Jaye Tyler

Review of SC Budget and Control Board, S...

I have been a state employee in SC for a year now....

I have been a state employee in SC for a year now. I came from NC where their state health plan is excellent. Had I known how drastically different the coverage would be in SC, I honestly would have never taken this job. I am CONSTANTLY having to fight denials and even when something is a covered benefit, the deductibles are so high that you run through your flex spending halfway through your benefit year.

Last fall, my 19 year old daughter's oral contraceptive was denied because our "benefit does not cover contraceptive services for dependent children." The entire reason she takes "birth control" in the first place is because her menstruation was so heavy and painful in high school, she kept having to miss classes every month. I won my appeal after her doctor sent in documentation stating it was medically necessary. So now we pay $8 instead of $15. That may not sound like a huge difference to you, but for a family of 5 on one income, it really is.

Presently, I am having to appeal the denial of about $2,000 worth of medical fees related to my other daughter's (age 22) Nexplanon removal and insertion (this only has to be switched out every 3 years). She has difficulty remembering to take a pill every day and opted for an internal option to regulate her heavy and painful periods.

When I called PEBA about the denial, I was told they don't cover "maternity care" for child dependents. Interesting. This isn't maternity care, but let's pretend it is. Let's say one of my 3 daughters gets pregnant while in college because you wouldn't cover medications used to prevent the pregnancy in the first place. See how that works? God forbid a woman in 2019 have control over her body.

PEBA needs to dump their archaic beliefs and move into this century. Women (and trans men) use hormonal contraceptives for medical reasons other than preventing pregnancy. But even if all they wanted was to put motherhood off for a bit, they should still have access to AFFORDABLE options. Don't even get me started on the fact pap smears aren't covered. So PEBA, when a woman gets cervical cancer because they couldn't afford the pap smear, will you cover the chemotherapy and radiation? Asking for a friend.