Does health insurance cover abortions?
An abortion procedure, including a medication abortion (the abortion pill) and a surgical abortion, may or may not be covered by your health insurance plan. The answer depends on your state's reproductive health care laws and restrictions, the type of health insurance, insurance company policies and the timeframe of the pregnancy. Some states restrict abortion, while others allow women to have access to abortion procedures depending on the situation. Laws have been changing rapidly since Roe v. Wade was overturned in 2022.
According to the Guttmacher Institute, as of June 2023:
- 11 states have laws restricting coverage for abortion in all private insurance health plans, including ACA plans.
- Eight states require coverage in all private insurance policies.
- 25 states restrict abortion coverage and plans offered through health insurance exchanges, with limit s to coverage that may include cases involving only one or more of the following exceptions: life endangerment, threat to the pregnant person's health, rape, incest, fetal abnormality, and "substantial and irreversible impairment of a major bodily function."
- 21 states restrict insurance coverage of abortion for public employees in health insurance plans.
ACA marketplace plans may or may not cover abortion services. In more than half the states, health insurance plans sold in the exchange aren’t allowed to cover abortions except for circumstances involving rape, incest, or the mother's life being in danger.
Find out the specifics of your state’s abortion restrictions and laws.
Also, on the federal government level, the Hyde Amendment is a Congressional provision that bars using federal funds to pay for abortions except to save the life of the mother or if the pregnancy was the result of rape or incest.
How much is an abortion with insurance?
If you have insurance that covers an abortion procedure, you could pay an amount ranging from nothing to a few hundred dollars out of pocket, depending on the type of procedure and your policy's copay or coinsurance requirements.
Without insurance, a medical abortion (effective only within a pregnancy's first 10 weeks) can likely cost between $300 and $700, and a surgical abortion (after the first 10 weeks) can cost more than $3,000.
The Kaiser Family Foundation reports that the median cost of an abortion is $500 at 10 weeks gestation versus $1,195 at 20 weeks of pregnancy.
Organizations like Planned Parenthood also offer services at no to low cost if you qualify. Contact Planned Parenthood health centers for more information about those options.
Health insurance companies that provide abortion coverage
Many health insurance companies provide coverage for abortion services if state laws allow it and if the insurer chooses to cover these services. Some health insurance companies may even pay for treatment that takes place in another state if laws force the patient to travel for care.
Since most health insurance companies operate in more than one state, the coverage available will vary by state, making it difficult to say definitively that one company or another does cover abortion. Check with your health plan to find out what's covered.
How are abortions paid for?
If you have health insurance that covers abortion services and live in a state that allows for this coverage and the services, you can have an abortion procedure done and submit a claim for the costs through your insurance company.
Your health insurance company will likely pay the provider directly. Alternately, you may pay for the procedure out of pocket if you don't have health coverage.