As of Jan. 1, 2019, all state-regulated health plans must provide additional coverage for certain reproductive health services. The Affordable Care Act requires insurers to provide free coverage for all federal Food and Drug Administration (FDA)-approved prescription contraceptives. State law requires this and now additional benefits, including:
- Coverage for All FDA-approved, over-the-counter contraceptives with no cost sharing, including condoms, spermicides, emergency contraceptives and sponges.
- Coverage for voluntary sterilization and vasectomies with no cost sharing.
- If a health plan covers maternity services, it must provide coverage for abortion services.
No cost sharing
Health plans cannot require copays or deductibles when services are provided by an in-network pharmacy or provider, unless you have an Health Savings Account (HSA) plan. If you have an HSA, your plan may apply a deductible for over-the-counter contraceptive supplies or services, but it cannot be more than the minimum deductible for a HSA-qualified plan, which is $1,350 per individual.
Know your rights
Your health plan must provide these and other reproductive benefits to you and cannot:
- Require a prescription for over-the-counter contraceptive drugs, devices, and products approved by the FDA.
- Deny coverage of contraceptives supplies or services because you changed contraceptive methods within a twelve-month period.
- Impose an unnecessary burden, restrictions or delays on required coverage of contraceptive services and supplies due to medical management techniques.
- Restrict, exclude or reduce coverage or benefits on the basis of gender.
- Limit your choice in accessing the full range of contraceptive drugs, devices or other products approved by the FDA.
If you believe you've been wrongly denied this coverage, file a complaint and we will investigate.
See additional health benefits for women.
Abortion services and Providence Health Plan members
Providence Health Plan has a religious objection (about.providence.org) to providing voluntary abortions and will not cover them, unless there’s a severe threat to the mother or the fetus is not sustainable.
For people enrolled in Washington state Providence Health Plans, the Washington state Department of Health (doh.wa.gov) will pay for abortion services. For information on how to receive these services, please contact DOH customer service at:
- Phone: 1-800-525-0127
- Email: ReproductiveChoice@doh.wa.gov
Providence Health Plan members (not Providence Health employer plans) can also get additional information on how to access abortion services by contacting the Washington Health Benefit Exchange (wahbexchange.org).
Note: You’re not required to notify Providence Health Plan about non-covered abortion services.