Most health insurance plans are required by federal law to cover IUDs at no cost to you. Under the Affordable Care Act, all non-grandfathered marketplace and employer-sponsored plans must cover FDA-approved contraceptive methods, including IUDs, without a copayment, coinsurance, or deductible when you use an in-network provider. That means the device itself, the insertion procedure, and related office visits should all be covered at zero cost sharing.
What the ACA Requires
The ACA’s contraceptive mandate applies to all marketplace plans and most employer-sponsored plans. It covers every FDA-approved IUD currently on the market, including both hormonal options (Mirena, Kyleena, Liletta, Skyla) and the copper IUD (Paragard). The coverage extends beyond the device itself to include the medical exam, insertion, and follow-up visits.
The key requirement is that you use an in-network provider. If you go out of network, your plan can charge you cost sharing or decline to cover the procedure entirely. Before scheduling an appointment, confirm with your insurance that both the provider and the specific IUD brand are covered under your plan’s preventive services benefit.
Plans That Don’t Have to Cover IUDs
Not every insurance plan falls under the ACA mandate. There are a few notable exceptions.
Grandfathered plans: If your employer’s health plan hasn’t made significant changes since March 2010, it may be classified as “grandfathered” and exempt from the contraceptive coverage requirement. Your plan documents or your HR department can tell you whether this applies. These plans are becoming less common each year, but they still exist.
Religious employer exemptions: Churches, houses of worship, and certain religiously affiliated organizations can opt out of covering contraception entirely. Nonprofit religious hospitals and universities that certify a religious objection are handled differently. In those cases, a third-party administrator or insurer makes separate payments for contraceptive services, so you still get access to an IUD without cost sharing even though your employer isn’t directly paying for it.
Short-term and health-sharing plans: Short-term health insurance and health care sharing ministries are not required to follow ACA rules. If you’re enrolled in one of these, IUD coverage is unlikely.
Medicaid and Medicare Coverage
Medicaid covers IUDs in most states, but the specifics vary. States have significant flexibility in how they structure contraceptive benefits, and some cover a broader range of brands or settings than others. If you’re on Medicaid, contact your state’s program or your managed care plan directly to confirm what’s covered and which providers you can see.
Medicare generally does not cover contraception. IUDs are not a covered benefit under standard Medicare. The one narrow exception is when a hormonal IUD is prescribed to treat a medical condition like endometrial hyperplasia rather than for birth control. In that case, coverage may be approved, but only when the claim is billed under a specific medical diagnosis code. For most Medicare beneficiaries, this won’t apply.
What It Costs Without Insurance
If your plan doesn’t cover IUDs or you don’t have insurance, the total cost for the device and insertion can reach up to $1,800. That includes the medical exam, the device, and the procedure. Removal later on typically costs between $0 and $250 depending on the provider.
Community health centers and Planned Parenthood clinics often offer IUDs on a sliding fee scale based on income. Some IUD manufacturers also run patient assistance programs that can reduce or eliminate the cost of the device for people who qualify. Title X-funded clinics are another option for low-cost or free contraception regardless of insurance status.
How to Verify Your Coverage
Even when the law requires coverage, the practical details matter. Some plans cover only one brand of hormonal IUD without cost sharing and require prior authorization or a medical reason to cover a different one. Others cover all FDA-approved options equally. The fastest way to find out is to call the member services number on the back of your insurance card and ask two specific questions: whether IUDs are covered as a preventive service with no cost sharing, and whether the brand your provider recommends is on the plan’s formulary or device list.
If your plan denies coverage for a specific IUD and your provider believes it’s the best option for you, you can file an appeal. The ACA requires plans to cover at least one version of each type of FDA-approved contraception. If no equivalent alternative exists on the plan’s covered list, the insurer may be required to cover the one your doctor prescribes.