A birth control implant is a long-term and highly effective form of hormonal birth control.
The implanted device slowly releases progestin, a synthetic version of the hormone your body releases during pregnancy. This hormone prevents your body from releasing an egg for fertilization, and it thickens the lining of the cervix.
The implants can offer birth control protection for up to 5 years, but they can also be removed earlier if desired.
Keep reading to find out whether insurance covers this form of birth control, how much it will cost, and what other similar birth control options are out there.
Birth control costs can add up over time. Even with oral contraceptives (“the pill”), a monthly copayment that seems small can become costly.
The birth control itself isn’t the only cost, either. In addition to the cost of any birth control method, including an implant, you’ll usually pay some sort of fee for your healthcare visit, whether it’s with a primary care physician or gynecologist.
Most insurance plans — including Medicare, Medicaid, and health insurance marketplace plans — allow for at least one preventive care visit every year for gynecological health.
This visit will usually include screenings, a pelvic examination, and a discussion about your sexual health, including birth control.
Usually, you can begin a birth control program at these appointments without coming back a second time. However, if you change your mind throughout the year and want to discuss a different option, you may need to pay for another visit.
Coverage of any medication or service, including birth control, varies by the type of insurance plan you have.
Birth control is one of the categories the Affordable Care Act (ACA) requires to be covered without a copayment or coinsurance, regardless of what type of plan you have and whether you have met your annual deductible.
What isn’t specified in the ACA is the coverage for services associated with the administration of birth control, including fees your doctor may charge to insert or remove an implant.
Below are some examples of costs for the Nexplanon birth control implant with different types of insurance plans.
Employee-offered or private insurance
With a private insurance plan, you can expect to pay whatever fees are associated with your annual preventive or condition-specific gynecological visit.
When it comes to the device itself, Nexplanon’s manufacturer states that 96 percent of people pay nothing at all for the device.
People who do have to pay a share of the cost — called an out-of-pocket cost — may pay anywhere from $1 to $963 for the device.
Before getting the device, you can check with your health insurance provider to find out exactly how much you can expect to pay out of pocket. This can help save you from surprise costs after the fact.
Like with private insurance, most people with Medicare pay nothing for the device.
Generally, Medicare doesn’t cover birth control, as the program is meant primarily for U.S. adults aged 65 and older.
However, you may be covered if a doctor determines that a particular form of birth control is medically necessary to address a medical condition, like ovarian cysts. In this case, Medicare Part B may provide coverage.
If you have a Medicare Part D plan, which is sold by a private insurance company, you may have coverage for birth control to prevent pregnancy.
Depending on your plan or network — especially if you have a privately sold Medicare Advantage plan — you may have certain restrictions on the types of birth control that are covered or even the medical professionals you can see without additional out-of-pocket costs.
Medicaid offers programs that can help with birth control and family planning services. It will usually cover the contraception of your choice.
Each state has slightly different coverage and out-of-pocket costs. Generally, the manufacturer of the birth control implant says that 99 percent of people with Medicaid pay no out-of-pocket costs. Those who do have to pay usually pay between $1 and $942.
People who receive both Medicare and Medicaid can have birth control devices, like implants, covered by Medicaid, even though they also receive Medicare coverage. People who fall into this group include adults with disabilities and those with certain medical conditions.
Marketplace or “Obamacare” plans are the result of the passage of the ACA in 2010. The ACA expanded insurance coverage for unemployed or low-income Americans.
It created a marketplace of affordable private insurance plans for people who don’t have coverage through their employer. The ACA also required that certain items — like birth control — are covered by plans sold on the marketplace, as well as in the commercial markets.
If you don’t have health insurance and don’t qualify for Medicaid, there are still options to help you pay for birth control, including implanted devices.
Without insurance, the list price of Nexplanon is $981.56. You’ll also have to pay for the initial appointment with a healthcare professional to discuss birth control options, as well as a fee for insertion and eventual removal.
Below are some options that can help offset these costs.
Manufacturer savings programs
Sometimes, manufacturers offer prescription medication savings programs for people who can’t afford their medications. At this time, there aren’t any manufacturer’s savings programs for Nexplanon.
Planned Parenthood offers a number of programs to help cover women’s healthcare and family planning. The non-profit organization accepts Medicaid and private insurance, but it also offers services on an income-based scale for people who have neither public health coverage nor a private health insurance plan.
Contact your local Planned Parenthood office for specific coverage information and options.
There are several savings programs, purchasing sites, and coupons offered to help offset the cost of prescription medications.
You can look into some examples here. Prices and coupons vary by company.
There are both national and local non-profit organizations that may also provide help with birth control and other family planning services. Check with your local health department or community organizations for options in your area.
Below is a list of several national organizations offering birth control assistance:
- Women’s International Network for Guatemala Solutions (WINGS)
- Pathfinder International
- Clínica Verde
- International Planned Parenthood Federation Western Hemisphere
Getting help with birth control costs
There are many options for people without insurance who are looking for birth control.
Some health departments offer free or low-cost birth control services. Planned Parenthood accepts Medicaid and private insurance or adjust costs based on your income.
Birth control implants are sometimes called long-acting reversible contraception (LARC). There are several other similar LARC options to consider.
Intrauterine devices (IUDs)
There are a couple options in this category:
- Copper IUDs trigger an immune response where the body attacks anything that enters the uterus. These implants can last up to 10 years and cost around $1,000 out of pocket.
- Hormonal IUDs deliver a continuous dose of progesterone, which prevents the release of eggs for fertilization. There are several brands of hormonal IUDs, and they can last between 3 and 7 years, costing about $1,000 out of pocket.
Both types of IUDs are about
Birth control patch
You have to remove and replace the patch yourself every 7 days. Birth control patches cost an estimated $55 per month out of pocket.
Birth control ring
The birth control ring works similarly to the patch, releasing steady amounts of progestin and estrogen to prevent pregnancy. Also like the patch, the ring is about
You have to remove and replace the ring yourself every 21 days. A year’s supply of rings cost around $1,000 out of pocket.
Birth control shot
The birth control shot is an injection given to you by a medical professional every 3 months. Progestin is injected into your arm or buttocks.
There are many options for birth control, from oral pills to long-term implants. Talk with a healthcare professional about the pros and cons of each option to find the best fit for you.
State public health programs, as well as private insurance plans, are required to offer basic birth control coverage. The portion you have to pay and the options you have for birth control methods may vary based on your insurance.
If you don’t have insurance and don’t qualify for Medicaid, you may still find help paying for birth control implants and other devices through Planned Parenthood or other community organizations.