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The Contraceptive Equity Act expands access to No Co Pay Birth Control! 

The new law provides Maryland women and men in state regulated plans expanded access to birth control, at little to no cost. It also ensures that cost will no longer be a barrier to everyone seeking birth control.

About The Contraceptive Equity Act

The Contraceptive Equity Act was signed into law by Governor Larry Hogan on May 10, 2016. This groundbreaking legislation passed with overwhelming support, including state-wide unprecedented bi-partisan vote counts. The law solidified Maryland’s trailblazing role in women’s health care.

Maryland was the first state to mandate contraceptive coverage in 1998, and in 2016, Maryland became the first state to legislate the most comprehensive insurance coverage of birth control in the nation.

When Does It Go Into Effect? 

The new law, which took effect on January 1st of 2018, provides Maryland women and men in state regulated plans expanded access to birth control, at little to no cost. It also ensures that cost will no longer be a barrier to everyone seeking birth control. 

One of the Affordable Care Act’s essential health benefits is preventive care, which includes full coverage for at least one form of every FDA-approved female contraceptive method. This requirement remains in force, as none of the 2017 legislative efforts to repeal or change the ACA have been successful.

This Isn't Controversial

Birth control is basic health care. This isn't controversial. It should be affordable and easy to get. Yet far too many people already struggle to access the birth control they need to live healthy, independent lives. Together, let's improve public health throughout Maryland and the nation by starting an affirmative conversation about no copay birth control and all that it makes possible.

The Contraceptive Equity Act enhances, expands, and protects access to contraception, regardless of federal actions.


In state-regulated plans with contraception coverage, the Contraceptive Equity Act will:

Prohibit most copayments for contraception:

Even under the Affordable Care Act, health insurers may still require copayments on many forms of contraception. For an individual facing financial challenges, these copayments can be a real barrier to obtaining the contraception that works best for them. The bill would ensure that there would be at least one option without copayment in every therapeutically equivalent category on the formulary. So a patient and their provider can choose the therapeutically best option without facing cost barriers.

It is important to note that a health insurer will retain an essential tool to manage costs. If two options are essentially identical, but have a variance in cost, the health insurer can incentivize the consumer to select the lower cost option. The lower-cost option would have no copayment, while the higher cost option could have a copayment.

Eliminate preauthorization requirements for Long-Acting Reversible Contraception in Private Insurance:

A health insurer and Medicaid will not be able to require a consumer to obtain approval of coverage before obtaining long-acting reversible contraception (LARC) methods, including intrauterine devices (IUDs) and implants. The CDC recommends that administrative and logistical barriers to LARC, including pre-approval requirements, be removed.

Require health insurers to pay for 6 months of contraception at a time:

Before January 1, 2018, a health insurer could limit the number of months of birth control pills or other forms of contraception that an individual can obtain. When a patient faces transportation problems or has a difficult working schedule, they may not be able to obtain their contraception, leaving them at risk for unintended pregnancy. There is evidence that providing more months of contraceptives leads to higher rates of continuation and significantly fewer unplanned pregnancies.

* Some insurers may require a 2-month “trial” period for new prescriptions before paying for a full 6 months.

Provide contraception equity for men by broadening coverage of vasectomies without cost-sharing requirements:

The law extends vasectomy coverage requirements to the rest of Maryland’s insurance market. If vasectomies are covered, there will be no cost–sharing requirements.

Expand access to over-the-counter contraceptive medications by requiring coverage without a prescription:

Right now, the ACA requires health insurance to cover all contraceptive medications with a prescription. However, if the same medication is available over-the-counter, then there are no coverage requirements such as Plan B.

Ensure that women can go off-formulary for contraceptives that work best for them:

An individual may need coverage of a contraceptive that is not on an insurer’s formulary. Maryland law already provides that an insurer has to provide coverage for a drug not on a formulary if the side effects are less. However, Maryland law does not include a provision required by the Affordable Care Act. Insurers must also cover a contraceptive off formulary if the consumer would have an easier time adhering to the regimen of taking that particular drug.

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