Does Medicaid Cover Birth Control?
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Medicaid is a national program that offers health coverage to more than 81 million people in the United States. In most states, Medicaid covers birth control at no cost to the patient.
Family planning with Medicaid
Federal rules say that state Medicaid programs must provide family planning services at no cost to the patient. As a broad category, family planning can include contraception, as well as other related services like screenings for sexually transmitted infections, HIV and cancers.
Beyond that broad requirement, federal rules don’t specify which services states have to include in family planning coverage. That can make the list of what’s fully covered dependent on where you live. Still, birth control is what most people think of when referring to family planning services, and most states cover it, according to the Kaiser Family Foundation.
Under the Affordable Care Act, or ACA, which passed in 2010, some states expanded some or all Medicaid health benefits to additional low-income Americans, even if they don’t meet other eligibility requirements. States could opt to expand only family planning services or offer all Medicaid benefits to the broader group of people.
The 38 states (plus Washington, D.C.) that opted in to the full Medicaid expansion have to adhere to stricter rules for coverage for people who qualify under the expansion. Similar to most private insurers, these state Medicaid programs have to provide preventive care, including birth control, at no cost to patients.
What birth control does Medicaid cover?
If your state Medicaid program covers contraception, it will cover the methods approved by the U.S. Food and Drug Administration. Those methods fall into broad groups:
Patient education and counseling.
Hormonal methods, including birth control pills and vaginal rings.
Implanted devices, such as intrauterine devices, or IUDs.
Barrier methods, including diaphragms and sponges.
Although the ACA doesn’t require coverage for vasectomies, the Kaiser Family Foundation reported that most state Medicaid programs it surveyed covered this procedure.
Like private insurers, state Medicaid programs may have limits in place to control costs. That means you could run into restrictions on the brands or quantity of medication you can get. You may also need a prescription for some over-the-counter contraceptive methods in order to have them fully covered.
Check with your state's Medicaid office for coverage details.