Consumer Advisory: Coverage for all FDA-Approved Contraception in Commercial Market
Coloradans have access to comprehensive preventive and emergency contraception in the commercial market.
DENVER - Reproductive health care is an important part of the health care services that every person deserves to achieve their own, self-determined reproductive well-being, and it is not a one-size-fits-all medical solution. There are many protections in place, in Colorado and federally, that ensure consumers have access to the care they need. Yesterday, Secretaries Xavier Becerra, Marty Walsh, and Janet L. Yellen of the U.S. Departments of Health & Human Services, Labor and Treasury (Departments), respectively, issued a letter to group health plans and health insurance issuers reminding them of their obligations under the Affordable Care Act (ACA) to provide coverage for contraceptive services at no cost.
Right to Abortion Services The Reproductive Health Equity Act (House Bill 22-1279), signed by Governor Polis on April 4, 2022, codifies the legal right to abortion services services in Colorado law. All Coloradans will continue to have access to abortion services, despite the Supreme Court ruling in Dobbs v. Jackson Women’s Health.
If You Need Preventive or Emergency Contraception The Affordable Care Act (ACA) requires that health insurance plans cover the full range of Food and Drug Administration (FDA)-approved birth control methods with no out-of-pocket expense to the consumer - that means consumers can’t be charged a copay, coinsurance, or deductible for it. There are currently eighteen (18) different categories of FDA-approved birth control options, including: tubal ligation, various intrauterine devices (IUDs), implants, shots, oral contraceptives (sometimes known as “the pill”), patches, rings, diaphragms, sponges, cervical caps, internal condoms, spermicide, and emergency contraceptives (sometimes known as “Plan B”).
If You Need a Different Type of Contraception If you need to try a different medication or contraceptive item in a category (for example, you need to switch to a different hormonal IUD or you need to switch to a different type of oral contraception because the one you tried first didn’t work for you), you are able to get that medication or method at no-cost to you. Your health insurance company must:
Have an exceptions process in place to cover (without cost to you) any necessary contraceptive service or item that is easily accessible, transparent, sufficiently expedient, and not unduly burdensome on you or your provider;
Communicate that exceptions process to you and your provider; and
Defer to your provider that the requested medication or item is medically necessary for you.
If You Use Oral Contraction (“The Pill) or a Vaginal Ring In Colorado, people who menstruate who have commercial insurance coverage can get twelve (12) months of a prescription oral contraceptive or three (3) months of a prescribed vaginal ring. So, when your provider gives you a prescription for either type of contraceptive, you can get a twelve-month or three-month supply at once with no-cost share to you.
If You Have Problems Getting No-Cost Contraception or a Longer-Term Supply: If any of the following happen to you, you can contact the Division of Insurance for help:
Your contraception (including Plan B) isn’t being covered at no-cost to you;
The contraception that works best for you, as determined by you and your provider, isn’t being covered at all or at no-cost to you; or
You want twelve months of oral contraception or three months of a vaginal ring, but your insurance won’t cover that quantity.
You can contact the Division of Insurance Consumer Services Team at:
303-894-7490 800-930-3745 (outside the Denver Metro area) DORA_Insurance@state.co.us
More information about your rights and protections in accessing preventive and emergency contraceptives can be found on the Division’s Contraception Health Care Rights and Resources website.
Unsure if these policies apply to your plan? You can take a look at your insurance card to see if it has “CO-DOI” on it. Don’t see it or still unsure? You can still contact the Consumer Services Section to get help or pointed in the right direction.
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About the Division of Insurance:
The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), regulates the insurance industry and assists consumers and other stakeholders with insurance issues. Visit doi.colorado.gov for more information or call 303-894-7499 / toll free 800-930-3745.
About DORA:
DORA is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado. Consumer protection is our mission. Visit dora.colorado.gov for more information or call 303-894-7855 / toll free 800-886-7675.
