Under the Affordable Care Act, all insurance plans available through the Health Insurance Marketplace® are required to cover prescription-only contraceptives and counseling services when prescribed by an in-network healthcare provider. By law, insurance plans must cover contraceptive methods without charging a co-pay or other out-of-pocket costs.
Good to Know:
☆ Insurance plans are required to cover prescription-only contraceptives ONLY, this does not include coverage for over-the-counter contraceptives (like Plan B One-Step®).
☆ You can learn more about insurance coverage for contraceptives by visiting Healthcare.gov/coverage/birth-control-benefit or contact your health plan
Medicaid coverage is determined by each state and varies in coverage options, accessibility, and availability on a state-by-state basis.
You can check your state’s medicaid agency to find out if your state has opted into the ACA Medicaid Expansion program.
Good to Know:
☆ Medicaid Expansion states are required to cover at least one product in each category of the FDA-approved contraceptive methods.
☆ Most state Medicaid programs and the District of Columbia provide coverage for:LARCs/ IUDsFDA-approved prescription contraceptive methods
☆ Most state Medicaid programs require a prescription to cover over-the-counter LNG EC (Plan B One-Step®) with the exception of 7 states and DC (see below).
☆ Medicaid coverage for a 12-month supply of hormonal birth control pills is provided across 13 states and the District of Columbia including California, Colorado, Nevada, Washington, North Dakota, Missouri, North Carolina, South Carolina, Maryland, Delaware, New York, Vermont, Massachusetts, and Rhode Island. Pharmacists can prescribe certain contraceptives to Medicaid recipients in 11 states including California, Colorado, Idaho, Maryland, Oregon, North Dakota, Tennessee, Vermont, Washington, and West Virginia.
☆ Medicaid coverage for over-the-counter LNG EC (Plan B One-Step®) without a prescription is available in 7 states including DC, Illinois, Kansas, Maryland, Michigan, New Jersey, New York, Pennsylvania, Utah, and Washington.
☆ Medicaid Expansion has not been adopted in 13 states including Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming.
