Free Birth Control—Maximize Your Affordable Care Act Benefit

Various types of contraceptives
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Thanks to the Affordable Care Act, women in the United States may now get free birth control. To get the most from the benefit you need to understand who the benefit applies to, what is and isn’t covered, and what the rules are.

Who Gets Free Birth Control?

Contraception is covered by most health insurance without cost-sharing like a copay, coinsurance, or deductible, but you must have health insurance coverage to get the benefit.

Although most health insurance plans are required to provide the benefit, some are not. Your health insurance should provide free birth control unless it is

  • a grandfathered plan
  • a self-funded student health plan
  • sponsored by a religious organization or non-profit with religious objections to contraception

If you’re not sure, you can find out if your health plan offers this benefit by calling your health insurance company at the phone number on the back of your health insurance card. The National Women’s Law Center provides a suggested telephone script to help you while speaking with your insurance company.

The contraceptive benefit only applies to women with reproductive capacity. Birth control for men, such as condoms or vasectomy, isn't covered.

Which Types of Birth Control Are Free?

Health plans should provide the full range of Food and Drug Administration approved contraceptive methods. This includes

    This Affordable Care Act benefit doesn't apply to abortion drugs, to contraceptive methods not prescribed by your doctor, to contraceptives meant for use by men, or to contraceptive methods not approved by the FDA. Learn more in "Birth Control & Health Insurance--When You Have to Pay."

    Are There Other Rules About the Free Birth Control Benefit I Need To Know?

    Health insurers are allowed to use medical management techniques to keep costs in check. This doesn’t mean that they can opt out of covering costly birth control methods. They must provide access to the full spectrum of FDA-approved contraceptives. However, they're allowed to charge a copay or coinsurance for the brand-name version of a contraceptive while providing the generic version for free.

    If your health insurer is charging you a copay or coinsurance for your brand-name contraceptive, ask your health care provider if it’s safe for you to switch to the generic version so you’ll get it for free. If your doctor feels it wouldn't be medically appropriate for you to switch to the generic drug, your health insurance company must waive the cost-sharing for the brand-name drug.

    You're entitled to get the services you need to safely and effectively use your prescribed method of contraception without cost-sharing.

    Using the example of an IUD, the IUD device itself would be covered without cost-sharing. In addition, the fee your doctor charges to insert the IUD would be covered without cost-sharing, as would the recommended follow-up office visit and any charges related to taking out the IUD later.

    If your health insurance is an HMO, PPO or POS plan, you’ll need to receive your contraceptives and any contraceptive-related services from an in-network provider in order to avoid cost-sharing. However, if there are no in-network providers who can provide the service, then the health plan is obligated to cover the service without cost-sharing even if you get it from an out-of-network provider.

    Is This Really Free?

    These benefits are available because the Affordable Care Act requires that preventive care be provided without cost-sharing. Since you don’t pay anything at the time of service, it seems as though these services are free. Rather than being free, you’re actually paying for the services, whether you use them or not, each month when you pay your health insurance premium.

    In fact, you’re paying for 62 preventive services in addition to contraception. While some of those services won’t be appropriate for you, by taking advantage of as many appropriate preventive services as possible you'll maximize the Affordable Care Act benefits you’re already paying for. It’s a wise choice for your wallet and your health.


    United States Department of Labor Employee Benefits Security Administration, February 20, 2013, FAQs About Affordable Care Act Implementation XII

    Health Resources and Services Administration, Women’s Preventive Services: Required Health Pan Coverage Guidelines

    The Institute of Medicine Report Clinical Preventative Services for Women: Closing the Gaps

    Federal Register Vol. 76, No. 149, Wednesday, August 3, 2011 notice: Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under the Patient Protection and Affordable Care Act (pdf)

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