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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Health insurance: we all know its importance, but many of us struggle to understand the details of our insurance coverage.
Whether it’s through the Affordable Care Act (ACA) or our employers, what insurance plans cover or don’t cover––and how much you have to pay out of pocket––gets confusing fast. One common question is about birth control. Is it free? If not, how much will it cost me?
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What types of birth control are covered by insurance?
Through the Health Insurance Marketplace created by the ACA, all plans available must cover birth control and reproductive health counseling. The only catch is it needs to be prescribed by a healthcare provider (HealthCare.gov, n.d.).
FDA-approved birth control methods covered by the ACA include diaphragms and sponges, hormonal birth control options (like birth control pills, vaginal rings, and IUDs), implanted devices, and emergency contraception (Plan B) (HealthCare.gov, n.d.).
You’ll need to make an appointment to get prescribed birth control. The ACA also mandates that you don’t have to pay a copay or coinsurance––as long as you see someone in-network. If you choose someone out-of-network, the amount you pay depends on your insurer (HealthCare.gov, n.d.)
Ask a healthcare provider during your appointment if there’s a generic form of birth control they can prescribe (generics are usually less expensive). Once you have the prescription, you are still responsible for the out-of-pocket costs for birth control. Generic drugs will be cheaper than the brand-name version no matter what insurance plan you have.
Insurance plans typically come with a prescription drug list divided into tiers. Preferred tiers are cheaper than non-preferred tiers. You can determine the cost of birth control through your healthcare insurance plan by checking where it falls within this tier system.
Getting birth control through Planned Parenthood
Appointments and prescriptions for oral contraceptives and other types of birth control may be cheaper through your local Planned Parenthood health center.
Many Planned Parenthood centers accept health insurance plans, in which case your appointment may be covered. Some locations scale pricing based on your income.
Like ACA contraceptive coverage, you still need to pay for birth control once you have the prescription for it. Whether you’re going to Planned Parenthood or another health center, talk to a healthcare provider about generic versions to lower the monthly cost.
Planned Parenthood also offers free condoms. When used correctly every time, condoms are highly effective at preventing pregnancy and also protect against sexually transmitted infections (STIs).
Tips on when to start birth control pills
Free forms of birth control
Condoms are your best bet for free birth control. As we mentioned, Planned Parenthood and other places give them away at no cost. They’re not the trendiest option, but barrier methods like condoms are very effective at preventing pregnancy and most STIs when used properly (Mahdy, 2021).
If you’re unable to find free condoms, they still are likely the cheapest option for birth control, especially if you buy from stores that sell in bulk. For example, Costco sells boxes of 40–100 condoms for $19.99, which works out to $0.20–0.50 per condom.
Condoms are available over-the-counter at many places, so you don’t have to worry about making (and paying for) an appointment.
Short-term vs. long-term costs
Condoms are low cost and effective, but you also have to keep buying them and make sure you have enough on hand.
Even though you’re paying a small amount now, you’ll need to spend regularly. Condoms are still a great option, but you may want to consider alternatives that you don’t have to buy continuously.
An intrauterine device (IUD) is another potentially cost-effective form of birth control, if you’re able to swing a higher one-time cost. Getting an IUD can cost up to $1,300 (yikes!). But that depends on where you go, what type you get, and your health insurance (Planned Parenthood, n.d.).
The great thing about IUDs is they last several years. Depending on the type, IUDs can last anywhere from 3–10 years. So, even though the up-front cost is high, when you divide it over however many years it lasts, it may be a cost-effective option for you (Lanzola, 2021). Other potential long-term contraceptive options include Depo-Provera (contraceptive implant) and Nexplanon, the birth control shot.
Regardless of what type of birth control you get, there should be affordable options for you depending on your insurance.
- HealthCare.gov. (n.d.). Birth control benefits and reproductive health care options in the health Insurance marketplace®. HealthCare.gov. Retrieved from https://www.healthcare.gov/coverage/birth-control-benefits/
- Lanzola EL, Ketvertis K. (2021). Intrauterine device. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved on Sep. 22, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK557403/.
- Mahdy H, Shaeffer AD, McNabb DM. (2021). Condoms.In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved on Sep. 22, 2021 from: https://www.ncbi.nlm.nih.gov/books/NBK470385/.
- Planned Parenthood. (n.d.). Where can I buy the IUD & how much will it cost? Planned Parenthood. Retrieved on Sep 22, 2021 from https://www.plannedparenthood.org/learn/birth-control/iud/how-can-i-get-an-iud