practice for anyone who is sexually active who might incur a pregnancy risk to keep a dose of EC (Plan B, etc) around just in case - most of them have a shelf life of around 3 years. While you do need to be sure that the medication is not expired and that you still meet the requirements for taking this medication (see the insert in the packaging for medication reactions, side effects, etc), it's a good way to make sure that you have access to contraception when the future of your access to contraceptive access is a little unsure.

If these changes go through, insurance companies may not have to cover birth control, and pharmacists could refuse to fill your prescription for contraceptives - any kind. So if this bill passes and birth control becomes much less accessible than it has been as a result of the Affordable Care Act, you may want to consider stocking up on contraception as much as possible beforehand. If you're currently insured and able to do so, now is the best time to get Long-Acting Reversible Contraception (like the implant or copper/hormonal IUD) to ensure that you have reliable pregnancy prevention for the next few years. To learn more about how to emergency-prep for imminent changes to the healthcare system (and more) under the Trump administration, check out the Healthcare section of Rebel Well: A Starter Survival Guide To a Trumped America.

keep in mind

  • Getting anything by mail means that anyone that has access to your mail can see it - your mail deliverer, your mom, your partner, etc. While these pharmacies will deliver the contraception in fairly discreet packaging, if you're concerned at all about someone else finding out about the contraception you're using, this may not be your best option. If this is the case, it might be better to have it delivered somewhere else (a P.O. box, a friend's house, etc) for more privacy.
  • These hormonal contraceptives do not prevent the spread of sexually transmitted infections (STIs) during sexual contact. To learn about the barrier methods that provide protection against the spread of things like gonorrhea, chlamydia, and HIV as well as pregnancy, see: All the Barriers! All the Time!
  • Emergency contraception (Plan B, Ella, etc) is not intended to used repeatedly as a long-term form of contraception. Besides potentially messing with your cycle every time you take it, which can make some people feel really stressed out, it can get very expensive, and the consequences of frequent use haven't really been studied much yet. There are other options that are cheaper, cause less side effects over time, and have better rates of overall effectiveness in preventing pregnancy. To learn more about what emergency contraception does and doesn't do, check out Birth Control Bingo: Emergency Contraception or Princeton's EC website.

other tips & ways to prepare for possible birth control apocalypse

  • If you don't know them already, another good way to prepare is to find out what, if any, Planned Parenthood branches and public health clinics are closest to you. While federal funding Planned Parenthood receives is currently at risk, they have a looooooong history of assuring access to contraception (and abortion, as well as other healthcare), even when they aren't federally or culturally supported, so it's safe to say Planned Parenthood will likely stay a place you can get access no matter what. Public health services may also be effected by federal or state changes, but people who work at public health clinics that provide sexual health services are generally very dedicated to providing access, so even if things change, they'll likely still be all-in to help you get what you need.
  • Talk to your prescribing physician about giving you more refills, then go ahead and fill them all now, particularly if you live in an area that tends to be conservative about these issues, and/or you don't have the ability to go to a few different pharmacies if one refuses. None of this is law yet, so there is still time to get things filled before people have the legal right to refuse you.
  • If you'd like a way to get condoms online -- due to potential refusals or just because -- don't forget about our own condom shop right here on Scarleteen. We work with Lucky Bloke to provide options for you, and they also ship very discreetly, in packages that give no clue what's inside.

Hang in there, guys: we're in for a very bumpy ride, no matter what. (But we've got your back.)

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