Supreme Court Roe v. Wade decision could affect medical insurance coverage


Golero | E+ | Getty Images

Even when Roe v. Wade was in effect and ladies had the legal right to an abortion regardless of where they lived within the U.S., medical insurance coverage of the procedure was limited.

Many states restrict what plans can cover, and a decadeslong national law bans using federal funds for abortions, meaning that ladies on Medicaid and Medicare were often not covered when it got here to pregnancy terminations.

With abortion now expected to be prohibited in at the least half the states after the landmark decision protecting women’s right to an abortion was overturned by the Supreme Court last week, coverage will only turn out to be rarer, experts say.

More from Personal Finance:
Cost to finance a recent automotive hits a record $656 per thirty days
Find out how to start constructing credit as a young adult
Stimulus checks rewired how some Americans see money

“State-regulated insurers in states where abortion is banned could have to drop coverage of abortions to remain in compliance with state criminal law,” said Caitlin Donovan, a spokeswoman for the National Patient Advocate Foundation.

Still, women looking for coverage for abortion can have options available to them. Although the landscape is quickly changing, here’s what we all know as of now.

How much does an abortion cost?

Medication abortions, which account for over half of all abortions, and include a two-drug regimen of mifepristone and misoprostol, may be safely used throughout the first 10 weeks of pregnancy, and might cost as much as $750 without insurance, in accordance with Planned Parenthood.

A surgical abortion, meanwhile, can run greater than $2,000 out of pocket.

How did coverage of abortions work before?

Prior to the Supreme Court’s decision last week, abortion coverage was still highly depending on where you lived and what kind of plan you had, Donovan said. “Most states impose restrictions on coverage in various degrees.”

Eleven states limit the coverage of abortion in all private medical insurance plans written within the state, in accordance with The Guttmacher Institute, a pro-abortion rights research organization. They’re Idaho, Indiana, Kansas, Kentucky, Michigan, Missouri, Nebraska, North Dakota, Oklahoma, Texas and Utah.

Meanwhile, just six states — California, Illinois, Maine, Latest York, Oregon and Washington — require abortion coverage, with some stipulations, on private plans.

The Hyde Amendment, passed in 1976, blocked federal funding for services corresponding to Medicaid from getting used for abortions, except in limited cases including rape and incest. States can select to make use of their very own budgets to complement their Medicaid coverage and extend their abortion policies, but greater than 30 states haven’t done so, Donovan said.

In consequence, “in lots of states, tons of of 1000’s of ladies looking for abortion services annually are left without coverage options,” in accordance with a 2019 report by the Kaiser Family Foundation.

How will coverage now change?

It’ll just get more limited, experts say.

Should you live in a state corresponding to Louisiana or South Dakota, where abortion is now banned, “you almost certainly haven’t any insurance coverage for it in any respect except within the case of rape, incest or a threat to the mother’s life,” Donovan said.

“Some states may not even allow those exceptions,” Donovan added.

Nevertheless, employers that self-fund for his or her medical insurance policy, meaning they tackle a lot of the costs of profit claims, may have the option to keep up their abortion coverage, said Joelle Abramowitz, an assistant research scientist on the University of Michigan. Such plans are inclined to be subject to less regulation, giving the corporate more flexibility on advantages offered.

Donovan recommends calling your plan provider and asking about its abortion coverage. In fact, if abortions are banned in your state, even in case you’re covered, you will probably need to travel to a different state to get one.

Some firms are also covering travel expenses for workers who need to depart the state for an abortion.

What about leaving my state for an abortion?

If you’ve gotten abortion coverage, it’s possible you’ll must go “out of network” in your medical insurance plan to see a physician in one other state, experts say.

Out-of-network coverage is usually less robust, and a few health plans, including HMO plans, don’t offer it in any respect. Abramowitz suggests calling your insurance plan and asking whether you’ve gotten out-of-network advantages and the way they work.

In some cases, people may find it’s cheaper to pay a provider out of pocket than to undergo their out-of-network insurance option, Abramowitz said. Many abortion providers work on a sliding scale, she added.

It is also value asking your insurance plan if there are any in-network abortion providers in one other state. There might be one right over the state line, for instance, Abramowitz said.

You furthermore may may have the option to see a provider in one other state virtually through a telehealth visit to get a drugs abortion. In these cases, your medication may be mailed to you or you may be asked to select it up somewhere.

Nevertheless, 19 states have already made it illegal to receive medication prescribed during a telehealth visit.

How can I get financial help?

A growing variety of resources can be found to assist individuals with the financial costs of an abortion.

Details about those options may be found at There’s also a national network of abortion funds.


Please enter your comment!
Please enter your name here