Are abortion pills covered by Medicare?
If you're wondering if Medicare covers abortion pills, you should know that Medicare does not cover medication abortion. In only two cases will Medicare cover abortion: if the mother's pregnancy is a result of incest or rape, or if the mother's life is in danger. However, laws vary from state to state.
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UPDATED: Jun 28, 2022
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- Medication abortion is not covered by Medicare, except for two specific reasons
- The Hyde Amendment restricts abortion coverage under the Indiana Health Service, Medicare, and the Children’s Health Insurance Program
- Recipients of Medicare coverage should be aware that different states have different laws regarding abortion services available
Health insurance is one of the most sought-after types of insurance, whether through a specified insurance company or Medicare. Medicare is a federal health insurance program that is broken down into three parts.
There is Medicare Part A that covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Medicare Part B covers certain doctor’s services, outpatient care, medical supplies, and preventive services.
The cost of prescription drugs, including many recommended shots or vaccines, is covered by Medicare Part D.
Different states have different laws for abortion and whether or not Medicare covers medication abortion. Find out if you’re covered for the abortion pill. Enter your ZIP code and get a free quote today.
Does Medicare cover medication abortion?
Medicare typically covers individuals over the age of 65 who are past reproductive years. Even so, certain disabilities can qualify some younger people for Medicare.
A medication abortion — also known as the abortion pill — requires the use of two pills that are taken up to 48 hours apart. This is not covered by Medicare, except for two reasons:
- The pregnant woman’s life is in danger.
- The pregnancy is due to rape or incest.
The Hyde Amendment restricts abortion coverage under the Indiana Health Service, Medicare, and the Children’s Health Insurance Program.
Recipients of Medicare coverage should be aware that different states have different laws regarding abortion services. This means that even though an abortion procedure may be covered by Medicare, it may not be available in your state. Even still, some of the best insurance companies may offer Medicare coverage.
Here are some standard Medicare rates:
|Medicare Taxes and Rates Summary||Estimated Monthly Medicare Rates||Estimated Annual Medicare Rates|
|Medicare taxes for less than 30 quarters, standard Part A rate||$458||$5,496|
|Medicare taxes for 30-39 quarters, standard Part A rates||$252||$3,024|
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How much does medication abortion cost?
The cost of an abortion pill varies depending on the state you receive care and your health insurance.
It could be free or low-cost with health insurance. You should call your insurance provider directly to find out if insurance covers abortions directly; some policies don’t cover them and some only cover it in certain cases.
Centers, such as Planned Parenthood, will work to give you the services you need whether or not you have insurance.
According to Medicare.org, medication abortion requires the use of two pills that are taken up to 48 hours apart. The first pill contains mifepristone, which causes the body to stop using its progesterone. This stops the pregnancy from progressing. The second pill has misoprostol, which causes the uterus to empty itself.
Depending on how far along you are in your pregnancy, medication abortion is anywhere between 91% and 98% effective. The further into your pregnancy you are, the less effective it is.
A follow-up visit is typically scheduled a week or two later to confirm that the pregnancy was terminated via ultrasound or blood test.
|Max. gestational age||Up to 70 days (10 weeks)|
|Mifepristone dosage||200mg (one pill), taken orally|
|Mifepristone administration||Dispensed in office; Where the medication must be taken (home or clinical setting)|
|Misoprostol dosage||800mg (four pills), taken buccually (placed in cheek) or vaginally|
|Misoprostol timing||24-48 hours after mifepristone buccally, or 6-72 hours after mifepristone vaginally|
|Misoprostol administration||Taken at home|
|Follow-up visit||7-14 days after mifepristone, no location specified|
|Prescriber requirements||By or under the supervision of a prescriber that has been certified by the manufacturer|
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There are three provisions that come with medication abortion.
- Mifepristone must be dispensed to patients only in certain healthcare settings, specifically clinics, medical offices, and hospitals, by or under the supervision of a certified prescriber.
- A provider must become a certified prescriber by completing and sending a Prescriber Agreement Form to the specific distributor — Danco Laboratories or GenBioPro — which confirms they are able to assess the duration of a pregnancy, diagnose ectopic pregnancies, and provide surgical abortion in the case of an incomplete abortion.
- The certified prescriber must obtain a signed Patient Agreement Form from the woman before dispensing the drug as documentation of safe use conditions.
Medication abortion can occur within the first 10 weeks of pregnancy.
Abortion pills can be found at Planned Parenthood health centers or they can be sent through the mail via telehealth or telemedicine services.
If your local Planned Parenthood health center does not provide the abortion pill, they would be happy to refer you to a location in your area where you may obtain it.
Learn if your insurance covers medication abortions. Enter your ZIP code and get a free quote today.
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