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Health Care Reform:

Health Insurance & Affordable Care Act

Birth Control Coverage: FAQ

You might have heard that birth control may be free as part of health care reform. Is your type covered? What about condoms? Are there any exceptions?

Here are answers to those and other common questions about birth control coverage as part of health care reform.

Will my birth control be free under the Affordable Care Act?

You will not have a copay or other out-of-pocket costs for birth control, if you:

  • Get your health insurance through most employers, through your state's Marketplace, or from most private insurers, and
  • Have a doctor’s prescription for any type of birth control approved by the FDA. This includes the ones usually sold over the counter like spermicides and sponges.

Does every health insurance plan have to pay for birth control?

  • These terms of the Affordable Care Act apply only to health insurance plans offered from your employer or that you buy on your own that are not considered “grandfathered” (you can check with your plan to find out). Certain religious employers are exempt from this requirement. Some private employers object to offering birth control on religious grounds, and may get a pass from the federal government. But in such cases their insurer must still provide birth control benefits without a co-pay or other charges.
  • Medicaid programs do not have to offer free birth control, either, but most state Medicaid programs do cover prescription birth control methods.



Which types of birth control are free?

Birth control methods that are covered by this requirement of the Affordable Care Act include any that are approved by the FDA:

Your plan may also cover over-the-counter birth control, but you will need a prescription from your doctor if you want it to be covered without out-of-pocket costs.

Will my doctor exam also be free if I get a prescription for birth control at that appointment?

Often, yes. Your well-woman visits are covered with no out-of-pocket costs to you under the Affordable Care Act. During this visit, your doctor can tell you about the types of birth control available to you and write you a prescription. However, if during the visit the doctor diagnoses or treats you for another medical condition you will likely have to pay out-of-pocket costs for the visit.

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