Minimum Contraceptive Coverage Requirements Clarified by HHS Guidance

Published: May 11, 2015

New HHS clarification on ACA contraceptive coverage requirement specifies that insurance plans must cover at no cost to women all of the 18 contraceptive methods approved by the FDA.  If a provider recommends a specific option or product, plans must cover it at no cost as well.

Minimum Contraceptive Coverage Requirements Clarified by HHS Guidance
Contraceptive MethodProducts/OptionsMust Cover
Surgical sterilizationAlso called tubal ligation
Implant sterilizationOnly Essure available
Implantable RodMultiple√ at least 1
IUD – CopperOnly ParaGard available
IUD – ProgestinMultiple√ at least 1
InjectionMultiple√ at least 1 (may be generic)
Oral contraceptives – combinedMultiple√ at least 1 (may be generic)
Oral Contraceptives – progestin onlyMultiple√ at least 1 (may be generic)
Oral Contraceptives – extended/continuous useMultiple√ at least 1 (may be generic)
PatchMultiple**√ at least 1 (may be generic)
Vaginal RingOnly NuvaRing available
Diaphragm with SpermicideOnly Milex Omniflex available
Sponge with SpermicideOnly Today Sponge available√*
Cervical Cap with SpermicideOnly FemCap available
Female CondomMultiple√*
Spermicide aloneMultiple√ at least 1 (may be generic)*
Emergency Contraception-ProgestinMultiple√ at least 1 (may be generic)*
Emergency Contraception- Ulipristal AcetateOnly ella available
*Approved for sale over-the-counter but only covered at no cost with a prescription.**The manufacturer of the brand name (OrthoEvra) patch has discontinued production and the generic alternative will be the only patch available.SOURCES: FDA, Birth Control Guide  and Depts of Labor, Health and Human Services, and Treasury, FAQs about Affordable Care Act Implementation (Part XXVI).