Family Planning and Sexual Health

  • Birth control

    Many generic contraceptives will be covered at no out-of-pocket cost to you on most plans. Because coverage varies by plan, sign in to your secure member account and use the drug search tool to see if your preferred brand is covered on your specific plan.

    Sometimes doctors prescribe birth control for other issues, such as balancing hormones or acne, which would not be covered at 100 percent by your plan. Talk to your doctor about finding the right option for you.

    All FDA-approved methods of birth control are covered under most plans, including:

    • Barrier methods, like diaphragms, condoms, spermicide and sponges. You can buy these over the counter. To get these covered, get a written prescription from your physician.
    • Hormonal methods, like birth control pills, patches, and vaginal rings
    • Implanted devices, like intrauterine devices (IUDs), Depo-Provera, Implanon, and Nexplanon
    • Emergency contraception, like Plan B® and ella®. This requires a prescription, but many doctors will write one for you at your annual exam, so you have it if you need it
    • Sterilization procedures, such as tubal ligation (often referred to as “tying the tubes”), implants, like Essure®, and vasectomies.
    • Patient education and counseling with your doctor

    Some employer or group-sponsored plans might not cover contraceptives. Please check with your group administrator or benefit booklet for information specific to your plan.

    Abortion

    Many health plans cover abortion procedures, though some employer-sponsored plans don't. Please check your benefit booklet to confirm.

    Plans purchased on Healthcare.gov require that money used for abortion benefits go into a separate fund. This is noted on your statement. No federal funds are used for terminations of pregnancy.

    Fertility

    If you are having trouble conceiving, some tests can be done to evaluate the issue. Available for men and women, these tests are billed as medical tests and are subject to copay and deductible.  Hormone tests and labs are covered if they're not coded for infertility.

    Fertility enhancement medications and treatments, such as in-vitro fertilization (IVF) are not covered on most plans. Some employer-sponsored plans do cover it. Check your benefit booklet or with your plan administrator.

    Erectile dysfunction

    Our plans typically don't cover erectile dysfunction. If you take medication, sign in and go to Pharmacy Services to search and see if it is covered on your plan.

    Sexually transmitted diseases (STD)

    If you've had unprotected sex or want to put your mind at ease, ask your doctor about STD tests. Some STDs don't have symptoms, so getting tested is a good way to protect you and future partners.

    There is no single test for all STDs, so talk to your primary care physician about the tests you need. Preventive STD tests, meaning tests done without signs or symptoms of infection, are covered at 100 percent on most health plans. If you are tested because you are exhibiting symptoms, your tests could be billed as diagnostic, which is subject to your plan's copay and deductible. Getting treatment early can prevent risk to you and others.

    Member privacy

    When a member is 18, explanations of benefits are sent directly to that member, even if he or she is on a parent's plan. This is done in accordance with state law, and means that parents are unable to see this dependent’s claims in the online member account and are unable to discuss sensitive claims with customer service representatives unless the dependent gives permission. Members 18 and older must set up their own online member accounts if they want to view their claims and explanation of benefits statements online.

    Note: Benefits under your health plan may differ, so refer to your benefit booklet for information on what your specific health plan covers.

    Your health plan covers preventive care services as required by state and federal law. For more information, review the "A" and "B" rated services on the United States Preventive Task Force, immunizations recommended by the Centers for Disease Control and Prevention and preventive care and screening recommended by the Health Resources and Services Administration. See the list on healthcare.gov.


  • Benefits under your health plan may differ, so refer to your benefit booklet for information on what your specific health plan covers.

    Your health plan covers preventive care services as required by state and federal law. For more information, please review the "A" and "B" rated services on the United States Preventive Task Force, immunizations recommended by the Centers for Disease Control and Prevention and preventive care and screening recommended by the Health Resources and Services Administration. See the list on healthcare.gov.