Intro: It's time for Conversations with MIT Health, care for the community. Here's your host, Melanie Cole.

Melanie Cole (Host): Contraceptives and condoms can help protect you against pregnancy and sexually transmitted infections. MIT Health offers a wide variety of birth control options to fit your needs and offers counseling and insurance options to help you make the right choices.

Host: Welcome to conversations with MIT Health. I'm Melanie Cole. And joining me, we have a panel today, Dr. Vini Anand, she has a doctorate in Family Practice and she's a primary care provider; and Allison Sherwood, she's a family nurse practitioner and primary care provider. They're both with MIT Health and they're here to tell us more about birth control options at MIT Health and the MIT Student Health Insurance Plan or MIT SHIP. You both for joining us. Dr. Anand, I'd like to start with you. What forms of birth control are available through MIT Health?

Dr Vini Anand: Thank you. Thank you for this opportunity. Me and Ali, we are both really excited to be here to discuss on this important topic. We have a lot of birth control options or pregnancy protection options at MIT Health. For example, we have progesterone-based birth control methods, such as IUDs or intrauterine devices; these are temporary, but long-term-acting birth control methods, which includes like a small device inserted into the uterus and can be removed at any time. Then, we also offer Nexplanon. It's a progestin-only rod that's placed in the inner arm around the biceps under the skin, and this can be used for three years. And then, we also offer depo shots, which is once every 13 weeks, given as an injection. Then, the estrogen-based birth control methods include birth control pills, which should be taken daily. Then, there are birth control patches, which can be used once a week. Now, the other option include birth control rings, which are inserted into the vagina and can be used for three weeks.

Then, the new non-hormonal options include Paragard IUD, which is made of copper, and it's good for 10 years. And there are condoms in the lobby and in all the patient rooms, which are available as well. Then, we also offer emergency contraception, which includes Plan B or ella, and then Mirena or copper IUD.

Host: Well, thank you for that comprehensive list, Dr. Anand. Allison, of course, each individual's birth control choices are based on their specific circumstances and needs. Can you give us a general overview of the pros and cons of these options for people who may have underlying issues or health concerns, or really for people that heard all of these options from Dr. Anand and they're not sure exactly what they mean?

Allison Sherwood: Thanks, Melanie. And thanks, Vini, for the really helpful overview for our patients listening. So, the big thing that we like to say is that each patient's needs and preferences need to be taken into consideration when we're thinking about birth control. And ideally, patients can reach out to us in primary care or OB-GYN and we have a more in-depth discussion about these different options based on each patient's profile that could include thinking about their menstrual cycle flow, the duration and their long-term goals of what they're looking to get out of a method. We can easily set up telehealth visits and meet with patients in the comfort of their own home. If you feel that, for example, IUD is most likely your goal, we do ask that you let us know so we can go through those kinds of counseling. So when it comes time for the insertion, the procedure, you're feeling extremely comfortable and that all the options have been given to you and all the questions that you may have have been answered. So, this method that we do choose is something that you feel settled in.

Host: And Dr. Anand, what's covered by the student health plan? Which forms require prescription?

Dr Vini Anand: So since the ACA mandate, there has been many updates to assure that birth control options are at no or even at low cost. All generic forms that comes through the prescription are covered. Birth control methods other than emergency contraceptives need a prescription. But also, there is an exception.

So, the ella, which is a prescription emergency contraceptive, is covered through the insurance, but needs a prescription. Then, we have Plan B, which is available over-the-counter, so this can be obtained without a prescription. SHIP insurance is the new update to the name of Student Health Insurance Plan, and there is a comprehensive grid on our website that outline s that all hormonal pills, patches, rings, IUD and implantable devices are covered.

Then, not every prescription will be zero co-pays. So, generic forms could be without co-pay and brand names may require additional co-pays. So for example, Lo Loestrin, that's the brand one, there are no generic forms available and usually expensive. But if we can get the same ingredient with the generic form, usually that's covered by the insurance.

Another way is like if you had an outside plan, say from your folks at home, you will be able to use your student access to see a provider at MIT to have the labs and most radiology workup done at MIT. But you can waive your desire to use your insurance to pick up the treatment. So in that case, it won't be covered if it is an outside plan.

The easiest way to find out, this would be from the insurance website or by calling the insurance when it comes to the coverage. So some examples of the covered services include barrier methods like diaphragms and internal condoms; hormonal methods like birth control pills, patches and vaginal rings, implanted devices such as intrauterine devices, Nexplanon, emergency contraception like Plan B or ella, sterilization procedures, patient education and counseling. So if a student is covered, is a dependent on someone else's health insurance, that will be up to the insurance about the coverage. So, a lot of times if you're on someone else's insurance, it's always a good idea to check with the insurance.

