HHS Issues Guidance On Birth Control Mandate


HHS issued guidance to clarify the requirement that insurers cover at least one form of each of the 18 FDA approved contraception (birth control) methods. This comes on the back of recent studies that showed that insurers were not covering certain birth control types or charging cost sharing for birth control of a certain category.

The guidance also makes it clear that:

  • Grandfathered plans (plans that started before March 23rd, 2010) are exempt from the rule.
  • Insurers cannot limit preventive services for transgender people based on their sex assigned at birth.
  • Birth control methods include morning-after pills and IUDs despite their being looked down upon by some religious and conservative groups for being “abortifacients,” meaning they cause abortion.

“Today’s guidance seeks to eliminate any ambiguity,” HHS said. “Insurers must cover without cost-sharing at least one form of contraception in each of the methods (currently 18) that the FDA has identified for women in its current Birth Control Guide, including the ring, the patch and intrauterine devices.”

Under the Affordable Care Act non-grandfathered plans must cover specified recommended preventive care services without cost sharing, consistent with PHS Act section 2713.

The 18 types of contraception are:

• Sterilization surgery
• Surgical sterilization implant
• Implantable rod
• Copper intrauterine device
• IUDs with progestin (a hormone)
• Shot/injection
• Oral contraceptives (the pill), with estrogen and progestin
• Oral contraceptives with progestin only
• Oral contraceptives, known as extended or continuous use that delay menstruation
• The patch
• Vaginal contraceptive ring
• Diaphragm
• Sponge
• Cervical cap
• Female condom
• Spermicide
• Emergency contraception (Plan B/morning-after pill)
• Emergency contraception (a different pill called Ella)

Read the clarification from HHS issued on May 11th, 2015 here.

Learn more about the new rules from the Hill.

Author: Thomas DeMichele

Thomas DeMichele is the head writer and founder of ObamaCareFacts.com, FactsOnMedicare.com, and other websites. He has been in the health insurance and healthcare information field since 2012. ObamaCareFacts.com is a...

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Under the new law, is it legal for my insurance company to only cover the one injectable drug and nothing else? Or are they required to cover 1 from each category of Birth Control methods.

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I am relieved at this.

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I believe the report above clarifies coverage that is available for contraception. I am delighted that these methods are covered and that local communities are working to insure that barriers to receive these contraceptives are being reduced. I feel contraception should absolutely be covered for all persons. This is a great improvement for everyone. Glad that persons making decisions about what ‘should be covered on our health plans” had the insight to determine all methods are available including Plan B and IUS/IUD’s. This is a great way to start Affordable Care!

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