Does Aetna cover birth control?

Wondering if Aetna covers birth control—and how to access it online? Most Aetna plans, including individual, employer-sponsored, and federal (OPM) plans, do cover FDA-approved birth control methods at no out-of-pocket cost, as required by the Affordable Care Act (ACA). However, certain plans, such as those from religious employers or those with grandfathered policies, may be exempt from this coverage. In this guide, we’ll break down which methods are typically covered, what may require extra steps, how to check your specific plan, and what to do if coverage is denied. 

Ready to get started? You can book a virtual appointment to see if you’re eligible to get birth control online through Aetna.

What types of birth control does Aetna cover?

Aetna provides broad coverage under both medical and pharmacy benefits. The following methods are typically covered at no cost, as long as they are approved by the U.S. Food and Drug Administration (FDA) and obtained through in-network providers:

• Oral contraceptives (generic and select brand-name pills)
• Contraceptive patch (e.g., Xulane)
• Vaginal ring (e.g., NuvaRing)
• Injectables (e.g., Depo‑Provera)
• Implants (e.g., Nexplanon)
• Intrauterine devices (IUDs)—both hormonal (e.g., Mirena, Liletta) and non-hormonal (e.g., Paragard)
• Emergency contraception (e.g., levonorgestrel, ulipristal)
• Prescription-based digital contraception apps (e.g., Natural Cycles)

The types of contraceptives covered can be found in Aetna’s Preventive Drug List (2024).

Find out if your insurance covers birth control

Talk to a provider on Klarity to explore birth control options and get guidance on whether coverage may apply.

Book your consultation today

What types of birth control does Aetna not cover?

While Aetna’s coverage is pretty expansive, certain contraceptive methods may not be covered or may require additional steps:

• Brand-name drugs, especially when a generic equivalent is available, unless medically necessary
  
• Male contraceptive methods, such as vasectomy, which are not included in the ACA mandate
  
• Fertility-tracking apps that are not FDA-cleared
  
• Off-label or investigational contraceptive options
  
• Contraceptives prescribed for non-contraceptive purposes (such as  to treat menstrual disorders) may fall under different medical benefits and billing guidelines.

Eligibility criteria for Aetna coverage for birth control

Even if you plan on using one of the covered types of contraceptives mentioned above, you still must be eligible. To qualify for no-cost birth control coverage through Aetna:

• Your plan must be ACA-compliant (not grandfathered or exempt)
• The contraceptive must be FDA-approved and appear on Aetna’s preventive drug list
• A valid prescription or prior authorization may be required
• You must use in-network pharmacies or providers

How to check whether my Aetna covers birth control

1. Log in to your Aetna member portal or app.
Sign in at aetna.com or use the Aetna Health app. This ensures your coverage details reflect your specific plan.

2. Use the “Find a Drug” tool.
Search for your contraceptive by name (e.g., “levonorgestrel,” “Nexplanon,” “Mirena”). This tool provides coverage status, tier level, and any special requirements, such as prior authorization or step therapy.

3. Review your Evidence of Coverage (EOC).
Your EOC or Summary of Benefits outlines your contraceptive coverage in detail, including covered methods, cost-sharing rules, and exceptions.

4. Check formulary tiers and restrictions.
Contraceptives are typically categorized as Tier 1 (generics) or Tier 2 (preferred brands). Higher tiers or excluded drugs may require an exception or authorization.

5. Contact Member Services.
If you’re unsure, call the number on your Aetna ID card or use the online chat tool. A representative can confirm coverage and explain next steps.

Does Aetna cover birth control online?

Yes, Aetna allows members to access contraceptive care through telehealth platforms. You can book a virtual appointment through platforms like Klarity Health to consult with a licensed provider. If a prescription is appropriate, it will be sent to your preferred in-network pharmacy, often with no out-of-pocket cost when covered under preventive benefits.

Why Aetna might deny birth control coverage

Aetna’s comprehensive plan covers most birth control, but, birth control coverage may be denied if:

• Your plan is not subject to ACA requirements
• The method is not FDA-approved or is excluded from the formulary
• You used an out-of-network pharmacy or provider
• It was prescribed for a non-covered use
• Prior authorization was required, but was not submitted

Tips for improving your chances of approval for Aetna coverage

For the best chance of getting your birth control covered by Aetna, you should: 

• Use in-network providers and pharmacies
• Request generic versions when available
• Ensure your provider documents FDA-approved contraceptive use
• Provide a medical necessity letter for brand-name prescriptions
• If denied, request a formulary exception through your provider

How to get prior authorization from Aetna for birth control

Prior authorization is a process in which your insurance provider requires your doctor to get approval before covering certain medications or services. It’s used to ensure the treatment is medically necessary and cost-effective based on your plan’s guidelines.

• Confirm whether prior authorization is required by checking your EOC or member portal.
• Have your provider complete Aetna’s prior authorization forms, including medical justification.
• Submit the form via fax, Availity portal, or Electronic Data Interchange (EDI).
• Standard requests are often processed within 2 weeks, and urgent requests typically within 24–72 hours.
• If denied, follow the appeal instructions. You generally have 60 days to submit an appeal.

Key takeaway

Aetna generally provides broad, no‑cost coverage for FDA‑approved contraceptive methods under most plans. But, you’ll want to be sure to verify your coverage, use in-plan resources, and understand the steps required for the method you need, like prior authorization or an exception.

Next steps to get birth control covered by Aetna online

Ready to get started? Book a virtual visit on Klarity Health to connect with a licensed provider who can evaluate your needs and discuss birth control options that may be covered under your Aetna plan. It’s fast, secure, and tailored to your goals.

Not sure if your insurance covers birth control?

Klarity connects you with licensed providers who can review your benefits and help determine the best birth control options for you.

Book an appointment