Birth control is a way to prevent pregnancy. Birth control and sexual health services may be covered by health insurance. Family planning clinics or public health offices may provide free or low-cost birth control, and those with low incomes may be eligible for low-cost birth control through programs such as Medicaid.

According to the Centers for Disease Control and Prevention (CDC), 65.3% of women between the ages of 15 and 49 in the United States used birth control between 2017 and 2019.

The Affordable Care Act, which is informally known as Obamacare, has made it so that most health insurance plans cover birth control and any associated expenses, such as doctor’s visits.

If a person does not have insurance, however, there are still ways they can access free or low-cost birth control.

This article discusses the different types of birth control, how to access free or low-cost birth control, and when to see a doctor for advice on birth control.

There are many different kinds of prescription and over-the-counter birth control a person can try.

The different types of birth control include:

A person interested in using hormonal methods of birth control may need to see a doctor or healthcare provider before they can get a prescription for their birth control.

Learn more about the different types of birth control here.

IUDs

Intrauterine contraception includes both copper and hormonal intrauterine devices (IUDs). An IUD is a t-shaped piece of plastic or copper that a doctor inserts into the uterus.

According to the CDC, a person can use the same IUD for between 3–10 years, depending on the type of IUD. The failure rate is less than 1%.

Other hormonal birth control methods

Other hormonal methods of birth control include:

  • Oral contraception: There are a few different types of oral birth control pills available, including a combination pill, which uses a combination of estrogen and progestin to prevent pregnancy, and a progestin-only pill. A person must take it around the same time every day to prevent pregnancy. These pills are approximately 93% effective, though effectiveness may vary depending on the user.
  • The patch: This adhesive patch contains a combination of hormones. A person applies it to their skin on the lower abdomen or buttocks and must change it once a week for 3 weeks per month. On the 4th week of the month, a person will not wear the patch so that menstruation can occur. The patch is 93% effective.
  • The implant: A healthcare provider inserts the implant underneath the skin of the upper arm. The implant is a small, rod-shaped device. This procedure involves an anesthetic injection and is done in person at a doctor’s office. The implant releases hormones that prevent over 99% of pregnancies for up to 3 years.
  • Birth control injections: A healthcare provider injects progestin into a person’s upper arm or buttocks every 3 months. It is 96% effective.
  • The ring: A person puts the ring into their vagina and leaves it in place, changing it once a week for 3 weeks out of the month. The ring is 93% effective.

Barrier methods

Barrier methods of birth control include many over-the-counter products like condoms, spermicide, and the diaphragm.

The only types of barrier birth control a person needs to see a doctor to obtain are the diaphragm or a cervical cap. Caya, a newer diaphragm, is available without seeing a doctor.

Barrier methods of birth control are generally less effective than other forms of birth control.

According to the CDC, failure rates of popular barrier methods range from 13% for condoms to 27% for the sponge. A person who has been pregnant before may find the sponge less effective than those who have never been pregnant.

Emergency contraception

Emergency contraception is often referred to as “the morning-after pill.” A person can use emergency contraception if their primary method of birth control fails, or they have unprotected sex. Emergency contraception is available in two different hormonal pills in the United States; Plan B and Ella. It is also available as the Paragard IUD. Some of them are available without a prescription.

Permanent birth control

Permanent birth control methods are surgical procedures known collectively as sterilization.

People with female reproductive organs can have a tubal ligation. During this procedure, a person’s fallopian tubes are removed, burned, or tied off.

A person with male reproductive organs can have a vasectomy.

Both male and female sterilization procedures have a failure rate of less than 1%.

Many different factors can affect whether a person has access to free birth control.

These include:

  • whether the person has insurance
  • the type of birth control the person chooses
  • whether a person’s employer has an exemption that does not require the employer to provide free birth control as part of their employees’ health insurance plans (e.g. religious exemption clauses)

General considerations

The American College of Gynecologists (ACOG) recommends that a person considers the following when choosing a birth control method:

According to Healthcare.gov, under the Affordable Care Act, health insurance plans are required to cover Food and Drug Administration (FDA)-approved birth control, as well as birth control counseling and education.

The plans do not have to cover medications to induce abortion or services related to a male’s reproductive system, like vasectomies.

The Affordable Care Act requires health insurance covers the cost of the following:

  • barrier methods
  • hormonal methods
  • implanted devices, like intrauterine devices (IUDs)
  • emergency contraception
  • female sterilization procedures
  • patient education and counseling

How and where to get free birth control depends on what kind of birth control a person would like and whether the person has health insurance.

Non-barrier methods of birth control may require a prescription from a doctor. If a person is insured either through the Health Insurance Marketplace or through an employer that does not have a religious exemption, the cost of these doctor’s appointments would be covered by the person’s insurance.

If a person does not have health insurance, they can consider visiting their local public health office, family planning clinic, or Title X clinic for a free or low-cost exam. For example, Planned Parenthood offers services to help people choose and find birth control that suits their health and budget needs.

After the exam, a doctor will issue a prescription for the type of birth control the person has chosen. Some facilities may be able to provide the prescribed birth control onsite.

Some university health centers may also offer free or low-cost birth control options.

Low-income families may qualify for healthcare under Medicaid.

Medicaid is a jointly-funded state and federal program that provides low-cost health assistance to low-income families, pregnant people, and people with disabilities.

According to the organization, Medicaid covers more than 72 million people in the U.S. Learn about how to apply for Medicaid and who is eligible here.

Learn more about Medicaid and Medicare here.

The birth control methods that are covered by Medicaid may vary from state to state. A person can check with their state’s Medicaid office to find which types of birth control are covered by Medicaid.

People with a low income who are not on Medicaid can check with their local public health department, family planning clinic, or Title X clinic to see if they could access a free or low-cost exam.

These clinics and offices may scale the price of their services based on a person’s income.

When paying for birth control, people may want to consider the cost per use. For example, birth control pills can be quite cheap compared to other methods in the short term. People without insurance or access to public health clinics, can pay out of pocket at places like their local pharmacy or Walmart for about $10-20 a pack. This is a low-cost option per unit, but may be costly as a regular or long-term option.

IUDs or the implant may be more cost-effective as a long-term birth control solution, although each is an investment requiring a larger up-front cost. For example, an IUD can cost around $500-1,300, but depending on the type can last up to 12 years. Over time, these long-term birth control options may be cheaper than regularly paying for one-off options such as birth control pills or condoms. Some IUDs may have payment plans available.

People may want to consider the long-term costs of any birth control option to choose the best investment.

Sexually active people may wish to consider contacting a doctor about the best choice of birth control for them. A doctor can help a person to make informed choices regarding their birth control, find a method that will work for them, and offer screenings for STIs.

A person should contact a doctor about birth control if:

  • they want to use a hormonal birth control method, an IUD, or are considering surgical birth control
  • if they have been using birth control and are now considering becoming pregnant
  • if they have been using birth control and would like to change their method
  • if they experience sudden menstrual cycle changes or other new or concerning symptoms
  • they think they may be pregnant

There are many birth control options available. Some involve a small procedure at a doctor’s office to put in or remove, while others do not.

Many people have access to free birth control through the Affordable Care Act and their health insurance plans.

People without insurance can find free or low-cost birth control options at a family planning clinic, Title X clinic, or a public health office.