Women’s Health

I bought emergency contraception over-the-counter (OTC) at my pharmacy and thought it would be covered by my insurance, but I ended up having to pay the full cost out-of-pocket. Why wasn’t it covered by my insurance?

Emergency contraception is one of the 18 FDA-approved methods for women that is covered by ACA-compliant plans, but it has to be prescribed by a health care provider. If you don’t have a prescription, you will likely have to pay the full cost out-of-pocket. However, if you get a prescription from your provider for emergency contraception,  bring the over-the-counter emergency contraception to the pharmacist and ask them to bill your insurance; your insurance should cover it without cost sharing.

If you are enrolled in an employer plan, and the employer has a religious or moral objection to contraceptives, your plan may not include emergency contraceptive coverage.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.