Birth control is used by women in their reproductive years to prevent pregnancy as a means of guiding pregnancy decisions. Additionally, some birth control medications are prescribed to assist with hormone balance concerns in women of all ages. While birth control medications are prescription-only, other forms of birth control include prophylactic products like condoms and intrauterine devices.

How Do Birth Control Medications Work?

Birth control medications usually prevent ovulation by changing the way that female hormones act within the body. Because hormones play a big part in the monthly cycles of ovulation and menstruation, affecting the action of hormones can change ovulation and prevent egg availability.

How Do Prophylactics Work?

A prophylactic is a protective measure that is usually meant to prevent a medical condition. In terms of birth control, prophylactics work to prevent pregnancy by stopping the fertilization process. When condoms are used, sperm is unable to reach an egg for fertilization. An intrauterine device (IUD) is a long-term and reversible implanted prophylactic device that changes the way that sperm operate. An IUD may prevent pregnancy by affecting hormones or by repelling sperm through the material composition of the IUD itself.

Paying for Birth Control

Although birth control medications are usually relatively inexpensive, especially when purchased in generic form, the monthly cost of birth control medications can add up. If you factor in the cost of prophylactic products or IUD implantation or removal in addition to birth control medications, you may be looking at even more money spent each year. Many private insurance plans cover the cost or offer discounts for birth control in various forms, and community programs may also assist women who meet low-income criteria to gain access to birth control at a reduced cost.

Does Medicare Cover Birth Control?

Medicare is a federal healthcare program designed to meet the needs of Americans who have reached retirement age. This is usually 65 or older, but some people qualify for Medicare benefits based on disability status. Because of this, not everyone on Medicare is beyond traditional child-bearing years, so it makes sense to wonder whether Medicare benefits apply toward birth control.

Medicare Part A and Part B are meant to cover inpatient and outpatient healthcare services, respectively. As such, these parts of the program do not apply toward birth control medication coverage. Medicare Part D is optional coverage that helps to pay for prescription drugs. Each Medicare Part D plan includes a formulary, a list of all covered prescription medications.

Some Medicare Part D plans may include coverage for birth control if these medications are deemed medically necessary, but this will be determined by the plan’s formulary and each Medicare recipient’s unique healthcare needs. Medicare does not, however, offer any coverage for prophylactic products like condoms or IUDs. By and large, Medicare does not cover things that it considers lifestyle items, meaning coverage is not available for medical products and services that someone chooses to use. Medicare Advantage plans may offer additional coverage for birth control compared to what is found in an Original Medicare plan, but this will be determined by the plan provider.

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