Can you use insurance for abortion (and how does it work)?

After making the decision to move forward with an abortion, the next step is deciding how you’ll pay for it. If you have insurance, your plan may cover in-person or virtual care from telehealth clinics like Hey Jane, and care could be as little as $0.

‍

Not every insurance plan will cover abortion care however, which could leave you with unexpected out-of-pocket costs. Understanding what your insurance does and does not cover can help you choose an abortion provider and determine if you want to seek financial assistance. Call the number on the back of your member ID card to find out if your plan covers abortion care through your clinic of choice to understand the specifics of your coverage. For Hey Jane patients, you can ask member services if your plan covers abortion care through Hey Jane, including through its affiliated provider groups, Possible Health or Jane Medical.

‍

Hey Jane is a virtual abortion clinic that accepts select insurance plans. To start the process with us, you’ll fill out a quick intake form before having a phone or video consultation with one of our licensed clinicians.

‍

If you’re medically eligible for treatment, we’ll prescribe safe, FDA-approved abortion pills and ship them to your doorstep or local post office for pick up. Treatment arrives in discreet, plain packaging to protect your privacy

‍

Here’s what you need to know about insurance coverage for abortion care.

‍

Does private health insurance cover abortion?

Yes! While the specifics of coverage vary plan to plan, many private insurance companies do cover abortion care. You’ll want to read the fine print in your plan to get specifics on what coverage you’ll actually receive for your care. Hey Jane is the first fully virtual abortion clinic to accept private insurance plans, and we’re actively working to expand coverage to even more plans.

‍

Unfortunately, The Affordable Care Act (ACA) permits states to ban abortion coverage from Healthcare Marketplace or private insurance plans. Some states have additional regulations impacting coverage for abortion care, so you might want to review your state’s rules if you have private health insurance.

‍

Does Medicaid cover abortion?

A federal law called the Hyde Amendment prohibits use of federal funds for abortion care that except for cases of sexual assault, incest, or when the person’s life is in danger (the “Hyde exceptions”). However, state Medicaid programs can use their own state funds to cover abortion care beyond the Hyde exceptions. Hence, similar to private health insurance, Medicaid coverage for abortion varies by state. As of September 2024, there were only 18 states covering abortion care through their Medicaid programs beyond the Hyde exceptions.  

‍

Hey Jane currently accepts Illinois Medicaid for medication abortion care (provided by Jane Medical), and we are actively working to expand our coverage to more state programs. We understand that the cost of abortion can be unexpected, and that it often comes with hidden expenses such as childcare, transportation, and time off work. That’s why we provide sliding scale pricing based on annual income for all uninsured patients, as well as financial aid via our abortion fund partners.

‍

How can I find abortion providers that are in-network with my insurance plan?

Be sure to confirm that the health care provider that you choose for in-person or virtual abortion care is in-network with your insurance plan. You can typically find this information by calling your insurance plan’s member services phone number, or logging into your account online.

‍

Choosing an in-network abortion care provider can help maximize coverage and minimize out-of-pocket costs, but if you have a plan (e.g. PPO) that allows you to see out-of-network providers, the difference might not be as significant.

When is abortion not covered by insurance?

Abortion coverage varies from plan to plan, but there are some common reasons why insurance may not cover as much (or any) of your bill as you expected. 

Certain plans don’t cover abortion care unless it is to preserve the life or health of the pregnant person. Other plans may have restrictions on specific types of abortion treatments.Sometimes, even if your plan covers abortion, you may still have to pay some or all of the bill. This may be because you have a co-pay or co-insurance, or because you haven’t met your annual deductible. You can call the member services number on your insurance card to get more specifics about your plan.

‍

What is a co-pay?

A co-pay is a fixed cost that a patient is required to pay out-of-pocket before receiving a specific health care service. Insurance plans typically have different co-pays for different types of services, such as doctor visits, prescriptions, and emergency room visits. You can typically find your co-pay on your insurance card, or you can call your plan’s member services number to confirm.

‍

What is co-insurance?

Co-insurance is the percentage of the cost of a covered health care service that the patient is required to pay after they have paid their deductible. The insurance company pays the remaining percentage. You can find your co-insurance by calling your plan’s member services line, on your online portal, or in your summary of benefits.

‍

For example, if you are seeking a covered service that costs $1000 and a co-insurance of 20%, you would pay $200, and the insurance company would pay $800, assuming the annual deductible has been met.

‍

What is a deductible?

An annual deductible is the amount a patient must pay out-of-pocket for covered health care services before their insurance plan starts to pay. Once the deductible is met, the insurance plan begins to cover the cost of services, usually with co-insurance or co-pays. You can find your deductible by calling your plan’s member services number, on your online portal, or sometimes on your health insurance card.

‍

For example, if your insurance plan has a $1000 deductible, you have to pay $1000 towards your medical costs that year before your insurance starts to cover expenses.

‍

Do I need a pre-authorization for abortion?

Your insurance plan may require pre-authorization or documentation from a health care provider before covering abortion care. Certain plans also require a phone or video consultation, known as a synchronous visit, in order for the service to be covered by your insurance. This is very common with virtual providers who offer certain services, like medication abortion, via telemedicine.

‍

Outside of insurance, each state has different requirements before an abortion can occur, such as waiting for 24-48 hours between a consultation for an abortion and the treatment itself. Knowing these requirements in advance can help streamline the process of treatment and avoid delays in care. To learn more about the differences between states, explore our guide here.

‍

How can I reduce the cost of an abortion?

If you’re uninsured or your insurance provider doesn’t cover abortion, there are several routes you can take to get financial support. Below are some ways you can seek help to pay for abortion costs:

‍

1. Use a virtual abortion clinic

A virtual abortion clinic like Hey Jane typically has lower out-of-pocket costs than an in-person clinic. Using telemedicine can also save you money on transportation, child care, and other expenses that might add up for in-person abortion care. 

Telehealth clinics like Hey Jane connect you with a team of licensed providers to get abortion pills delivered and receive supportive care completely online. Hey Jane prescribes the abortion pills mifepristone (which stops the pregnancy from growing) and misoprostol (which helps empty your uterus), which you can take from the comfort of your home to end your pregnancy. 

‍

2. Find an abortion fund

Abortion funds can help cover the costs of ending a pregnancy for those who are unable to afford it. Hey Jane partners with several abortion fund partners to make abortion care more affordable for our patients. Funds can cover up to 100% of treatment costs, and can often also provide financial aid for transportation, overnight accommodations, and child care for people seeking abortion care outside of their home state. 

‍

3. Ask your OB-GYN

If you are comfortable discussing abortion care with your OB-GYN, they may be able to share contact information for financial assistance programs that can help.

‍

At Hey Jane, we believe cost shouldn’t be a barrier to health care.

That’s why we accept select insurance plans and are working to continue expanding our insurance coverage even more, and have financial assistance partnerships in place with abortion funds. To see what insurance plans we currently accept, click here. 

If you have any of these plans, share your insurance details during signup and we’ll take it from there.

If your insurance plan isn't on the list, Hey Jane also accepts health savings accounts (HSA), flexible spending accounts (FSA), and out-of-pocket payments for medical services.