Medicaid Family Planning Services

• What is Medicaid Family Planning Services?
• Who is eligible for Medicaid Family Planning Services?
• What services are covered under Medicaid Family Planning Services?
• What services are NOT covered?
• Can my Managed Care Organization (MCO) restrict my access to Family Planning Services?
• Do I need to get approval from my MCO before using Family Planning Services?
• Are there fees or limits to how much I can use Family Planning Services?
• Is it confidential?

The Medicaid Family Planning Services policy provides all Medicaid recipients, including those enrolled in Medicaid Managed Care, with unrestricted access to reproductive health information and services.

If you are a man or woman of reproductive age, including minors, and are enrolled in Medicaid or Medicaid Managed Care program, you are eligible for Medicaid Family Planning Services.

Services that are covered include:

• Most contraceptive devices
• Sterilization
• Screening and testing for pregnancy
• Medication abortion

If provided during family planning visits, Medicaid Family Planning Services also covers:

• Screening and treatment for STIs.
• Screening and testing for women’s health problems including cervical and pelvic abnormality or pathology, breast disease, anemia, and high blood pressure.
• Education and counseling related to women’s health problems.
• HIV testing and pre- and post- test counseling.

Medicaid Family Planning Services does NOT cover ongoing obstetrics/gynecology care, including hysterectomies, prenatal, delivery and postpartum care, and treatment for anemia, glycosuria, proteinuria, hypertension and breast disease.

Your MCO cannot stop you from receiving Family Planning Services from any Medicaid provider of your choice. The MCO is required to inform you of this right.

You do not need prior approval or referrals to receive Family Planning Services from a Medicaid Provider.

There are no fees and no limits.

It is completely confidential.