Is Abortion Covered by Health Insurance?
Health insurance plans are required to cover abortions in 10 states.
In other states, you may have coverage for abortions in certain situations. Health insurance coverage for abortions closely mirrors state laws about when an abortion can be performed. For example, abortion is only legal in Texas if a pregnancy threatens a woman's life or puts her at risk of serious harm. So health insurance in Texas would only cover abortion in those cases, if the plan covers it at all.
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Does health insurance cover abortion?
Whether your health insurance covers an abortion depends on why you need one, where you live and the plan you have.
Each state decides whether or not to allow abortion coverage on health insurance you buy from the marketplace. Only 10 states, including California and Illinois, require marketplace plans to cover abortion. In other states, companies have the choice of whether or not to cover abortion, but coverage can be restricted by the state's abortion laws.
For example, if you live in a state where abortion is legal until you are 24 weeks pregnant and your insurance covers abortion, you would only have coverage up until 24 weeks. Your plan couldn't cover an abortion after that unless it was medically necessary and in line with state laws.
States can set their own rules about how health insurance can cover abortion, but they generally fall into one of five categories:
- Plans are required to cover abortion: In these states, abortion coverage is required on all marketplace plans and on Medicaid. Some employer plans also have to cover abortion.
- Plans can choose to cover abortion: Health insurance companies in these states can choose whether or not to cover abortion and in what situations to cover it. Medicaid in these states also covers abortion using state funds.
- Abortion coverage is restricted on marketplace plans: Plans you buy on the marketplace might cover abortion, but only in certain situations defined by the state.
- Abortion coverage is restricted on Medicaid: States do not cover abortions under Medicaid unless the pregnancy is a result of rape or incest, or if the pregnancy threatens a woman's life.
- Abortion coverage is restricted on marketplace plans and Medicaid: Both marketplace plans and Medicaid can only cover abortions in situations defined by the law. Usually, this means abortions are allowable for life-threatening situations, rape and incest, but some states have stricter laws.
In states that require coverage, both abortions that you decide to have and abortions needed for medical reasons are covered. In states where there are no restrictions, abortions might be covered, but it depends on your health insurance plan. If you have coverage, it could just be for medically necessary abortions. Essentially, each health insurance company gets to decide what coverage to offer.
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Medicaid, which is primarily for people with low incomes, uses state funds to cover abortion in 17 states.
State restrictions on abortion coverage
State | Covered or not restricted | On marketplace | On Medicaid |
|---|---|---|---|
| AL | |||
| AK | |||
| AZ | |||
| AR | |||
| CA |
Source: KFF. Coverage rules may be different if a state's laws have recently changed.
Even in states where abortion coverage is restricted, you might still have some coverage. In many states, for example, it's legal for health insurance companies to cover abortions if your life is at risk or the pregnancy is a result of rape or incest. If the company does offer abortion coverage, those are the only scenarios where the insurance would pay.
States that require abortion coverage
In states where abortion coverage is allowed but not required, plans can choose not to offer coverage. Only 10 states require that private health insurance plans include coverage for abortions.
- California
- Illinois
- Maine
- Maryland
- Massachusetts
- New Jersey
- New York
- Oregon
- Vermont
- Washington
In these states, you might not have to pay for an abortion. Insurance companies can't charge you a copay or coinsurance amount, except in New Jersey. You may still have to pay if you haven't reached your deductible.
Does the insurance from my job cover abortion?
If you have insurance through your job, you might have abortion coverage, but it depends on where you live and the type of plan your company offers. The best way to know if you have abortion coverage through your job is to review your plan documents or talk to your HR department if you are comfortable.
If your employer offers coverage through a health insurance company, it has to follow state laws regarding abortion coverage. In this case, your coverage will depend on your state's laws. Ten states restrict fully insured group health insurance coverage of abortion.
- Idaho
- Indiana
- Kansas
- Kentucky
- Missouri
- Nebraska
- North Dakota
- Oklahoma
- Texas
- Utah
In these states, your group health insurance plan might cover abortion, but only for the circumstances allowed by the state. This usually means abortion is only covered if your life is in danger or you were a victim of rape or incest.
But if your employer pays for its employees' medical bills, it isn't bound by state laws in the same way. That means that your employer might offer abortion coverage even if you're in a state where coverage is otherwise restricted. But your travel costs to get to a state where abortion is legal may not be covered.
Does Medicare cover abortion?
Medicare only covers abortion if the woman's life is in danger and in the case of rape or incest. That's because Medicare is funded by the federal government, and a law called the Hyde Amendment prevents the use of federal money for abortion.
The Hyde Amendment bans the use of federal money to pay for abortions except in cases of rape, incest or danger to the pregnant woman's life. It applies to Medicare, the Children’s Health Insurance Program and the Indian Health Service. The Hyde Amendment also blocks Medicaid from covering abortion with federal dollars. States that cover abortion on their Medicaid programs use state money to do so.
How much is an abortion?
Abortions can cost between $580 to $2,000, depending on the type of care you get.
The cost of an abortion depends on the type of procedure you have, how far along you are, where you get the abortion and if you have to travel out of state. If you have health insurance that covers abortion, you might not have to pay anything.
The Food and Drug Administration (FDA) currently approves the use of medication abortions for pregnancies up to 10 weeks.
Medication abortions cost between $580 and $800, according to Planned Parenthood. This type of abortion usually involves two medications. State laws regulate how medication abortions can be performed. For example, in many states, you have to be with a doctor when you take the first pill.
If you need a surgical abortion, the cost is generally between $600 and $2,000. This depends on how far along your pregnancy is. The farther into pregnancy you are, the more the abortion will cost.
Health insurance doesn't usually pay for travel costs if you have to travel to another state for an abortion. But if you have abortion coverage through your job, check to see if travel costs are also covered.
Abortion funds can help you get care if you can't afford an abortion, or if you can't afford the cost of traveling to a state where abortion is legal. The National Network of Abortion Funds and AbortionFinder.org can help connect you to abortion access, support and funding.
Frequently asked questions
Does insurance cover abortions?
Your health insurance might cover an abortion, but it depends mostly on where you live and what type of health insurance you have. In most states, health insurance companies can choose whether or not to cover abortions, and they have to follow state laws. But in 10 states, companies have to cover abortions, including elective abortions.
Does insurance cover the abortion pill?
Coverage for abortion pills depends on your health insurance plan and where you live. In most states, health insurance companies get to decide whether or not to cover abortions. And state laws regarding medication abortions vary widely and are changing rapidly. Research your state laws and review your plan documents to see if you have coverage. You may also be able to reach out to women's health care clinics to get confidential help and information.
How much does an abortion cost?
The cost of an abortion is usually between $580 and $2,000, depending on what type of abortion you need and where you get care. You'll pay less if your health insurance covers abortion. If you can't afford your procedure, you might be able to get financial assistance through an abortion fund.
Sources
Sources on abortion and health insurance include KFF's state policy dashboard, research into the Hyde Amendment and data on employer-sponsored plans. State laws are accurate as of December 2023, according to KFF. Regulations are changing rapidly and your state's laws may be different from what is listed based on recent changes.
Information about medication abortion laws is from the Guttmacher Institute. Medicare coverage information is from the Centers for Medicare & Medicaid Services. Abortion cost data is from Planned Parenthood.
Editorial note: The content of this article is based on the author's opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.