Birth Control Insurance Coverage: How to Get Contraception With or Without Insurance

Obtaining free or low-cost birth control can be challenging, even if you have health insurance. The Affordable Care Act (ACA) made some forms of birth control free of charge for the first time — whether you have an employer plan or one through the health insurance marketplace — but there are limitations. It can also be hard to get birth control if you don’t have insurance.

Costs can be a reason. Birth control costs have largely gone down since the ACA’s coverage provision went into effect in 2012. But women still may not be able to get affordable birth control. This may be due to rules that limit the number of covered options available to women. In fact, 18% of women aren’t using the type of birth control they prefer. And 25% say that’s because they can’t afford it. 

Consumer complaints also suggest some health plans aren’t following the law in making at least one choice of covered birth control free in every appropriate category. Recently, there has been a push to try to ensure that the ACA rules are enforced so women don’t have to bear out-of-pocket expenses for birth control.

Here’s a look at the current landscape for birth control coverage and what to do if you’re having trouble getting the contraception you need.

Does insurance cover all birth control?

Under the ACA, most health plans must have one option available with no out-of-pocket costs in each of the FDA-approved birth control categories. These include: 

• Oral contraceptives

• Cervical caps

• Intrauterine devices (IUDs)

• Vaginal rings

• Implantable rods

• Sterilization

Depending on which product you choose, your plan may or may not cover your birth control. And keep in mind that some newer products may not yet have coverage. Your plan also should cover counseling for birth control and all services related to its management.

Health insurers do not have to cover male reproductive procedures such as vasectomies or medications to induce abortions. They also don’t have to cover methods sold over the counter (OTC) without a prescription, such as condoms. But every state offers free condoms through different organizations, and some programs send them by mail.

You can talk with your healthcare provider about finding a method that works for you and is covered by insurance. Note that the law does not let a healthcare provider influence a person’s choice of birth control.

If your desired method isn’t covered but you think it should be, you can use the cost-sharing exception or appeal process. CoverHer.org may also be helpful: It is a project of the National Women’s Law Center that aims to help insured women get the birth control coverage due to them under the ACA.

Coverage by insurance type

Here’s a breakdown of birth control coverage by type of insurance.

Private insurance 

About two-thirds of privately insured women are able to get their prescriptions fully covered. 

But 21% are still paying some out-of-pocket costs for contraception, even though the ACA mandated that private health insurance plans had to completely cover prescription birth control for in-network services. 

Only female birth control is covered (male options such as condoms and vasectomies don’t have to be covered). And plans only have to cover one product in each category, which is partly why some people with private insurance still have out-of-pocket costs.

Health insurance marketplace plans

If you have a marketplace health plan, the insurer must cover birth control as prescribed by a healthcare provider. Even if you haven’t reached your deductible, the plan must cover the services free of charge if you stay in your plan’s network. This means that they cannot charge a copayment or coinsurance if the provider is in-network. There are exceptions for “grandfathered” health plans established before the ACA provision began, and for religious employers. These plans don’t have to cover birth control. After a 2020 Supreme Court ruling, employers with a sincere religious or moral objection also can choose not to cover birth control.

Medicaid

If you have Medicaid, your plan also will cover products in the FDA-approved categories of birth control. But Medicaid, like other insurers, can impose utilization controls like prior authorization or requiring the use of a generic drug first. So you may not be able to get the exact brand that you want. 

More states are starting to cover long-acting reversible contraceptives (LARCs) for Medicaid participants. These include IUDs and implants, and few states say they impose utilization controls on their use. In fact, some Medicaid programs offer a reimbursement if you have an IUD put in after having a child. 

How do I know if my insurance covers birth control?

Check your policy (including the prescription plan) and talk to your healthcare provider about your options. If you see a provider regularly, you also may be able to email them questions through a secure online health portal. 

Your plan likely covers some birth control, but may not cover all the fees for the exact brand you want. If you can use the brand covered by your health plan (and stay in-network), you could get it at no out-of-pocket cost. 

How much does birth control cost without insurance?

Without any coverage, birth control can cost over $2,000 per year. This depends on the form of birth control you choose, however. It also varies based on your insurance coverage. If you choose a generic form of birth control, you can save money. If your plan covers a specific brand or generic, you may not have to pay anything. 

