Family planning is an important aspect of health care, with benefits for women, babies, families, and communities. The ability to freely access contraceptive care is a key part of family planning. New Jersey has many benefits in place to make family planning services available to its residents, at low or no cost. The insurance laws in New Jersey protect the right to access family planning services for people of all income levels.

Three Public Insurance Programs are Available, Depending on Income and Immigration Status

Medicaid is available for adults aged 19 to 64 with income up to 138% of the Federal Poverty Level (FPL). Below age 19, Medicaid for children has even higher income limits. As with other New Jersey Medicaid programs, you have to be a New Jersey resident and must be a U.S. citizen or “qualified” immigrant. The quickest way to apply is online on the NJ FamilyCare website. Care and prescription coverage is coordinated through your managed care organization (Medicaid insurance company). As with all Medicaid services, there is no charge.

Plan First NJ is available for adults aged 19 to 64 with income between 138% and 205% of the Federal Poverty Level (FPL). It is not full Medicaid coverage, but covers a wide range of family planning services. The coverage is available to both women and men. You can have Plan First NJ coverage in addition to another insurance policy. If a family planning service is not covered or there is a charge by your other plan, Plan First will cover it. You can apply by filing the general NJ FamilyCare application for health care coverage. It has a question asking whether you want to be evaluated for family planning services (Plan First Program). The quickest way to apply is online on the NJ FamilyCare website. Care is provided by the organizations listed below, either Federally Qualified Health Care Centers or Planned Parenthood clinics.

NJ Supplemental Prenatal and Contraceptive Program (NJSPCP) is available to anyone of any gender whose income would qualify for coverage under Plan First NJ, but who does not have the necessary immigration status. Applications and care under this program are only accessible through participating providers, which are located at hospitals, outpatient clinics, Federally Qualified Health Care Centers (See Locate a Health Center (from the New Jersey Primary Care Association)); and most Planned Parenthood clinics (See Health Centers in New Jersey). For a list of all providers in your area, contact the Medical Assistance Customer Center serving your county (See Medical Assistance Customer Center Directory).

Contraceptive care is a required benefit for most insurance plans in New Jersey

Even if you have a private insurance plan, contraceptive care is a required benefit for all plans purchased on the Marketplace (Get Covered NJ). In addition, most private health plans are required to cover this care as well. There is an exception for private health plans sponsored by certain religious employers. However, employees may still be able to get additional coverage for this purpose through Plan First NJ, depending on their income level. Plan First NJ would pay for any cost or care that is not covered under your employer-based plan.

Contraceptive care includes education, counseling, contraceptives, and follow up care. It also includes at least one form of birth control in each of 18 different categories. The required categories of covered birth control include surgical (for women), intrauterine, oral contraceptives, and emergency contraception, among many others. The cost of this contraceptive care must be provided at no cost even for patients who have not met their deductibles. However, a plan can charge for certain forms of birth control if a covered alternative is available, unless your medical provider recommends a particular form as a matter of medical necessity. In that case, the plan cannot charge for that service.

New laws in New Jersey make it easier to access contraceptive care

A recently-passed NJ law requires private and Medicaid insurers to provide any contraceptive drug, device, or product approved by the FDA for a 12-month supply at one time. Previously, insurers only had to provide 6 months at one time, so this will make it easier for people to protect against a lapse in their contraception. A lot of providers and pharmacies do not know that this is a covered benefit, so you should make sure to ask about it.

Starting on May 1, 2023, pharmacists in New Jersey will be able to provide self-administered hormonal contraceptives to patients. “Hormonal contraceptives” will include any oral, transdermal, or vaginal contraceptive product, including, but not limited to, birth control pills, vaginal rings, and diaphragms. This will allow you to purchase those forms of contraceptives without a prescription. The pharmacist will ask you to fill out a form with medical questions. Based upon your answers, the pharmacist will be able to provide those contraceptives to you without the need for you to see a provider first.

Contraceptive Care is Critical Coverage

New Jersey recognizes that freedom of reproductive choice is a fundamental right guaranteed to New Jersey residents by the state constitution. This includes the right to determine whether and when to bear children. The right to access contraceptive care is an important part of this choice.

This information last reviewed: Apr 25, 2023