Getting birth control from telehealth services online can increase access for people who live in contraceptive deserts, where they lack reasonable access to contraception; can help people overcome other barriers such as finding childcare or taking time off of work for an appointment; as well as helping patients skip the clinic visit during the COVID-19 pandemic. And telehealth allows patients to get safe and effective birth control on their own terms at a time that works for them.
Just as with any new service or way of getting health care, people have questions. We surveyed and interviewed Bedsider users to find out their most frequently asked questions and concerns about getting birth control online. For references and more information about the research behind the answers, check out this telehealth research roundup. Here are the questions that patients most often ask:
What kind of birth control can I get online? Patients can get most short-acting, hormonal birth control like the pill, the patch, the ring, the shot, and emergency contraception and barrier methods, like condoms and internal condoms, delivered to them or their local pharmacy after a telehealth visit. And patients who use birth control for non-contraceptive benefits, such as improving acne, managing heavy periods, or PCOS can get birth control through telehealth too.
Companies, such as Hers, Hey Doctor, Nurx, Pandia Health, Pill Club, PillPack, Planned Parenthood Direct, PRJKT RUBY, Simple Health, and Twentyeight Health, vary slightly in what methods and brands they offer. And depending on where people live, the requirements are slightly different. Refer patients to Bedsider’s How To Get It guide to find the most up-to-date information on the telehealth and delivery options available in their area.
Do I need a physical exam or a pap smear before starting birth control? Questions and concerns about physical exams before getting birth control online (and in person) were common among the Bedsider users we talked to. But the truth is you don’t need a physical exam or an in-person visit to start most birth control methods. Unless you’re placing an IUD, you don’t need to perform a pelvic exam or an STI test, and you never need to do a Pap smear to start birth control. We still recommend Pap smears and STI tests for most people, they just aren’t necessary before someone starts on birth control, making virtual and telehealth visits an ideal way improve access to short-acting, hormonal birth control methods.
However, to start methods that contain estrogen, people will need to have a recent blood pressure reading. You can discuss with patients that they will need to have that information available for their telehealth visit.
Is it safe to get birth control online? Am I talking to a real provider? Patients expressed concerns about the safety and quality of telehealth and deliver to your door services, but research shows that that telehealth prescribers adhered to the US MEC, withholding prescriptions when there was a contraindication, 93% of the time which is actually higher than rates reported for in-person visits!
And telehealth providers are real providers, not bots. They have the same licensing, education, and certification requirements as any other provider. Many providers who work in telehealth also see patients in person. We even found that many Bedsider users we talked to were already using and loving telehealth services, such as mail order prescription delivery, they just didn’t realize it!
How much does it cost to get birth control online? Depending on the birth control method patients want, the prices can vary. However, most are free with insurance (including public insurance, like Medicaid) and many companies offer low- to no-cost options without insurance, starting at $5-15 per month. To find out how much a particular method costs with or without insurance, patients can check out this Bedsider article about the costs of getting birth control online and should be encouraged to shop around for the best price.
Can I keep my birth control information private when I order online? Yes, but patients should think about who they are trying to keep their birth control private from. In terms of privacy, patient information that is shared through secure apps or online with telehealth companies is protected by HIPPA and kept private by the telehealth companies.
To keep the services private from family, partners, and the person delivering your package, most companies offer discrete packaging with no mention of what’s inside, but patients should keep in mind that a signature is not required, so someone else could open the package after it is delivered and see that there is birth control inside. If patients are concerned about someone they live will seeing their birth control package, help them consider other places to have their package delivered or if they can have it held at the post office. And just like with in-person visits, people should think about who might see an explanation of benefits if they use their insurance and consider paying out of pocket if they are concerned.
How do I follow up if I’m having side effects, am unhappy with my birth control method, or want to switch? Each company does it a little bit differently, some have apps or online portals, others use email, but all of them have a way for patients to get in touch to change their method or talk about ways to manage side effects. Patients should be encouraged to ask about how to follow up with telehealth providers or with you.
Patients may have more questions about getting birth control online but being ready to answer these commonly asked questions from patients can improve patient satisfaction and knowledge about these services.