Birth control is used to prevent pregnancy, and in some cases, treats PMS symptoms, acne, and conditions such as endometriosis. But is birth control covered by insurance?

Birth control is covered under the Affordable Care Act (ACA)’s minimum essential coverage and isn’t difficult to get, but you need a prescription from a doctor if you’re interested in receiving birth control.

Can you get birth control pills over the counter?

No, you cannot get birth control pills over the counter (OTC). You must get a prescription from a doctor.

You typically can get a prescription for birth control from your primary care provider (PCP), an OBGYN, or via mail order birth control services, such as Nurx or Favor (formerly The Pill Club). Check and make sure with your health insurance plan to see if they cover mail order services.

Additionally, it’s important to keep in mind that these birth control mail order services may be considered out-of-network depending on your health insurance plan. You can always call your health insurance provider to double-check which pharmacies and mail order services are covered.

Forms of birth control you can buy over the counter include:

• the sponge
• external condoms
• internal condoms
• some emergency contraceptives – for example, Plan B.

These OTC medications are usually not covered by health insurance unless you can get a prescription. However, it is easy to get birth control items – such as internal or external condoms – from your local Planned Parenthood at low or no cost.

How can I get birth control pills for free?

Birth control pills aren’t free on their own. However, you can get birth control pills for free – or at relatively low cost – if you have ACA-compliant insurance.

According to Planned Parenthood, birth control pills can cost up to $50 without coverage but can be $0 with ACA-compliant coverage. Additionally, you will likely have to front the cost for the appointment to get a prescription for birth control – doctor’s visits can cost up to $250 – unless you have health insurance. However, you can get the pill prescribed online.

Is birth control free?

One option you have to get free – or extremely low-cost – birth control is to get ACA-compliant health insurance coverage. Of course, almost nothing is truly “free”—you only benefit from full coverage of birth control options if you are paying monthly premiums for a compliant health insurance plan.

Due to a 2012 provision of the ACA, coverage for women’s and reproductive health care has been expanded, making these services included as a minimum essential benefit. Beginning on August 1, 2012, all health insurance plans were required to cover a prescription for most birth control methods. 

Furthermore, plans that are sold through the health insurance marketplace must cover at least one option for each FDA-approved birth control method for women without copays or deductibles.

Which birth control methods are covered under the Affordable Care Act?

All plans bought in the health insurance marketplace are required to cover contraceptive methods, so if you have insurance under the Affordable Care Act, you will have birth control coverage.

Contraceptive methods that the ACA will cover include: 

• Barrier methods such as diaphragms and sponges
• Emergency contraception, such as Plan B and ella
• Birth control pills, vaginal rings, and other hormonal methods
• Intrauterine devices (IUDs) and similar devices
• Sterilization procedures

Additionally, the ACA covers other female-centered health benefits, apart from birth control. Some benefits include:

• Well-woman visits
• Sexually transmitted infection (STI) counseling, including HIV
• The HPV vaccine
• Prenatal screening and tests
• Breastfeeding counseling and supplies

What if I am not covered and need birth control?

If you do not have health insurance, and it is not near the open enrollment period, you can get some coverage through short term health insurance plans. Not all short term plans provide coverage for prescription medications, such as birth control, but some do. While short term coverage is a great way to find some coverage when it’s outside of open enrollment, it’s important to keep in mind that you can be denied short term health insurance coverage based on preexisting conditions.

If you make below 133% of the federal poverty line (FPL) and are looking to get birth control – and other healthcare expenses covered – you may qualify for Medicaid or other government assistance.

Birth control coverage by insurance type

The specific insurance that you have will determine what is covered and what isn’t. While Medicare is the largest provider of all types of birth control methods, other insurance types are different. If you have Medicaid, then you can expect birth control to be covered. Keep in mind that your Medicaid will only cover FDA approved forms of birth control, as well as generic versions. There may also be other stipulations that may exist depending on your specific state. 

If you have any speculation that your birth control will no longer be covered by your health insurance plan in 2023, you should contact your insurance provider to determine what is covered and what isn’t. 

Cost of birth control without insurance

If you don’t have health insurance, then you need to determine how much birth control will cost. You could potentially end up paying as much as $2,000 per year for birth control. Of course, this will depend on the specific contraceptive method you opt for as well as the brand. If you opt for the generic form of birth control pills, then you can save a significant amount. 

Get birth control coverage with insurance

To make sure your birth control expenses are completely covered, you can enroll in an ACA-compliant health insurance plan during the annual open enrollment period. The annual open enrollment period runs from November 1st through December 15th in most states every year for coverage starting the following year. Make sure to check your state though, because many states have extended open enrollment periods. Additionally, you can check if you qualify for a special enrollment period, which can happen at any time of the year, as long as you have a qualifying life event to justify it. The cost of birth control can vary significantly depending on the type of insurance you have and if you have insurance at all. However, health care laws are constantly changing, so in order to keep up to date with health care coverage, including for birth control, you should visit eHealth as a source to find insurance that covers birth control, and more. eHealth agents will help you find health insurance that is right for your specific needs so you can pay nothing—or close to nothing— for your birth control.