Obamacare and Birth Control

The Affordable Care Act, widely known as the ObamaCare, covers one type of birth control service for every individual based upon the 18 categories approved by the Food and Drug Administration (FDA) at no “out of pocket” cost, though it is important to note that some insurance plans have exemptions. This page will offer useful information on this law and birth control.

The 18 Contraception Categories Approved by the FDA

Under the ObamaCare, non-grandfathered plans are mandated to cover specified preventive care services that are recommended by the FDA without cost sharing. This is postulated so the law will be consistent with PHS Act section 2713. Now, the 18 types of approved contraception items and services are: surgical sterilization implant; sterilization surgery; copper intrauterine device; implantable rod; shot/injection; IUDs with the hormone progestin; oral contraceptives with progestin only; oral contraceptive pills with progestin and estrogen; oral contraceptives of extended or continuous use that delay menstruation; vaginal contraceptive ring; the patch; sponge; diaphragm; female condom; spermicide; cervical cap; a pill called Ella for emergency contraception; and the Plan B/morning-after pill for emergency contraception.

Unless it is medically needed to use a name brand, the ObamaCare covers generics with no “out of pocket” costs. Also, take note that not all plans provide all types of contraception, but it is clarified by the Health and Human Services (HHS) that at least one type from each of 18 categories enumerated above will be covered on all qualified plans.

As stated by HealthCare.Gov, all contraceptive methods that are approved by the FDA and prescribed by doctors are covered. In general, these include:

  • Hormonal methods
  • Barrier methods
  • Emergency contraception
  • Implanted devices
  • Patient counseling and education
  • Sterilization procedures

On the other hand, there are also items or services that are not required to be covered, such as those related to the male reproductive capacity like vasectomy and drugs that induce abortion.

Insurance Plans That Do Not Have to Cover Birth Control

As of July 2015 there are certain health plans that are not required to cover birth control methods approved by the FDA. These are:

  • Grandfathered health plans.
  • Religious employer health plans.
  • Alternative plans that are provided by insurance companies that exclude particular forms of birth control.
  • Short-term health insurance.

Take note that all non-exempt health plans are required by the ObamaCare to cover basic birth control, but not all of them would cover all types of birth control. Basically, the rule states that each of the 18 methods has to be covered by at least one service or drug, and not that everything contraception-related must be covered.

Is Birth Control Free Under the ObamaCare?

Well, some birth control methods are absolutely free with no “out of pocket” expense, even before you have a deductible under a qualified non-grandfathered plan, but not all of them are free. If your health plan is covering birth control, then you can enjoy being fully covered for at least one of the 18 FDA-approved categories, with no cost-sharing. But if your health plan is exempt, such as a grandfathered plan or a short-term insurance, then the birth control services you are getting will not be covered.

Are All Means of Contraception Free Under the ObamaCare?

You would pay for some sort of birth control on almost all health plans, like when they might only cover generics or have a copay for a particular type of birth control. As previously mentioned, some plans are exempt from offering contraceptive coverage. Also, some institutions and employers have become exempt because of religious objections, but the present administration has issued a new rule that offers free contraceptive coverage with third parties, still allowing employees to have access to birth control products and services, while being covered.

Getting Free Birth Control

If you already have an individual or family plan, employer plan or Medicaid that was sold after 2010, then at least one type of the 18 FDA-approved birth control categories is covered for free. You can get free birth control prescriptions from a family doctor, a public or private health center or a hospital where emergency birth control is accommodated. Your prescriptions will then be filled in by the facility or at your local pharmacy, where you can buy some birth control products, like spermicide. For emergency birth control, such as plan B, you can purchase it without prescription and still be covered.

The ObamaCare and Abortion

Services related to abortion are explicitly excluded from the 10 Essential Health Benefits (EHB) offered on all non-grandfathered health plans under the Affordable Care Act, and the same goes for drugs that induce abortion. For other drugs that some people feel are crossing the line, such as IUDs, they are mandated by the ObamaCare, but are commonly exempted from selected plans. Under federal law, there is no plan to cover abortion.

Religious Employer Exemptions and Non-Profit Religious Exemptions

Some houses of worship, religious employers, employers who have religious exemptions, health sharing ministries, higher education institutions, non-profit hospitals, etc. do not provide services for contraceptives, not even counseling. However, as previously mentioned, the Obama administration has passed a new rule in July 2015 for employees of religious employers to have access to free contraceptive coverage through third parties, but there are institutions that are exempt or not affected by this rule, particularly houses of worship and health sharing ministries, as they are not employers.

Now, if you want to use contraceptive services while working for an exempt religious employer, you may have to pay for them out of your pocket, so you should look for low-cost options through Planned Parenthood and some clinics.

Things to Do If You Do Not Have Insurance

In case you do not have any health plan and just earning low, you can access women’s health services, including birth control, for free at public and private health centers that provide assistance or at organizations, such as Planned Parenthood. Also, you can often find very affordable generics at your local pharmacy and save more by paying in cash and telling the pharmacy that you do not have health insurance. You can also try looking into Medicaid and other cost-assistance options.

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