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Health Care Reform:

Health Insurance & Affordable Care Act

Birth Control Coverage: FAQ

Will my insurance cover the cost of over-the-counter female birth control methods?

Only if you have a prescription from your doctor. Over-the-counter birth control for women includes sponges, the female condom, and spermicides.

You'll still be able to buy them without a prescription, but you’ll have to pay for them on your own.

Where do I need to buy my birth control for it to be covered?

You don't have to change how or where you get it. You can get your birth control where you usually buy it: at your local pharmacy with a doctor's prescriptionP or through a mail order or online pharmacy. Your insurance company may, however, require you to go to an in-network provider or pharmacy.

Does the plan cover any other types of birth control services?

Yes. You also can get contraceptive counseling from your doctor at your well-woman visit at no additional charge. That includes information on:

  • The types of birth control that are available
  • How these methods work to prevent a pregnancy
  • Which type of birth control might be best for you

When does this new coverage start?

Most health insurance plans now cover birth control. Plans that existed before the health reform law may be grandfathered in and may not have to offer this coverage if they have not changed a lot. Check your policy or call your insurance company for information about your coverage.

Can I get brand-name birth control pills?

Insurance companies can charge you a copay, coinsurance, or deductible for a brand-name drug if a generic version is available unless your provider determines there is a medical reason why you need the brand-name drug instead of the generic.

Is birth control covered for men in health insurance plans?

No. Only women's birth control is covered. Health insurance companies do not have to pay for services related to a man’s reproductive capacity, such as condoms and vasectomies. In some states, Medicaid provides family planning services and supplies to eligible men and women under the state plan. Contact your local state Medicaid agency to see if you qualify for coverage for family planning services.

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