Are IUDS covered by OHIP?

By Krista DeKuyper | December 27, 2023 | OHIP


For those contemplating the most effective method of birth control, the intrauterine device (IUD) is an option that often stakes a claim for attention due to its high efficacy rates and long-term convenience. However, one of the questions that may arise for residents in Ontario, Canada, is, “Are IUDs covered by the Ontario Health Insurance Plan (OHIP)?” In this blog post, we will delve into this question, exploring the particulars of OHIP and IUD coverage.

Defining IUDs: The Basics

IUDs are small, T-shaped devices that are inserted into the uterus to prevent pregnancy. They are a form of long-acting reversible contraception (LARC) and come in two forms: hormonal, such as the brand Mirena, and non-hormonal or copper IUDs, like ParaGard. IUDs can last between three and twelve years, depending on the type and individual considerations, making them an appealing option for sustained, low-effort birth control.

Understanding OHIP: What it Covers and Does not Cover

OHIP is a government-run health plan that provides free basic health care services for all permanent residents of Ontario. This includes visits to doctors and specialists, surgeries, hospital stays, and certain tests—all under certain conditions. However, there are a number of services that are not covered by OHIP, such as prescription drugs for individuals under 65, cosmetic surgery not deemed medically necessary, and specific types of birth control including IUDs.

Are IUDS covered by OHIP?

No. IUDS are not covered by OHIP. In fact no form of birth control is covered by OHIP if you are above 25 years old. If you are considered “low-income” and qualify for a specialty drug program you may get birth control covered by OHIP. Besides that you will need to have private insurance or pay for your birth control out of pocket.

IUDs and OHIP: The Current Landscape

Bringing the focus to IUDs, the actual device is not covered by OHIP. However, the costs associated with the insertion and removal of an IUD by a healthcare professional are typically covered by your health insurance provider. The cost of the IUD varies depending on the type and brand, typically ranging between $100 to $380, and these costs need to be borne by the individual unless they have private insurance that provides coverage.

Comparing Policies: IUD Coverage Across Canada

When we compare the policies across Canada, British Columbia, under its Fair Pharmacare plan, offers coverage for contraceptives, including some IUDs, based on income, while the Saskatchewan Prescription Drug Plan provides benefits for eligible residents, including coverage for several types of IUDs. However, in other provinces like Alberta and Manitoba, like in Ontario, the device itself is not covered.

Conclusion

Although the cost of IUDs might seem high at first glance, it’s essential to consider its long-term benefits and compare them to other types of contraceptives. While OHIP does cover certain aspects of reproductive health, including the insertion and removal of an IUD, the device itself is typically an out-of-pocket expense. For individuals seeking birth control solutions in Ontario, it is imperative to consider all applicable expenses and potential coverage options, perhaps through private insurance or other government programs. This will help persons to make the most informed decision about which type of contraception best aligns with their healthcare needs and financial circumstances.