Medicaid and Family Planning: Background and Implications of the ACA

Appendix 4: Coverage Requirements for Medicaid Family Planning Services

Appendix 4: Coverage Requirements for Medicaid Family Planning Services, by Type of Program
Coverage Requirement
Traditional Full-Scope Medicaid Medicaid Family Planning Program ACA Medicaid Expansion

FDA-approved prescription contraceptives:

  • oral contraceptives
  • vaginal ring
  • IUD
  • injectables
  • patch
  • implants
  • diaphragm
  • ella
State determined for each method State determined for each method Federally required for all FDA-approved methods
Sterilization for women State determined State determined Federally required
FDA-approved over the counter contraceptives:

  • male condom
  • female condom
  • Sponge
  • Plan B
State determined for each method State determined for each method State determined for each method without a prescription; federally required if prescribed
Contraceptive counseling State determined State determined Federally required
STI and HIV counseling State determined State determined Federally required
STI testing State determined State determined Federally required
HIV testing State determined State determined Federally required
HPV testing State determined State determined Federally required
HPV vaccine Federally required for beneficiaries ages 11-21; State determined for beneficiaries 22 and older State determined for beneficiaries 22 and older Federally required
Cervical cancer screening State determined State determined Federally required
Breast cancer screening State determined State determined Federally required
Appendix 3: States that have Expanded Eligibility for Coverage of Family Planning Services Under Medicaid