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By Ryan Kennelly

September 15, 2016

Topics:

  • Individual & Family Health Insurance
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What contraceptive methods are covered under the ACA?

September 15, 2016

  • Individual & Family Health Insurance

Plans in the Health Insurance Marketplace must cover contraceptive methods and counseling for all women, as prescribed by a health care provider.

Plans must cover these services without charging a copayment or coinsurance when provided by an in-network provider — even if you haven’t met your deductible.

Covered contraceptive methods

FDA-approved contraceptive methods prescribed by a woman’s doctor are covered, including:

  • Barrier methods, like diaphragms and sponges
  • Hormonal methods, like birth control pills and vaginal rings
  • Implanted devices, like intrauterine devices (IUDs)
  • Emergency contraception, like Plan B® and ella®
  • Sterilization procedures
  • Patient education and counseling

Plans aren’t required to cover drugs to induce abortions and services for male reproductive capacity, like vasectomies.

TIPTo be sure if a specific method is covered by your plan, check your plan’s materials or ask your employer or benefits administrator.

Birth control benefits rules for employer-provided coverage

If you work for a religious employer

Health plans sponsored by certain exempt religious employers, like churches and other houses of worship, don’t have to cover contraceptive methods and counseling.

If you work for an exempt religious employer and use contraceptive services, you may have to pay for them out-of-pocket. Contact your employer or benefits administrator for more information.

If you work for a non-profit religious organization

Some non-profit religious organizations — like non-profit religious hospitals and institutions of higher education that certify they have religious objections to contraceptive coverage — don’t have to contract, arrange, pay, or refer for contraceptive coverage.

  • If your health plan is sponsored or arranged by this type of organization, an insurer or third party administrator will make separate payments for contraceptive services that you use.
  • You’ll have access to contraceptive services without a copayment, coinsurance, or deductible when they are provided by an in-network provider.

Contact your employer or health plan to learn more.

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