Updated on November 19, 2014.
The IUD, the implant, and sterilization.
To get the most effective birth control methods—an IUD, the implant, or, if you're looking for something permanent, sterilization—you have to visit a health care provider. (BTW, we can help you find one here.) Visiting a provider might seem like a pain, but for women who know that they don’t want to have a baby for at least a few years, these methods could be super convenient and save you money in the long-term. Once these methods are in place, you don’t have to worry about them for years (or, in the case of sterilization, ever again). That means greater spontaneity in your sex life and no more “oops” moments.
The shot, the pill, the ring, and the patch.
These hormonal methods are pretty effective, but not as good as the IUD, implant, and sterilization. To use [the shot, you need to go to your provider every three months to have it administered. If that’s inconvenient and you think you’d be comfortable giving yourself a shot, you can also ask your provider about a version of the shot that you can administer yourself. For other prescription methods like the pill, the ring, and the patch, you need to see a provider to talk about your medical history and get a prescription, then go to the pharmacy to fill your prescription every month—or every three months if your provider will write you a prescription to fill three months at once.
The diaphragm and the cervical cap.
You also need to visit a provider to get the diaphragm or the cervical cap since you’ll need to get fitted, then pick up the prescription. This might change down the line with the diaphragm Caya, which was designed to be one-size-fits all and is on its way to the U.S. market.
Got health insurance? Great news!
If you have private health insurance, you should be able to get any FDA-approved prescription birth control method for no out-of-pocket cost thanks to the Affordable Care Act (ACA, a.k.a. ObamaCare). If you have trouble getting your method covered, you may need to talk with your insurance company or even your pharmacy to make sure it’s not an oversight. There’s one exception: if you use a brand-name birth control and there’s a generic version of it available, you might have to pay some out-of-pocket costs. Keep in mind that not all clinics accept private insurance, so make sure they take your insurance before going.
Many insurers and pharmacies offer programs where you can sign up online or send in to get routine prescriptions mailed directly to your home. In addition, some workplaces allow you to set aside part of your salary before taxes for health care expenses (usually called Flexible Spending Accounts). That saves you money because the taxman won’t touch the part of your paycheck that you spend on meds.
No health insurance? Don’t give up!
The marketplace. First of all, the ACA actually requires you to have health insurance or pay a penalty, so if you’re uninsured you should seriously consider taking advantage of the 2015 open enrollment period from November 15, 2014, to February 15, 2015. Many people qualify for financial help to make insurance more affordable, so it’s definitely worth exploring your options in the marketplace.
Medicaid. If your income is below a certain amount, you may be eligible for Medicaid. Many people don’t realize they qualify, so if you’re not sure, look into it. If you qualify for basic Medicaid, all FDA-approved methods of birth control should be covered. Even if you don’t qualify for basic Medicaid, you may be able to get free or very low-cost birth control if you live in a state that has something called Medicaid family planning waivers. You can learn more about Medicaid coverage in your state from the Kaiser Family Foundation or the Guttmacher Institute. Some health care providers and clinics accept Medicaid and some don’t, so make sure you check before making an appointment.
Title X. If you don’t have health insurance or Medicaid and for whatever reason getting covered isn’t possible right now, clinics like Planned Parenthood, your city or county health department, or a community health center may be your best option. Many clinics get what is called Title X (as in the number 10) funding that allows them to provide a range of birth control methods for free or at reduced cost, depending on how much money you make.
Prescription discounts. If you choose a method that requires regular trips to the pharmacy, CVS and Rite-Aid have discount prescription programs open to anyone, and using their mail-order on online services can cut costs even further. The Partnership for Prescription Assistance helps people without insurance get prescriptions for no or little cost. Contact them at 1-888-4-PPA-NOW (1-888-477-2669) or through their website.
The bottom line
Whatever your insurance situation, try to put price aside to talk to a health care provider about which birth control options would be the best fit for your body and your lifestyle. Then, if price is an issue, explore your options for making sure your insurance covers that method or finding that method at reduced cost. Your provider might also be able to recommend payment plans or deals through the manufacturer or refer you to a low-cost clinic.
If you want one of the methods with high up-front costs like the IUD or the implant but you have to pay full price, it still might be worth it. Check this out: A woman without insurance using generic birth control pills will typically pay about $25 a month, or $300 a year. The Mirena IUD can cost anywhere from $500 to $927, but it keeps you pregnancy-free for up to five years, saving you as much as $1,000 compared to the pill if you leave it in for the full 5 years. The ParaGard IUD lasts even longer, saving you as much as $2,500. Without insurance, the implant can cost from $450 to $800 up front, but it’s good for three years—saving as much as $450 compared to the pill. The savings are even greater when compared to brand-name pills which can cost as much as $50 per month.
If all that sounds great, but the idea of talking to a medical professional about your sex life raises your blood pressure, we may be able to help. And if you want to hear some stories about people's experiences with these methods, we can help with that too.