Host: Well then, Allison, can you expand a little bit on what Dr. Anand just was discussing? Tell us more about Medstop, MIT Health's kiosk for over-the-counter medications and supplies for birth control coverage and emergency contraception through the MIT Student Health Insurance Plan.

Allison Sherwood: Yes, of course. So, Medstop is a newer option for our patients to be able to utilize getting some over-the-counter products right here at MIT Health, which has been excellent. They do carry Plan B, which is the generic name of levonorgestrel. Plan B is something that can be taken within 72 hours of unprotected intercourse. And this can be bought at our Medstop without a prescription for a $15 copay. And we would want to remind everybody about their hours. They are open during daytime business hours, so the 8:30 to 5:00 hours. So if that's an option for folks, we really do encourage people to use that MedStop.

Host: Can they just walk up, Allison? Or do they have to make an.

Allison Sherwood: Yes. So for the Plan B, levonorgestrel, yes, you can just go out, walk up without a prescription, without an appointment, and buy that at the MedStop. However, like we said, this needs to be taken within 72 hours. So if you're looking for the prescription-based ulipristal, ella, there is a trade name there, that can be taken up to 120 hours after unprotected intercourse. This does require a prescription and we would encourage you to talk with our triage nurses, our urgent care providers, to talk through getting a prescription for this.

Host: What a great service. And Dr. Anand, if a student is covered as a dependent on someone else's health insurance, will that person be notified if the student gets a prescription for birth control? You mentioned a little bit briefly before if someone is covered on someone else's health insurance, tell us a little bit more about that.

Dr Vini Anand: So, we encourage students who are on the plan through their family to set up on their own insurance account. So, they could call the number on the back of their card and change the mailing address to their address in case sometimes insurance companies mail this explanation of benefits information to the plan holders. So if you really want to keep everything private, that's one option, to change the mailing address to your address. So, that's one way to address it and keep the privacy.

Host: I'd love to give you each a chance for a final thought here, because this really is such an important topic to have that knowledge about. So Dr. Anand, what would you like the key message to be for MIT students? As far as MIT Health and the MIT Student Health Insurance Plan, MIT SHIP, what would you like them to know about getting involved, finding more about their birth control options and reaching out if they need help?

Dr Vini Anand: So, there are a lot of resources out there. Of course, social media is a great resource to learn. But remember, everyone has their individual health needs and consideration. So, one option right for one person may not be the perfect option for yourself. So, it's always important to check other options and reach out to your healthcare provider to find what would be the best option for you.

And we offer comprehensive services. So, we can definitely get you with real help that we really want you to have. You start on any of these options, and there are many websites such as Reproductive Health Access website that offers information on the MIT portal with the education. We can send information through their portal to each patient as well. And of course, they can access this podcast and many more.

Host: And Allison, as some students may be new to using contraception and STI protection, when you offer them your advice and you give them counseling, and I'd like you to speak about how they can get more counseling to determine which is best for them and how to properly use it, but I'd also like you to touch on what you tell them when you're saying your information about birth control and STI protection. What's some of the best advice you offer?

Allison Sherwood: I'd like to kind of think about the encounters that we get with our patients, either if it's through some of our STI clinics or our one-on-one visits or things like these type of podcasts, that we do really like to take the time to get to know a patient and their needs and really understand, you know, what kind of background they're coming from in terms of what they've learned about contraception, what's their worldview in terms of either family members or religious background, things that might have influenced their knowledge around STI protection or contraception in the past. And getting to know some of that background, I think that we really can get to know a patient and understand what we can be doing to be helpful in terms of meeting their needs from the many different lenses we need to be thinking about.

So, all this is to say we want to make ourselves very approachable. Come to MIT Health. We are very well versed in having all kinds of conversations tailored to the needs of our patients, and we welcome your questions. No question is a bad one. Please look forward to reaching out to us and we look forward to serving the needs that you have.

Host: Thank you both so much for joining us and sharing your incredible expertise for this very important discussion today.

Listeners can visit Health.mit.edu for more information and to get connected to one of our providers. That concludes this episode of Conversations with MIT Health. Please remember to subscribe, rate and review this podcast and all the other MIT Health podcasts. . I'm Melanie Cole. Thanks so much for joining us today.