Does Health Insurance Cover Abortion?

Deciding to have an abortion can be a difficult decision. Trying to determine if your health insurance will provide coverage shouldn’t be. Still, health insurance coverage for abortion has always varied but has only gotten more complicated since the Supreme Court overturned the Roe v. Wade decision in June 2022.

This change has resulted in some states setting limits or banning abortion except for specific circumstances. That means not everyone has equal access to all methods of abortion, and accessing one, or determining health insurance coverage, can prove challenging.

How to know if my health insurance covers abortion?

Just because an insurance plan covers abortion doesn’t mean it’s allowed in your state. Health insurance regulations and limits on covering abortion vary by state and are determined based on the type of procedure and the gestation of the pregnancy.

To determine if individual health insurance covers abortion, begin by considering factors such as:

• The state of residence. Check for state rules and restrictions regarding health insurance coverage and state reproductive health care laws.
• The type of abortion. The gestational age, or how far along the individual’s pregnancy is, determines the type of abortion.
• The individual’s health insurance plan. A person may have individual coverage through workplace insurance, the health insurance marketplace, private insurers, or Medicare/Medicaid.

If Medicaid or Medicare is the insurer, some states adhere to the Hyde amendment, which prohibits using federal funds for abortion. Exceptions may be made in cases of life endangerment, rape, or incest. This requirement may also bind many insurances offered in the Affordable Care Act marketplace.

Cost of abortion with insurance

With insurance coverage, the fee for an abortion ranges from free to a few hundred dollars, depending on if there are potential co-pays or coinsurance requirements. Additionally, the duration of the pregnancy will determine which procedure is available, which impacts the cost of an abortion.

The three types of abortion include:

• Medical abortion. It is often referred to as the abortion pill and terminates a pregnancy no later than 12 weeks with oral medication. The medicine can cost from $300–$700 without insurance, although costs can vary by state and whether the drug was obtained in a clinic or ordered online.
• Surgical abortion with vacuum aspiration. It is performed up to 16 weeks in a clinical setting, and costs without insurance can start at $575.
• Surgical abortion by dilation and evacuation (D&E). It is completed in a clinical setting up to 24 weeks and can cost from $895 to over $3000 for later pregnancies without insurance. Abortions are rarely done late in the second trimester, such as after 24 weeks.

Another option is to check with communities and organizations that may pay for abortion or help with associated costs.

Other costs could include out-of-state travel for a provider or a state permitted to perform the procedure. In addition, consider costs for out-of-network rates and income lost for taking time off from work. A flexible spending account may be a way to cover some of those costs.

Health insurance companies that cover abortion

Even with health insurance in a state that permits abortion, individual health care plan coverage can vary. It’s important to review personal insurance plans regarding abortion coverage and restrictions, or speak with the plan provider to confirm coverage.

Some states have limits on whether private insurers can cover abortion. However, a company with a self-insured plan isn’t bound by these laws because they assume all the financial liability for the employees in their program. However, no law requires any health plan to cover elective abortion.

Insurance carriers that may offer abortion services, dependent on the procedure, location, and factors related to the specific plan, include:

• Aetna. Aetna offers numerous plans, and some job-based health plans cover abortions, although the recent change has reduced or eliminated insurance coverage for many plans. Review individual plan documents or check with the insurance provider to ensure coverage if this is your insurer. Non-elective abortions, or those to prevent the death of the mother or due to incest or rape, are usually covered unless expressly excluded from the member’s plan.
• UnitedHealthcare. The UnitedHealthcare medical policy may cover abortion funds. UnitedHealthcare Medicare Advantage only covers an abortion when the mother’s life is in danger or the pregnancy results from rape or incest.
• Cigna. The standard Cigna benefit plan usually covers abortion and may cover medically necessary treatment of complications following an abortion.
• Kaiser. Kaiser offers coverage if specific coverage for abortion is included in the individual’s plan.