The Affordable Care Act (ACA) included a first-of-its-kind requirement that health insurance plans cover the full range of Food and Drug Administration (FDA)-approved birth control methods with no out-of-pocket expense to the consumer - that means consumers who can get pregnant can’t be charged a copay, coinsurance, or deductible for it.
- There are currently eighteen (18) different categories of FDA-approved birth control options, including, tubal ligation, various intrauterine devices (IUDs), implants, shots, oral contraceptives (sometimes known as “the pill”), patches, rings, diaphragms, sponges, cervical caps, internal condoms, spermicide, and emergency contraceptives (sometimes known as “Plan B”).
- The no-cost coverage also includes “contraceptive counseling, initiation of contraceptive use, and follow-up care (e.g., management, evaluation, as well as changes to and removal or discontinuation of the contraceptive method).”
Health plans and issuers must cover without cost sharing at least one form of contraception in each of the method categories, noted above, identified by the FDA. While health plans and issuers can use different medical management techniques, like imposing a cost-share on some methods within a category, to encourage a patient to use one medication in the same category over another, they cannot use those techniques to override the determination of a provider and the patient.