Health benefits & coverage

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

A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible.

Refer to glossary for more details.

coinsurance

The percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible.

Refer to glossary for more details.

when provided by an in-network provider — even if you haven’t met your deductible

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.

Refer to glossary for more details.

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.

TIP To 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.