However, overall coverage was fairly good for core family planning services. Following are some of the key findings:

Thirty-six out of 41 states covered all prescription methods in the survey under their traditional Medicaid pathway.
Of the five states that did not cover all methods, two states did not cover one form of injectable and three of them did not cover Ella, an emergency contraceptive pill.
While most contraceptives are covered, a number of states apply utilization controls such as quantity limits on oral contraceptives and injectables.
Other states have taken the opposite approach, and allow clinics to dispense a 12-month supply of oral contraceptives.
Coverage of IUDs and implants is widespread; no states reported that they limited access to long-acting reversible contraceptives by requiring prior authorization, although some have use limits under fee-for-service, such as limiting coverage to certain brands.
Payment policies to facilitate postpartum long-acting reversible contraceptives are appearing in more states, and others report they are studying such policies. While maternity services are typically paid for with a global fee that includes postpartum care, some states have developed a separate payment outside the global fee to compensate clinicians and hospitals for postpartum long-acting reversible contraceptives insertions.
Several states continue to include either the device or clinician fee in the maternity global fee, often seen as a disincentive for providers to insert postpartum long-acting reversible contraceptives given the relatively higher costs of IUDs and lack of separate reimbursement for the insertion.
Variation in coverage across the states was most notable for over-the-counter contraceptives, including condoms and Plan B emergency contraception. Coverage for OTC supplies also varied across state Medicaid eligibility pathways, and a number of states require prescriptions for coverage, which creates an access barrier for products the FDA has deemed to be safe and effective for OTC use.

Coverage issues

Instant Insights /

Family planning coverage still dependent upon state policies

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