Does Health Insurance Cover Birth Control?

Trying to figure out exactly what your health insurance covers and doesn’t cover can seem like a daunting task. Due to the rocky political climate, what health insurance includes and doesn’t include can be complicated, as things are ever-changing. The Affordable Care Act (or Obamacare, as it’s often referred to), changed the scope of coverage, as it automatically required all health insurance plans to cover certain pre-existing conditions and services; birth control being one of them.

The current administration has stated that it will repeal and replace the Affordable Care Act (ACA), which has left many people wondering – and rightly concerned – about what their health insurance will cover. Fortunately, things haven’t changed much and the ACA is still effective, which means that the conditions and services that it covers are still very much in-tact. Therefore, if you have health insurance – whether it’s through your employer or through the Marketplace – birth control is likely covered. It’s important to note, however, that you should contact your carrier to ensure that your plan does, in fact, cover contraception. There are religious exemptions in place; for instance, if you work for a religious group that provides health insurance, your contraception may not be covered if they applied for an exemption. In that case, you would be responsible for the entire cost of your birth control. If however, your health insurance plan does cover birth control and you see an in-network healthcare professional for a prescription (and you are using a contraceptive method that is included with your plan) birth control should be completely covered; you shouldn’t have a copay, either.

What Forms of Birth Control does Health Insurance Cover?

Under the Affordable Care Act, all health insurance plans must provide coverage for FDA-approved forms of birth control (unless there’s a religious exemption), including the following methods:

• Hormone birth control pills
• Intra-uterine devices (IUDs)
• Implants that are inserted in the arm
• Emergency contraception (also known as Plan B birth control pills)
• Female (tubal ligation) and male (vasectomy) sterilization

While all of these FDA-approved forms of birth control should be covered by your health insurance plan (again, with the exception of plans that have religious exemptions in place), again, it’s important to note that you should contact your health insurance carrier before you have a prescription filled or schedule a procedure. Every plan is different and the forms of contraception that each one covers differ.

What About Medicaid?

If your healthcare coverage is provided by Medicaid, birth control will still be covered. Though your options may be more restricted because all methods of contraception that are approved by the FDA aren’t required to be covered, there are definite options available. Contact the Medicaid office of your state, as coverage for birth control is different in each state.

What if You don’t have Health Insurance?

If you don’t have Marketplace or employer-sponsored health insurance, or Medicaid, there are ways that you can get birth control. Planned Parenthood and other similar woman’s reproductive health organizations, do offer contraception. Planned Parenthood provides no- or low-cost healthcare services for women, including annual exams, STD screenings, birth control, and assistance with pregnancy. If you need birth control and don’t have health insurance, this organization – which has offices in all states – will help you find the best option to meet your needs.

The cost of birth control without health insurance will vary and is largely dependent on the form that you choose. Generally, hormonal birth control pills are the most cost-effective; they’re also highly reliable. The NuvaRing, a contraceptive that’s inserted vaginally, is just as effective as the pill, but it usually costs more. Implants are also very effective at preventing pregnancy; however, they tend to have the highest out-of-pocket cost.

If you have health insurance and you aren’t sure what forms of birth control are covered by your carrier, speak to a representative to learn more. If you do not have health insurance and need contraception, contact a reputable health insurance agent to find out what type of options are available to you that offer affordable birth control options. While there are ways to secure birth control without insurance, the most affordable way to obtain a prescription is through a health insurance plan.

The Bottom Line

Thanks to the Affordable Care Act, most health insurance companies cover FDA-approved birth control plans; however, don’t assume that just because you have coverage that contraception will be covered. It’s always in your best interest to speak to your insurer before you obtain a prescription to confirm that it is, in fact, covered, and if so, what methods are covered. The last thing you want to do is get a prescription, fill it, and find out that you are responsible for the cost and get hit with a big bill.