Birth control is vital to a person’s overall health. According to the U.S. Centers for Disease Control and Prevention (CDC), more than 65.3% of all U.S. women ages 15–49 use some form of birth control.
“The average cost of birth control in the U.S. varies depending on the type of contraceptive and insurance coverage. Out-of-pocket yearly costs can range from $0 to $2,000,” says Noelle Acosta, co-founder of Noula, a reproductive wellness startup offering at-home testing and support. Many different types of birth control are available, and some cost more than others. Yet, the primary factor in the cost of birth control is whether someone is insured and what their insurance covers.
- The cost of birth control is largely determined by your being insured and whether your employer is exempt from Affordable Care Act (ACA) coverage mandates.
- Most private and employer-sponsored plans are required to cover birth control and family planning counseling at no additional cost, but each plan may choose the methods it offers, and not all methods may be fully covered.
- Although some plans do cover them, abortion-inducing drugs and male contraception, like vasectomies, are not required to be covered by all health insurance plans.
Average Birth Control Costs in the U.S.
The average out-of-pocket cost of contraception has dropped significantly since 2012, when the Affordable Care Act (ACA) mandated that private insurance cover a range of birth control methods at no cost. “For birth control pills, specifically, people who menstruate spend an average of $226 (with insurance) and $268 (without insurance) per year,” Acosta says of the approximately 10% of oral contraceptive users with out-of-pocket costs.
However, the ACA has faced several legal challenges. Recently, the then-Trump administration exempted many religious and religion-affiliated institutions, like churches, schools, and hospitals, from these rules. And while health plans, including Medicare and Medicaid, are required to cover 18 U.S. Food and Drug Administration (FDA)-identified contraceptive methods, states and individual plans determine which formulas or brands to cover; not all available options will be fully covered by your insurance plan.
Hormonal Birth Control
Common hormonal birth control methods include pills, patches, rings, intrauterine devices (IUDs), shots, and implants. The expenses outlined below only apply to people with out-of-pocket costs.
Pills are among the most common types of hormonal birth control. There are many different types and brands, but all of them contain hormones. According to a 2021 GoodRx survey, prices for the 50 most popular pill brands ranged from $22 a month for Sprintec to $303 a month for Tri-Lo-Mili.
Levonorgestrel, or the morning-after pill, is backup contraception for emergency situations. For those with insurance, the morning-after pill is covered and free, but plans may require a prescription, which could be difficult to get within the five-day window in which the pill is effective. Alternatively, the pill can be purchased over the counter without a prescription and typically costs less than $50.
Patches adhere to the skin and release hormones into the body to help prevent pregnancy. Patch prices are usually around $30 per month, and many providers will authorize their patients to pick up a year’s supply at one time, helping them save money on doctor visits.
Rings, inserted into the vaginal canal, release hormones into the body to help prevent pregnancy. According to Planned Parenthood, the NuvaRing (which lasts up to five weeks) can cost up to $200 if paying without insurance. The Annovera ring (which lasts up to a year) is similar to the NuvaRing in that most, if not all, costs may be covered by insurance but can cost up to $2,200 for those paying out of pocket.
Hormonal Intrauterine Devices (IUDs)
An intrauterine device (IUD) is a small, T-shaped device that comes in hormonal and nonhormonal varieties. Hormonal IUDs work by releasing the hormone progestin into the body to prevent pregnancy. According to GoodRx, the cost for FDA-approved IUDs ranges from $833 for Skyla, which lasts three years, to $1,000 for Mirena, effective for up to seven years.
There are currently four FDA-approved hormonal IUDs on the market and no generic, meaning that nonexempt insurance must cover at least one brand-name IUD at no cost. IUDs need to be inserted and removed by a physician, but ACA-compliant plans must cover provider fees associated with these procedures. For those without insurance, the IUD plus insertion and removal can cost $500 to $1,300, but clinics like Planned Parenthood offer programs to help those without insurance or whose insurance is ACA-exempt.
The shot is a progestin injection that prevents ovulation and is administered every three months. Costs range from $50 to $200 for the initial prescription and first shot, with follow-up shots costing $20 to $40.
The implant is a small, flexible rod inserted under the upper arm’s skin. Like an IUD, it releases a low dose of hormones to prevent pregnancy. Since there is no generic alternative, the only FDA-approved implant, Nexplanon, must be covered by insurance at no cost. When paying out of pocket, pricing is on par with the IUD ($982–$1,500), and removal can cost up to $300. The implant is a long-acting form of contraception that should last for three years.
