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 limits to coverage that may include cases involving only one or more of the following exceptions: life endangerment, a 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 is 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.
Know about the best health insurance companies for 2024.
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. Alternatively, you may pay for the procedure out of pocket if you don't have health coverage.
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Preferred-provider Organization (PPOs)
Preferred-provider organization (PPOs) plans are the most common type of
employer-based health plan. PPOs have higher premiums than HMOs and HDHPs, but
those added costs offer you flexibility. A PPO allows you to get care anywhere
and without primary care provider referrals. You may have to pay more to get
out-of-network care, but a PPO will pick up a portion of the costs.
Find out more about the differences between plansHealth maintenance organization (HMO)
Health maintenance organization (HMO) plans have lower premiums than PPOs.
However, HMOs have more restrictions. HMOs don't allow you to get care outside
of your provider network. If you get out-of-network care, you'll likely have to
pay for all of it. HMOs also require you to get primary care provider referrals
to see specialists.
Find out more about the differences between plansHigh-deductible health plans (HDHPs)
High-deductible health plans (HDHPs) have become more common as employers look
to reduce their health costs. HDHPs have lower premiums than PPOs and HMOs, but
much higher deductibles. A deductible is what you have to pay for health care
services before your health plan chips in money. Once you reach your deductible,
the health plan pays a portion and you pay your share, which is called
coinsurance.
Find out more about the differences between plansExclusive provider organization (EPO)
Exclusive provider organization (EPO) plans offer the flexibility of a PPO with
the restricted network found in an HMO. EPOs don't require that members get a
referral to see a specialist. In that way, it's similar to a PPO. However, an
EPO requires in-network care, which is like an HMO.
Find out more about the differences between plans
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Health insurance FAQs
Can you get an abortion without insurance?
Yes, you can have an abortion procedure done if you lack health insurance coverage and your state allows it. But be prepared to pay out-of-pocket costs that can be a lot more expensive than if you had insurance coverage for these services.
Does Medicaid pay for abortions?
Medicaid covers most or all medically necessary abortions in 17 states. However, in 32 states and the District of Columbia, Medicaid will only provide abortion coverage in instances of rape, incest, or life endangerment. South Dakota restricts public abortion coverage to cases of life endangerment.
Does Blue Cross Blue Shield PPO cover abortion?
Blue Cross Blue Shield PPO will cover some abortion services in certain states, depending on the plan and reason for the procedure.
Does Cigna insurance cover abortion?
Cigna will cover some abortion services in certain states, depending on the plan and reason for the procedure.
Does UnitedHealthcare cover abortion?
UnitedHealthcare will cover some abortion services in certain states, depending on the plan and reason for the procedure.
Does Medicaid cover abortions in Texas?
No. Texas will not pay for abortions via its Medicaid program, except in limited circumstances such as incest or rape.
Will an abortion show up on insurance?
If you have an abortion procedure done and submit an allowable claim through your insurance company, that claim should be reviewed, verified, and reimbursed to the extent indicated in your policy.
Does insurance cover the abortion pill?
Depending on your plan, the state you live in, the reason for the procedure, and how far along the pregnancy is, your health care insurance may cover the abortion pill (also called a medical abortion).