State law also requires that state-regulated health plans cover over-the-counter birth control for free.
Breastfeeding services
Breastfeeding services include supplies, equipment, and lactation help. To get these services at no cost, you must see someone in your health plan’s approved network of providers.
Prescription birth control
FDA-approved birth control that requires a prescription must be covered by all health plans with no cost to you. However, you must get your prescription from an in-network provider and have it filled by an in-network pharmacy.
Over-the-counter birth control
Washington state law requires some health plans to cover over-the-counter birth control products, including condoms, spermicides, emergency contraception, and some forms of hormonal contraception, without copays, cost-sharing, or deductibles.
If you have a Health Savings Account (HSA), your plan may apply a deductible, but it cannot be more than the minimum deductible for an HSA-qualified plan.
Where to buy it
To get no-cost OTC birth control, you must buy it from an in-network pharmacy.
- Give the pharmacist your insurance card
- Ask them if they’re in your health plan’s network
- Ask them to submit a claim to your health plan if they are
How to get reimbursed
Some plans let you buy OTC birth control and then get reimbursed. Most health plans have a form you can use to submit out-of-pocket claims. Look on your plan’s website under “Member Services” or “Pharmacy Benefits” or contact your plan for assistance.
To be reimbursed, you will likely need to submit the following items:
- A copy of your receipt that includes the name of the product, the date purchased, and how much you paid
- Your member ID/policy #
- Group number if you get your insurance from your employer
- Pharmacy name and National Provider Identifier (NPI)
What if you need help?
- Call the customer service number on your health insurance card
- Ask your pharmacy
- File a complaint with us if you have problems getting prescription or OTC birth control or getting reimbursed