Is Abortion Covered by Insurance?

If you are unexpectedly pregnant and considering your options, monetary costs are likely at the top of your mind. There is probably a range of questions going through your mind – one being, is abortion covered by insurance?

While abortion is legal in the United States, each state is permitted to have its own laws or restrictions regarding insurance plans and what they can or cannot cover. Where you live and how you are covered determine whether your health insurance will cover an abortion procedure.

For you information on Medicaid’s coverage of abortion costs, you can read our February blog post on the subject.

What does “private insurance plan” mean?

A private insurance plan refers to any insurance plan provided by the private health industry, as opposed to government-run insurance programs.  Private insurance commonly includes plans provided by your employer or plans that you purchased on your own. Government-run insurance plans refer to coverage from options like Medicaid and Medicare.

Private health insurance constitutes a vast majority of today’s healthcare landscape in the United States, currently applying to well over half the population.

Which states do not permit abortion coverage in most circumstances?

Roughly half of the states have banned abortion coverage in at least some private insurance plans, except for in cases of life endangerment, rape or incest.

Of the states that have restrictions on abortion coverage, 11 of them have banned coverage in all private plans and others have bans for marketplace plans only.

To see a map of all the states with bans on abortion coverage, view Guttmacher Institute’s breakdown.

What is an “insurance exchange?”

A health insurance exchange is an online marketplace where consumers can compare and buy individual insurance plans. The number of private exchanges taking place has increased in recent years. Private exchanges are those that were established by benefit companies and health insurance carriers. However, a majority of the exchanges still involve state health insurance that were established through the Affordable Care Act.

Because these are state health insurance exchanges, there are states that have regulations regarding abortion coverage. These regulations range from no abortion coverage at all to limiting abortion coverage to only instances when the mother’s life is in danger. Here is a list of those states and some additional information on the restrictions in each state.

To learn more about abortion coverage in your state, we recommend searching for your state’s insurance regulations.

So, is abortion covered by insurance in any states, no matter the circumstances?

Because each state has its own definition regarding what constitutes a “medically necessary” abortion, and what that phrase is defined as, it is hard to give an exact answer to that question. Some abortion procedures under specific circumstances are covered in most cases, and we recognize that is quite vague. Health insurance is complex and state-specific. Therefore, the best way to find the best answers to particular questions is to target your search by state.