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No insurance? No worries! When it comes to birth control, we’ve got you covered.

With 500,000 people without health insurance coverage for birth control in Illinois, if you’re struggling to figure out how to pay for your birth control, you’re not alone!

Let’s walk through the answers to some common questions to help you understand your insurance options to ensure you can get the birth control method of your choice for low cost or for free!

First things first… What do these insurance terms even mean?!

We know – it’s confusing! Let’s lay out a few of the basics: 

  • Federal poverty level (FPL): A measure to help see if you’re eligible for certain public (aka government) insurance plans like Medicaid based on how much money you make and how many people you live with.
  • Health insurance: An agreement with a health insurer to pay some or all of your health care costs in exchange for a payment from you each month (aka premium). 
  • Premium: What you pay each month to have an active insurance plan.
  • Network: The providers and health centers your insurance plan partners with to deliver care. Your insurance should tell you how to search for providers or health centers that accept your insurance (aka “in-network”). Medicaid covers birth control services at 100% whether your provider is in- or out-of-network – that means they’re free to you!
  • Deductible: What you pay each year before your insurance starts to pay. You do not need to reach your deductible to get coverage for preventive care services like birth control.
  • Co-payment (aka co-pay): What you pay each visit for the service you receive. 

Example: As a single person earning under $1,366 a month (138% FPL), Maria qualifies for and is enrolled in Medicaid health insurance. Even though Maria’s favorite birth control provider is out-of-network and she hasn’t reached her annual deductible of $300, her co-pay is $0 because birth control is a preventive service, and Medicaid allows her to see any provider of her choice for birth control services.

Example: Alex works full-time as a teacher and gets their private health insurance through work. Alex pays a $40/month premium for their health insurance plan. Alex makes an appointment with their in-network gynecologist to get an IUD. With their insurance plan, they will have to pay a $30 co-pay at the visit.

Do I qualify for Illinois Medicaid?

Illinois Medicaid is available to anyone 19-64 earning less than 138% FPL (~ $1,500/month) with U.S. citizenship or on the pathway to U.S. citizenship. If you’re a member of one of Illinois’ Medicaid Managed Care Organizations (Aetna Better Health, Blue Cross Community Health, CountyCare, Meridian of Centene Molina), you already have insurance through Medicaid, including for all FDA-approved birth control methods for free!

I am, or was recently pregnant. Are there health insurance options for me?

Regardless of citizenship or pregnancy outcome (birth, miscarriage, or abortion), anyone recently pregnant earning less than 213% FPL (~$3,000/mo) is eligible for full Medicaid Mother/Baby benefits during pregnancy and up to 12 months post-pregnancy. That means all birth control options are free. Even better, pregnant people are eligible for what’s called Medical Presumptive Eligibility (MPE) – this means you can start using your benefits right away.

What if I don’t qualify for Medicaid?

Beginning December 1st, 2022, if you’re between 138-213% of the federal poverty level (~$1,500-$3,000/month), you qualify for coverage specifically for family planning services, including sexual health education, testing and treatment for STIs and HIV, cervical cancer screening, and all birth control methods.

Anyone 12+ can apply on their own, even if you have other insurance through a parent, partner, or work. This coverage includes Family Planning Presumptive Eligibility (FPPE), which means you can start using it right away while you’re waiting for your application to be reviewed. After your application is reviewed, depending on how much money you make, your household size, and citizenship status, you will either get full Medicaid benefits, family planning benefits, or be referred to the Health Insurance Marketplace to look for other health insurance options that fit within your budget. All Health Insurance Marketplace plans cover all birth control methods so your birth control will be free.

Chart showing the three step process for applying for FPPE.

What if I have private insurance?

Private (aka commercial) insurance like Blue Cross Blue Shield or United Healthcare is insurance usually provided by your job. Some employers may not cover birth control for religious reasons.

If you’re not sure if your birth control is covered, call your insurance company.

Some examples of questions to ask:

  • Does my insurance plan cover all birth control methods?
  • Will I have to pay anything out of pocket for birth control?
  • When do I pay?
  • How will I receive my bill?
  • How do I know if a provider is in-network?
  • If I use my parents’ or partner’s insurance for birth control, will they be notified?

What if none of the options above apply to me?

ICAN! health centers never turn someone away due to their ability to pay. Use the ICAN! health center search to find a free or low cost birth control provider near you. When calling to make an appointment, be sure to mention any payment concerns so you can discuss your insurance and payment options.

When it comes to birth control, you always have options. Schedule your appointment today.

Still have questions?

© 2022 ICAN! All rights reserved.

© 2022 ICAN! All rights reserved.