Will Insurance Cover Over-the-Counter Contraceptive Pills? A Discussion of Coverage Options and Challenges

The U.S. Food and Drug Administration recently approved Opill—the first over-the-counter daily oral contraceptive pill in the United States. Beginning in early 2024, people will be able to purchase Opill without a prescription, expanding options for contraceptive access across the country.

While federal policy requires most private health insurance plans and Medicaid expansion programs to cover—without patient copays—the full range of FDA-approved contraceptive methods with a prescription, there is no federal requirement that plans cover nonprescription contraception. However, some states have passed laws requiring coverage of other over-the-counter contraception, such as emergency contraceptive pills or condoms, in certain plans.

On September 15, 2023, a panel of experts joined Laurie Sobel, associate director for KFF’s Women’s Health Policy program, to explore approaches to covering over-the-counter oral contraception without a prescription. The panel discussed lessons learned from the implementation of private insurance or Medicaid coverage from the perspectives of various stakeholders.

Michelle Long, senior policy analyst at KFF, presented about the experiences, challenges, and opportunities in providing insurance coverage for over-the-counter contraceptive methods without a prescription. Based on a new KFF report, the presentation included possible approaches for coverage of over-the-counter contraception.


  • Laurie Sobel, JD, associate director for Women’s Health Policy at KFF


  • Michelle Long, MPH, senior policy analyst for Women’s Health Policy at KFF


  • Christine Gilroy, MD, MSPH, chief medical officer at Express Scripts
  • Don Downing, clinical professor at the University of Washington School of Pharmacy and endowed chair of the Institute for Innovative Pharmacy Practice
  • Victoria Nichols, MPH, project director of Free the Pill


KFF Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

www.kff.org | Email Alerts: kff.org/email | facebook.com/KFF | twitter.com/kff

The independent source for health policy research, polling, and news, KFF is a nonprofit organization based in San Francisco, California.