Medicare is most often used by individuals over the age of 65; however, this insurance is also available to those under the age of 65 that have been diagnosed with permanent disabilities or with end-stage renal disease. Across the United States, there are nearly one million women receiving Medicare benefits that are between the ages of 18 and 44.
This demographic often tends to use contraceptives to prevent pregnancy, and an intrauterine device (IUD) is an effective, long-lasting option that can be utilized. However, Medicare does not generally provide coverage for birth control to their recipients, leaving the out-of-pocket costs much higher unless an individual is dual-eligible for Medicaid.
What is an IUD?
IUDs are T-shaped devices that are inserted through the cervix and into the uterus. These devices are made of flexible plastic, and there are five different brands of IUDs that can be used. These five types are split into cooper and hormonal IUDs.
The only available copper IUD is known as the Paragard, and this IUD does not contain hormones. Parts of the T-shape are wrapped in copper, which prevents the eggs from being able to be fertilized as sperm is repelled by copper and will not pass by it. These IUDs can be left in place for up to 12 years without needing to be replaced.
Hormonal IUDs include Mirena, Kyleena, Liletta, and Skyla, and these options all contain progestin. Progestin is similar to the hormone progesterone that is found in the body. Progestin works to thicken the cervical mucus to block and trap sperm and by preventing ovulation from occurring, which makes pregnancy impossible. The Mirena and Liletta products can be used for up to seven years, the Kyleena IUD can be used for five years, and the Skyla IUD can be used for three years.
IUDs are highly effective, and because of their placement, there is little ability for human error to alter their effectiveness. This method of contraception does not require a daily pill or education to ensure it is being used correctly. IUDs are all more nearly 100 percent effective at preventing pregnancy, making them one of the best overall options available.
IUDs can also be used as emergency contraception to prevent pregnancy after unprotected sex. The copper IUD must be used, and as long as the IUD is inserted within 120 hours of having sex, it is 99.9 percent effective at preventing pregnancy from occurring. IUDs are also not permanent and can be easily removed by a physician. After their removal, a woman can immediately become pregnant.
Does Medicare Cover IUDs?
For the majority of Medicare recipients, birth control, including an IUD, is not covered. There is no federal requirement mandating that Medicare must provide contraception to its recipients. This means that many women of reproductive age will not be able to receive any Medicare benefits in this regard.
If you do fall into this category, there are a few options available to you. While not required by law, there are a few oral contraceptive options that may be covered under the Medicare Part D prescription medication plan. While this option will not cover an IUD, it may still provide an effective birth control option.
Medicare Advantage Plans, also known as Medicare Part C, are provided by private insurance companies, and some of these plans may include additional benefits that could include IUD contraception. However, these plans are highly specific, and it is important that you check with your provider to know your exact benefits.
Another option exists if you are dual-eligible for both Medicare and Medicaid. Generally, this applies to around 70 percent of younger women using Medicare. Medicaid does offer coverage for family planning services, including birth control and IUDs. If you do qualify for Medicaid, be sure to explore this option as you will be able to obtain coverage with much lower out-of-pocket costs.