Under the Affordable Care Act, most insurance plans must cover at least one form of FDA-approved contraception in each category at $0 out-of-pocket cost. This includes pills, patches, rings, IUDs, implants, injections, and emergency contraception. However, brand-name contraceptives may have copays if a generic alternative is available at $0, and some employer and religious exemptions exist.

Key Facts

ACA requires $0 copay coverage for at least one contraceptive in each FDA-approved category
Generic birth control pills are covered at $0 on most ACA-compliant plans
Brand-name contraceptives may require copays if a generic is available at $0 in the same category
IUDs (Mirena, Paragard, etc.) and implants (Nexplanon) are covered at $0 including insertion costs
Religious employer and moral exemptions allow some plans to exclude contraceptive coverage
Emergency contraception (Plan B, ella) must be covered at $0 with a prescription on most plans

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Coverage varies by plan. Use our formulary checker tool to look up your exact copay and restrictions.

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Sources and standards behind this page

Drug coverage in the United States is governed by published rules rather than by any one insurer's summary, and the sources below are the primary ones. They are linked so a reader can check a claim without taking this page's word for it.

This page describes how coverage and formularies work. It is not medical advice, and a reader's own plan documents and prescriber decide what applies to them.

Frequently Asked Questions

Is birth control really free with insurance?

On ACA-compliant plans, at least one form of contraception in each FDA-approved category must be covered at $0 copay. This typically means generic pills, generic patches, and generic rings are free. Brand-name products may have copays. IUDs and implants are covered at $0 including the insertion procedure. Some exempt plans (grandfathered, religious employer) may not cover contraception.

Does insurance cover brand-name birth control like Lo Loestrin?

It depends. If a generic equivalent is available at $0 in the same contraceptive category, your plan may charge a copay for the brand-name version. Your doctor can request a formulary exception if there is a medical reason you need the brand-name product (e.g., adverse reactions to generics). Some plans cover all contraceptives at $0.

Does insurance cover vasectomy or tubal ligation?

ACA requires coverage of female sterilization (tubal ligation) at $0 copay. Male sterilization (vasectomy) is not specifically mandated at $0 under the ACA's contraceptive coverage provision, but many plans cover it with standard surgical copays or coinsurance.

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