Does Medicare Cover Birth Control?

Even though the majority of Medicare beneficiaries are seniors, who are past the age of reproduction, around 3% of Medicare beneficiaries are between the ages of 18 to 44. And people in that group are still capable of giving birth to a child.

Which brings up the question that some people have which is “does Medicare cover birth control?” In this article, we answer that question in clear, plain English. You will also find the average costs of birth control supplements and procedures and other helpful info.

Does Medicare Cover Birth Control?

The short answer is no. In most cases, Medicare will not cover the cost of birth control supplements and procedures. That said, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your birth control supplements and procedures.

Original Medicare

Original Medicare (Medicare Part A and Part B) does not provide coverage for birth control supplements and procedures. That means you will have to pay 100 percent of the cost of your birth control supplements and procedures. Birth control is not considered medically necessary which is why Original Medicare does not provide coverage for it.

Original Medicare consists of two parts, Medicare Part A and Part B. Medicare Part A focuses more on treatment and services that take place in an inpatient setting such as hospitals and skilled nursing facilities, as well as covering home health services.

On the other hand, Medicare Part B provides coverage for treatment, services, durable equipment, and certain medications and vaccines, that take place in an outpatient setting and as long as it is considered medically necessary. Neither Medicare Part A and Part B provide coverage for birth control supplements and procedures.

However, in very rare cases, Medicare Part B may provide coverage for some birth control supplements and procedures as long as it is medically necessary to treat a medical condition. For example, hysterectomies may be medically necessary to treat specific health conditions.

Some birth control pills also contain ingredients that can be used to treat some medical conditions. These medical conditions may include the following:

Ovarian cysts
Endometriosis
Polycystic ovary syndrome
Fibroids

Part C and Part D Coverage for Birth Control

However, some Medicare Advantage plans (Medicare Part C) provide coverage for birth control supplements and procedures. Medicare Advantage plans must cover everything Original Medicare covers though they typically also offer many other benefits. Exactly what each plan covers and how much the extra services cost will depend on the specifics of your plan.

Medicare Part D plans also provide coverage for birth control medications. However, not all birth control medications may be covered. For example, if the birth control medication has an available generic variant, then your Part D plan may choose to provide coverage for that medication instead.

How Much Do Birth Control Pills Cost?

The average cost of birth control pills ranges from $20 to $50 a month. This depends on the type of pill and where you buy them.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.