Out-of pocket expenses for birth control pills saw a steep decline after the ACA went into effect. By 2018, more than 2 out of 3 women were able to get oral birth control pills for free compared to only 15% in 2012. 

Among those who still have a cost, the average annual out-of-pocket cost for birth control pills is $226 for people with insurance and $268 for those without insurance. You may also have to pay for a visit to the healthcare provider to manage your birth control. The average annual out-of-pocket cost for extra healthcare provider care is $87.

Some other costs on popular forms of birth control:

• Pills: Prices for 30-day fills range from $22 to $79 among the most popular pills. Generic forms of birth control can be much cheaper than brand-name pills.

• Patch: Expect to pay about $140 for three patch es without insurance. 

• IUD: The cost of an IUD without insurance is about $1,000 or $200 per year, assuming you have it for 5 years. 

• Implant: For those without insurance, the implant costs about $1,300 — that’s an annual cost of about $433, assuming you have it for 3 years. 

• Ring: The average monthly cost of a ring is over $167 without insurance coverage, or about $2,000 a year out of pocket.

What if my insurance doesn’t cover my birth control?

Birth control coverage is on some people’s minds after the Supreme Court overturned Roe v. Wade in June 2022. There is uncertainty as birth control potentially gets swept up into related health insurance lawsuits. 

Coverage is still mandatory under the ACA. But some employers may opt out or may only offer minimal coverage for the reasons described above.

If your birth control isn’t covered by insurance, you do have some options, like using a GoodRx coupon. Keep in mind that the prices mentioned below reflect the lowest possible costs using GoodRx as of July 2022.

If you’re on the pill:

• There are hundreds of oral contraceptive brands out there, and GoodRx offers savings for a majority of them — and almost certainly the most commonly prescribed options.

• If you’re on a brand-name version of the pill, call your healthcare provider to see if they can switch you to the generic form as generics tend to be 70% to 80% cheaper.

• Here are some costs for popular birth control pills using GoodRx coupons: tri-previfem ($8.12), orsythia ($7.20), junel FE 1/20 ($3.49).

If you’re using the patch or the ring:

• These are monthly costs, so you may want to consider switching to another type of birth control if it is too expensive in the long run.

• GoodRx can save you 68% on the patch (Xulane, $43.11) and up to 63% on the ring (Nuvaring, $49.64).

If you’re taking the shot:

• The generic version (medroxyprogesterone, $11.50) costs 82% less with GoodRx — and lasts 3 months at a time.
  

If you have an IUD or implant:

• Implants typically last 4 years and IUDs last 3 to 12 years (depending on the type of IUD you have) so you’re probably protected for a little while longer.

• If you have to get your contraceptive device removed, the procedure can cost up to $250 if you don’t have insurance. Contact your local Planned Parenthood health center as they may charge you less, with or without insurance.

• After removal, you can look at other birth control options to continue preventing pregnancy, and save with GoodRx.

How can I get free birth control without insurance?

If you are uninsured, there are some low-cost birth control options. You may even find ways to get free birth control without insurance.

One option is to explore online birth control services that do not require insurance, such as GoodRx Care. There may be restrictions based on what state you live in. But some providers can distribute birth control to women in all 50 states. (You may also be able to fill your prescriptions with this service, even if you have Medicaid or private insurance.)

Community health centers also offer services on a sliding fee scale depending on your income, family size, and ability to pay.

Another option is Planned Parenthood, a nonprofit organization.They may be able to help you receive free birth control without insurance, or help you obtain low-cost birth control, depending on your income. It also can provide information on other resources in your area.

Why trust our experts?

Written by:

Kristen Fischer

Kristen Fischer is a health writer, copywriter, and journalist with more than 15 years of experience. She currently lives at the Jersey Shore and is a member of the Association of Health Care Journalists.

Reviewed by:

Kristen Gerencher, MSOT

Kristen Gerencher is an award-winning writer who has reported on healthcare, medicine, and insurance for a variety of national publications. Before contributing to GoodRx, she was a healthcare and personal finance reporter for MarketWatch.

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