Most employer plans and all Marketplace plans must cover at least one form of all FDA-approved, granted, or cleared birth control services and supplies for women, without cost sharing. This includes sterilization services, insertion and removal of long-acting reversible birth control methods, and follow-up services. While some birth control methods are available over the counter without a prescription, plans typically require a prescription to trigger coverage.

Though it is up to an insurer’s discretion using reasonable medical management practices whether to cover a brand name or generic birth control, if both are available, at least one therapeutically equivalent drug or device must be covered without cost sharing. Insurers are required to cover other birth control if medically necessary and must provide a process for policyholders to request coverage for a contraceptive that is not already covered without cost sharing by the plan. If your plan says that the method your provider has recommended for you is not covered or that it requires cost sharing, ask your health care provider to help you request a “waiver” or “exception” from the insurer, which would allow you to use the brand name drug or device your provider recommends with no cost sharing.

If you are enrolled in an employer plan and the employer has a religious or moral objection to contraceptives, your plan might not include contraceptive coverage. If you are covered by a plan that was in effect on or before March 23, 2010, it may be a “grandfathered plan.” These plans are not required to cover preventive services, or they may require cost sharing. If you are not sure if your plan is grandfathered, check with your employer or your insurance plan.