Reproductive Health Benefits

Most health insurance plans in Oregon cover a broad range of reproductive health services. In many cases you do not pay anything out-of-pocket. Ask your insurance company for details about what is covered under your plan. Commonly covered services include:

• Annual wellness visits – Schedule a wellness visit with your health care provider each year at no cost. This annual wellness visit, also known as a well-woman visit, is an important way to help you stay healthy. Wellness visits include preventive services such as a pelvic exam, breast exam, pap smear, screenings for certain types of cancers, and discussions around reproductive health.
  

• Birth control – You have the choice to determine the type of birth control or contraceptive you would like in consultation with your health care provider. This includes coverage of more permanent birth control procedures such as hysterectomy, salpingectomy, and vasectomy.

  If prescribed by your health care provider, you can receive up to a 12-month supply of a contraceptive following the first three months using that type of contraceptive. Insurers are required to cover any contraceptive drug, device, or product (or the therapeutic equivalent) approved by the U.S. Food and Drug Administration. Delays in receiving birth control due to insurance are generally prohibited, such as requiring you to try a different contraceptive first (step therapy), needing extra time to review the request (prior authorization), or other utilization review techniques.

• STI screening – Screenings for sexually transmitted infections (STIs) are covered under your health insurance plan. Get tested for STIs, such as chlamydia, gonorrhea, hepatitis B, hepatitis C, HIV, human papillomavirus, and syphilis. Make sure the laboratory you go to is in-network with your insurance company to avoid any out-of-network charges.
• Abortion services – Many health plans in Oregon cover abortion services and some provide coverage without a copay or coinsurance. Contact your health insurance company to get more information about your plan details. Resources are available in the community to find a reproductive health clinic or to help with cost. Click here for more information on these resources to help you access care.
• Cancer screenings – Screenings for cervical cancer and breast cancer are covered under your health plan, as well as counseling and testing for the presence of BRCA genes that may increase your likelihood of developing breast cancer.
• Breastfeeding support and counseling – Your insurance covers counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing patients.
• Other services for pregnant women or those who may become pregnant – Folic acid supplements, gestational diabetes screening, maternal depression screening, Rh incompatibility screening, and tobacco intervention and counseling are examples of other covered services for people who are or may become pregnant.