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Health insurance plans typically cover FDA-approved contraceptives, including the birth control pill, intrauterine devices (IUDs), and emergency contraception. If you have an Affordable Care Act (ACA) marketplace plan, you aren’t required to pay anything out-of-pocket for birth control when you visit an in-network provider.
Not all health insurance plans are required to cover contraceptive methods. For example, 20 states and the District of Columbia allow certain employers and insurance companies to refuse to cover contraception and counseling for women. If you’re wondering is birth control covered by your insurance, you can find out by reviewing the plan’s summary of benefits.
Key Takeaways
- Most—but not all—health insurance plans cover birth control at no cost to the patient.
- Businesses with a moral or religious objection to birth control do not have to cover it.
- Out-of-pocket birth control costs for those without health insurance range from about $50 a month for pills to more than $1,000 for implants or an IUD.
Does Insurance Cover Every Kind of Birth Control?
Most health insurance plans provide coverage for 18 FDA-approved birth control methods. This typically includes:
- Oral contraceptives
- Intrauterine devices (IUDs)
- Vaginal rings
- Barrier methods, like diaphragms
- Female sterilization
- Emergency contraception
- Birth control counseling
Birth Control Coverage By Type Of Insurance
Every health insurance plan has its own coverage requirements for birth control. See how birth control insurance coverage works based on the type of plan.
Health Insurance Marketplace
All health insurance plans purchased through the Health Insurance Marketplace are required to cover all FDA-approved forms of birth control and emergency contraception. You aren’t required to pay anything out of pocket, even if you haven’t reached your deductible.
Employer-Sponsored Insurance
Under the Affordable Care Act (ACA), most non-grandfathered employer-sponsored health insurance plans are required to cover contraception for women with no cost-sharing. However, there are some employers that can refuse to comply with this requirement. If an employer has a religious or moral objection, it doesn’t have to cover birth control.
Private Health Insurance
Most private health insurance plans are required to cover birth control methods with no cost-sharing. According to the Kaiser Family Foundation (KFF), about two-thirds of women with private health insurance have full coverage for all FDA-approved forms of birth control, with no cost-sharing requirements. However, 21% of privately insured women have to pay something out of pocket to get birth control.
Medicaid
Medicaid plans are federally required to cover FDA-approved birth control methods. However, some plans have quantity limits, age restrictions, and generic drug requirements, which can restrict access to specific birth control methods. Additionally, some states require Medicaid recipients to get a prescription for emergency contraceptives that are normally available over the counter.
Which Types of Birth Control Are Free?
All FDA-approved forms of birth control are free under most health insurance plans. If you have health insurance through the Marketplace, all contraception is covered at no cost, even if you haven’t reached your deductible. Many employer-sponsored plans and private insurance plans are also required to cover birth control with no cost-sharing.
The only instances when birth control is not free includes:
- Your health insurance plan didn’t offer coverage for birth control before the ACA was passed, and hasn’t undergone any significant changes since then.
- You have private health insurance from an employer or company that has religious or moral objections to covering contraception.
- You have a short-term health insurance plan.
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Birth Control Insurance Frequently Asked Questions (FAQs)
Is birth control free in all states?
Under federal ACA guidelines, non-grandfathered health insurance plans are required to cover approved contraceptive methods with no copayment, coinsurance, or deductible. However, birth control isn’t free in all states, depending on where you get insurance. For example, if you work for a religious organization that can refuse to cover contraception, you might have to pay for birth control out of pocket. Additionally, some plans only cover certain types of birth control for free, or only cover generic prescriptions.
How can I determine if my insurance includes coverage for birth control?
To find out if your health insurance plan includes birth control coverage, you can check your policy’s summary of benefits. This will tell you what forms of birth control are covered and how much of the cost is covered. You should also check your prescription plan to see which contraceptive brands are covered. If your policy only covers some birth control methods, you can talk to your doctor about your best options.
What are the out-of-pocket expenses for birth control without insurance?
If you don’t have health insurance, the cost of birth control depends on the method you choose.
Planned Parenthood says you can expect to spend about:
- $50 for a pack of birth control pills
- Up to $150 for a Depo-Provera shot
- Up to $2,200 for birth control implants such as Nexplanon and Implanon
- Up to $1,300 for an IUD
In addition to the birth control itself, you will also have to pay an exam fee to get a prescription or to have the birth control administered in the case of a shot, implant, or device.