Coverage of Sexual and Reproductive Health Services in Medicare Meredith Freed, Juliette Cubanski, Michelle Long, Nancy Ochieng, and Alina Salganicoff Published: Apr 30, 2024

https://www.kff.org/medicare/issue-brief/coverage-of-sexual-and-reproductive-health-services-in-medicare/?utm_campaign=KFF-Medicare&utm_medium=email&_hsenc=p2ANqtz--c5_3O7e1AlHClLiAZOUQfbgOwCMJjx_5Q1Ym1yFkqbB-Z7sl926BU5HMbjyCAQO22CJuyP1Ve74ZJGMe-AdqabPPpsQ&_hsmi=305034676&utm_content=305034676&utm_source=hs_email Does Medicare Cover Sexual and Reproductive Health Services? A new KFF brief examines the extent of Medicare’s coverage for sexual and reproductive health services and how that coverage compares to Medicaid and private health insurance. These benefits are particularly relevant to nearly 1 million women of reproductive age (20-49) who are eligible for Medicare due to having a long-term disability. Women of reproductive age with Medicare coverage are more likely to be Black or Hispanic, have lower incomes, be in worse health, and experience functional and cognitive impairment than women with Medicare who are age 65 and over. Medicare covers many types of contraception, but its coverage is more limited than in Medicaid and private insurance, and beneficiaries may have to pay cost sharing for services that are covered in full by other insurance. For example, most people enrolled in Medicare Part D drug plans have coverage for contraceptive pills, rings, patches, and injections in 2024, but not for IUDs or implants, which are generally higher-cost products. In contrast to coverage under Medicaid or private insurance, people with Medicare can face out-of-pocket costs for visits to insert or remove long-acting reversible methods such as IUDs and implants. Medicare also requires cost sharing for pregnancy-related services, unlike Medicaid, and typically requires cost sharing for prenatal visits and related preventive services, unlike private plans. Medicare coverage of preventative services such as wellness visits, screenings for sexually transmitted infections and HIV, and cancer screenings, is on par with coverage in Medicaid and private insurance. Nearly 8 out of 10 women of reproductive age with Medicare are also covered by Medicaid, which gives them broader coverage of sexual and reproductive health services, and assistance with Medicare’s cost-sharing requirements. Many low-income women of reproductive age with Medicare also receive subsidies that help pay their cost sharing for contraceptive products covered under Part D. A related analysis released today examines 10 key facts about women with Medicare, a population that numbers 35 million. The analysis presents new statistics on the health, economic and functional status of women with Medicare. 10 Key Facts About Women with Medicare Meredith Freed, Juliette Cubanski, Michelle Long, Nancy Ochieng, Tricia Neuman, and Alina Salganicoff Published: Apr 30, 2024 https://www.kff.org/medicare/issue-brief/10-key-facts-about-women-with-medicare/?utm_campaign=KFF-Medicare&utm_medium=email&_hsenc=p2ANqtz-95bzdjwICGJt2WPcwVIfFvu1p0v9TjSXgvSldpDPu-WA2nCyWzaoZOK4yLNg2t8l2IgBJrHc1kXt2GHQyflVyOuaImxA&_hsmi=305034676&utm_content=305034676&utm_source=hs_email