Nonhormonal Birth Control
Nonhormonal birth control methods do not rely on hormones and include barrier methods like (female and male) condoms and diaphragms, as well as permanent methods like sterilization. Unlike hormonal birth control methods, most physical barriers also help protect against sexually transmitted infections (STIs).
The nonhormonal IUD contains copper, which interferes with the sperm’s ability to fertilize an egg. Copper IUDs are long-acting, lasting up to 10 years.
Copper IUDs can cost up to $1,300, including up to $250 for insertion, for those paying out of pocket. Due to their longevity, copper IUDs can be less expensive than hormonal IUDs in the long run. Insurance companies must cover the only FDA-approved copper IUD, Paragard, as well as insertion and removal.
Female and Male Condoms
Male condoms are a common form of contraception that can be bought at any pharmacy. While male condoms are not covered by insurance, they are relatively inexpensive and eligible for reimbursement with flexible spending accounts (FSAs), health savings accounts (HSAs), and health reimbursement arrangements (HRAs).
Female (or internal) condoms are a pouch inserted into the vagina prior to sexual intercourse. Female condoms are on the list of contraception that insurance is required to cover. Without insurance, these condoms can cost around $3 each and are usually sold in packs. A box of three female condoms will cost $9–$10 on average.
Other Barrier Methods
Other barrier methods include diaphragms, cervical caps, sponges, and spermicides, which either block sperm from entering the uterus or make the sperm ineffective.
Because diaphragm and cervical caps need to be an appropriate size for the user, a prescription from a doctor or nurse is required to get them from the drugstore or pharmacy. They work for around two years and cost less than $300 each, including the spermicide that needs to be used alongside them. Most health insurance providers cover them.
Spermicides, which kill sperm or render them immobile, can be used in combination with barrier methods. They come in various forms, including gels, foams, suppositories, and sponges. These typically cost less than $15, and each kit or package usually contains multiple doses. Although some insurance plans cover spermicides, others do not. Like male condoms, they are approved for reimbursement through an HRA, HSA, or FSA.
Sterilization is a permanent birth control solution. There are two types of sterilization procedures for people who menstruate: tubal ligation and hysterectomy. Tubal ligation is a surgical procedure to block, tie, or cut the fallopian tubes. A hysterectomy involves removing the uterus entirely. ACA-compliant insurance must cover at least one method of sterilization.
The Reproductive Health Access Project estimates the cost of tubal ligation without insurance to be $1,500 to $6,000. There are different types of hysterectomies (and recovery times associated), but they are all expensive without insurance. According to one study of hysterectomies performed from 2009 to 2016, the average cost ranged from $25,535 for a vaginal approach to $42,816 for a robotic approach.
For people with penises, a vasectomy cuts and seals the small tubes in the scrotum. The cost of these procedures varies from $0 with insurance to about $1,000. Though vasectomies are not required to be covered by insurance, they are usually significantly less expensive than sterilization for people who menstruate. According to one study, the average cost of vasectomy in 2015 was $938. The average out-of-pocket cost of an in-office procedure was just $173.
How to Save Money on Birth Control
There are many ways to save on birth control. Some of the most common methods include getting prescriptions from Planned Parenthood, online pharmacies, or government-run healthcare centers.
Though insurance companies must cover contraceptives within the 18 FDA-indicated categories, some patients may encounter health plans that only cover one option, such as a specific brand. If the brand or formula that a patient needs isn’t covered by their plan, they can have their doctor submit a request to waive cost sharing on that contraceptive. The insurer is required by law to have a process in place to accommodate patients’ needs.
According to the advocacy group Power to Decide, more than 19 million American women in need of publicly funded contraceptives live in “contraceptive deserts,” meaning that they lack reasonable access to a clinic in their county that offers all FDA-identified contraceptive methods. And more than 1.2 million of these women live in counties without a single health center that provides the full range of methods. In these cases, online pharmacies offer accessibility and affordability.
“Getting birth control online is a wonderful way to increase access to affordable birth control, especially since many forms of contraceptives require prescriptions. Fortunately, many companies in this space offer transparent pricing with birth control being free with insurance or under $20 without insurance,” says Acosta.
Otherwise, patient assistance programs can help offset birth control costs for those who qualify, and a prescription from any Planned Parenthood Health Center can significantly lower birth control costs.
The Bottom Line
Most people with health insurance are entitled to free contraception and family planning. For those with out-of-pocket expenses, it’s important to consider how long each form of birth control lasts to determine its true cost.