The decision to start taking birth control is a big one, and especially if you don’t have much experience dealing with health insurance, it can be intimidating. Under current law, if a parent has health insurance, and if the insurance covers policy holders' dependents, young people can stay on their parents' insurance plan until they turn 26 years old. However, that's not a practical or affordable choice for everyone, and it also means your parents might be more involved in your healthcare decisions than you wish. Can you get birth control without your parents knowing, even if you’re still part of their insurance plan? It’s possible for some people, but the process can be a little confusing — so here’s everything you need to know.
First of all, the decision to start taking birth control pills is different for everyone, and it may or may not be connected to your decision to become sexually active. Dr. Tristan Emily Bickman, board-certified OB-GYN, explains that there are many reasons someone might choose to start a contraceptive. “[A woman] should start birth control when she is sexually active, or thinking about becoming sexually active and does not desire pregnancy,” she says. According to Planned Parenthood, the pill is 99 percent effective at preventing pregnancy when taken perfectly, and 91 percent effective when you account for the occasional missed pill. “There are also some young women who have heavy periods, irregular periods, or painful periods, and birth control (hormonal contraception) can help these women too," Dr. Bickman says. In some cases, the pill is even prescribed as a cure for hormonal acne.
If you think it's at all possible to have a conversation with your parents or guardians about birth control, consider that option before you start the process of getting it on your own. In fact, it might be necessary — 20 states limit the circumstances under which a minor (under 18 years old) can consent to contraceptive services without parental involvement. If you haven’t always had an open dialogue about sexual health in your family, this may be scary to bring up. Family and relationship psychotherapist Dr. Fran Walfish tells Elite Daily, “Having open, honest communication with your parents about getting on birth control, sex, sexual engagement, and feelings can be frightening and overwhelming.” She suggests explaining to your parents that you’re trying to look out for your health, which hopefully they will understand and endorse. And if they don't take it well, you can always have the conversation in multiple parts. “If it gets too heavy, put a bookmark in it and tell your parents you’d like to pick it up after everyone takes a beat to get perspective," Dr. Walfish suggests.
In an ideal world, everyone would have parental support when it comes to taking care of their sexual health, but unfortunately this isn’t the reality for everyone. If you and your parents have differing views about sex, and they aren’t on board with your decision to start birth control, you may be wondering how to protect yourself from pregnancy without involving your parents at all. The good news is, there are several different ways to do this. Condoms are easily available at any drugstore, and they’re the best way to protect yourself from STDs and STIs — but they’re only 85 percent effective at preventing pregnancy, according to Planned Parenthood. So even if you’re using condoms regularly, it’s smart to use another form of birth control as well.
This is where a medical professional can come in handy. In most cases, you need to visit a doctor in order to get a prescription for birth control; you cannot buy it off the shelf at a drugstore or order it online. (However, there is a way to get a prescription virtually — more on that below.) A licensed healthcare provider will be able to discuss your birth control options with you in an honest and non-judgmental way, without the heightened emotions that might arise around your parents. You’ll typically sign a confidentiality agreement before your first OB-GYN visit, which legally requires your doctor not to disclose the information you share with him or her.
If you’re nervous about your doctor sharing medical information with your parents, board certified OB-GYN Dr. Sandra Fleming suggests calling ahead to ask. “If you choose to see a private doctor, ask them about their confidentiality prior to your visit so there are no surprises,” she explains. Confidentiality laws vary by state, and your healthcare provider can clarify whether your visit will be kept completely private. Something to note, however, is that if your doctor perceives you are in an abusive relationship, or that you were sexually assaulted (and you are under 18), he or she may be required to report your situation to child protective services, depending on state law.
To get free medication on your parents’ insurance plan without them knowing, you’ll want to check the confidentiality requirements of your specific insurance provider. “Some insurance companies have protocols for keeping patient information private from policyholders,” explains Dr. Janelle Luk, board-certified OB-GYN and Medical Director at Generation Next Fertility. “You may be able to protect your privacy by contacting your insurance company and telling them to disclose your sensitive health information only to you.” Insurance companies send out something called an Explanation of Benefits (EOB) when your plan is used to cover a medical service or prescription, which is a written document explaining what the insurance company paid and how much money is still owed. EOBs typically arrive by mail, so if your parents are the policyholders on the account, the EOB will likely come to their address. You can call and ask to get your EOB sent to a separate address so your parents won’t see it, but the insurance provider isn’t always obligated to honor that request. It never hurts to ask, though — you can find the customer service number on your health insurance card and give it a call. Simply ask whether your prescription can be kept confidential from the policyholder (your parents), and whether the EOB can be sent to a different address.
If you can’t get a confidentiality guarantee through your insurance, another way to avoid your parents knowing you are on birth control is to pay for the doctor’s visit and prescription out-of-pocket. Many clinics and services exist to help patients get birth control at a low cost. “Title X clinics like Planned Parenthood or many other family planning clinics can provide contraception directly in the office without going through insurance,” says nurse practitioner Andrea Martin, DNP, CRNP, WHNP. On Planned Parenthood’s website, you can look up your local clinic to get information about how much your medication will cost.
There are also companies like Nurx, Maven, Planned Parenthood Direct, and Alpha Medical that allow you to get birth control without ever having to see a doctor in person. After a short online intake process, you can get medication delivered straight to your door (or a friend's door) for as low as $15 a month without insurance. As long as you’re in a state that doesn’t require parental consent to get birth control, you can do this independently of your parents. Keep in mind, though, that the American College of Obstetrics and Gynecology recommends patients begin seeing a gynecologist between the ages of 13 and 15 (regardless of sexual activity) — so if you haven’t begun doing this annually, now is a good time to begin.
If you’re still unsure which option is best, remember that medical professionals are there to be an advocate for you, even if your family is unsupportive. Anyone seeking advice on starting a new prescription should reach out to a doctor for support. “[A] doctor can help a young woman understand her options,” Dr. Bickman says. “As far as options are concerned, there are many — and a healthcare provider will work through what is best for her based on a variety of factors, such as her age, willingness to comply with a regimen, and other medications she is currently taking.” And even if your medical provider can’t set you up with low-cost birth control directly (due to insurance constraints), he or she should be able to point you in the right direction.
No matter your family circumstances, your sexual health is paramount. The fact that you are taking this step to care for yourself — even if your family dynamic makes it difficult — is a testament to your maturity in the face of challenging circumstances. You should never feel shame about engaging in sexual activity, and the most important thing to look out for is your physical and emotional health. Do your research, learn your options, and choose whatever plan makes the most sense for your life.