2025 Medicare Birth Control Coverage & Costs: What You Need to Know

Original Medicare, which includes Parts A and B, generally does not cover birth control for pregnancy prevention. However, certain Medicare Advantage (Part C) and Medicare Part D prescription drug plans may provide some coverage for contraceptives.

Medicare Part A primarily covers inpatient hospital care, while Part B covers outpatient services such as doctor visits and diagnostic tests.

Unlike Marketplace and Medicaid plans mandated by the Affordable Care Act (ACA) to cover birth control, Medicare is exempt from this requirement. Consequently, Original Medicare covers birth control only when it is medically necessary for conditions other than pregnancy prevention, as most Medicare beneficiaries are over 65 and beyond reproductive years.

If you require birth control for reasons not classified as medically necessary, exploring Medicare Advantage or Part D plans that include contraceptive coverage might be beneficial. Continue reading to understand eligibility and coverage details.

Does Medicare Cover Birth Control in 2025?

Common contraceptive methods that may be covered under some Medicare plans include:

• Birth control pills
• Implants like Nexplanon
• Injectable contraceptives such as Depo-Provera
• Intrauterine devices (IUDs)
• Birth control patches
• Vaginal rings like NuvaRing
• Hysterectomy and vasectomy procedures

While Medicare Part B covers many preventive services, pregnancy prevention is typically excluded. However, Part B may cover contraceptives when used to treat medical conditions such as endometriosis, ovarian cysts, or polycystic ovary syndrome (PCOS). It may also cover gynecological surgeries like hysterectomy if medically indicated.

Medicare Part D Coverage

Part D plans assist with prescription drug costs, including many birth control medications. Since private insurers administer these plans, coverage varies widely. Each plan has a formulary listing covered drugs.

Most Part D plans include contraceptives, but it is essential to verify whether your specific birth control method is covered by reviewing your plan’s formulary or consulting your insurer. Some plans may require use of generic options or in-network pharmacies.

Medicare Advantage (Part C) Plans

Medicare Advantage plans are private insurance alternatives to Original Medicare and must provide at least the same basic coverage. While they do not inherently cover birth control, some plans offer additional benefits, including contraceptive coverage.

Coverage varies between plans, so it is crucial to check with your plan administrator or review plan documents to confirm if birth control methods and procedures are included. Some Medicare Advantage plans also bundle Part D drug coverage, allowing access to covered contraceptive medications.

Discuss your birth control options with your healthcare provider and verify your plan’s coverage to minimize out-of-pocket expenses.

Is Birth Control Free with Medicare in 2025?

Birth control is unlikely to be fully free under Medicare plans. Costs depend on the specific Medicare Advantage or Part D plan you select and the coverage it offers.

For 2025, the standard Part D monthly premium is $36.78, while the average Medicare Advantage (Part C) premium is approximately $17.00 per month.

After plan coverage, the remaining cost for contraceptives varies. Studies show that insurance coverage, including under ACA provisions, has significantly reduced out-of-pocket expenses for birth control pills and devices.

For example, the average cost of IUDs was about $594, and hormonal implants around $463, with most of these costs reimbursed by insurance. Insertion fees averaged between $72 and $108.

Tips to Lower Your Birth Control Costs

To minimize expenses, select a Medicare plan aligned with your contraceptive needs. Consult your healthcare provider, insurance agent, or benefits administrator to confirm coverage of your preferred birth control methods.

Review plan requirements carefully, such as preferred pharmacies or generic drug mandates, before choosing a contraceptive.

Additional Cost-Saving Options

Medicaid, a federally funded program managed by states, covers many birth control options and may be available if you qualify. In 2019, about 12.3 million individuals were enrolled in both Medicare and Medicaid.

If Medicare does not cover your preferred method, check with manufacturers for discount programs or assistance. Local public health clinics and reproductive health organizations like Planned Parenthood often provide free or low-cost contraception.

Use the CDC’s health department locator to find nearby clinics offering reproductive health services.

Frequently Asked Questions

What birth-related services does Medicare cover?

Though rare due to the typical age of beneficiaries, Original Medicare covers pregnancy and delivery-related medical expenses. Medicare Advantage plans are also required to provide this coverage.

Does Medicare cover IUD removal?

If your plan covers IUD insertion, it generally covers removal as well.

Does Medicare cover the abortion pill?

Medicare does not cover emergency contraception like Plan B or elective abortion procedures. Coverage is limited to abortions resulting from rape, incest, or when necessary to protect the life of the patient.

Summary

Original Medicare typically does not cover birth control for pregnancy prevention unless medically necessary for other conditions. Some Medicare Advantage and Part D plans provide contraceptive coverage, so consider these options if birth control is a priority.

Always verify your plan’s formulary and coverage details to ensure your chosen birth control method is included. Medicaid and local reproductive health services can also be valuable resources for affordable contraception.

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