Birth Control Coverage with Friday Explained

Here at Friday Health Plans, we understand that birth control is an important option to consider for varying reasons at different life stages. Since we’re an Affordable Care Act plan, birth control is available to all of our members for no cost, because it’s preventive care.

Besides working to prevent pregnancy, birth control can help you regulate your menstrual cycle, aid with cramps and other aches and pains, relieve endometriosis symptoms, clear up your skin and even help prevent some cancers.

Covered Birth Control Methods

Under the Affordable Care Act, all FDA-approved contraceptives are covered. These include:

  1. Barrier methods, such as diaphragms, female condoms, and sponges.
    • You can request these at any in-network pharmacy’s counter. The item will process for a $0 copay, or if they have you pay, you can submit a receipt for reimbursement to questions@fridayhealthplans.com.
  2. Hormonal methods, such birth control pills and vaginal rings (aka contraceptive rings). The office visit(s) may be subject to costs, but the prescriptions are covered at 100%.
    • Jolessa
    • Quasense
    • Amethyst
    • Kariva
    • Errin
    • Azurette
    • Nuvaring
    • Sprintec/Tri-Loc Sprintec/Tri Nessa
    • Xulane (Patch)
    • Depo-Provera (shot every 3 months at a physician’s office)
  3. Implanted devices, such as intrauterine devices (IUDs).
    • Paraguard and Mirena brands only.
    • Coverage is only for the insertion and the replacement. If it’s getting removed, it’s not covered at 100%.
  4. Emergency contraception (aka the morning after pill).
  5. The brand is Ella. You will need a prescription from your doctor to get it for $0.
  6. Sterilization procedures.
  7. Patient education and counseling.
  8. Tubal ligation
    • Covered at zero cost per the ACA. Generally, happens after a woman delivers her child. However, per the ACA, Friday must cover this at ANY time.

Please note that coverage for vasectomies for male reproductive prevention is subject to a plan’s deductible. Coverage to induce abortion is not covered.

Accessing Birth Control Prescriptions

Most birth control methods are categorized as Tier 1 (ACA generic) or nonformulary. All Tier 1 drugs are $0 under Friday’s plans, and you will fill medications such as birth control pills by talking to your doctor and picking them up at your local pharmacy. Some contraceptive methods count as nonformulary because you get them from your doctor, such as an IUD. We encourage talking with your doctor to find the best method for you.

Quick note: When making an appointment with your OB/GYN or primary care doctor to discuss birth control options, be sure to ask if they prescribe birth control.

Your reproductive health is up to you, and we’re here to answer any questions you may have. Email questions@fridayheatlhplans.com or go here to contact our friendly Friday Care Crew today.

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