The Ontario Health Insurance Plan provides coverage for prescription drugs and medical services, including reproductive healthcare. If you’re wondering does OHIP cover birth control, then the answer is no – at least not for those over 25

Types of Birth Control You Can Get in Ontario

First and foremost you should talk to your family doctor to discuss which type of birth control is right for you. There are hormonal adn non-hormonal options and some that are more effective than others. Also remember that no birth control is 100% effective.

Oral Pills

Probably one of the most well-known types of birth control often referred to as “the pill”. This type of contraceptive is taken orally at the same time each day. There are two main kinds of birth control pills

1. combination birth control pills: contain both estrogen and progestin
2. The minipill: only contain progestin

From those two types it can be broken further down. Talk to your healthcare provider for more details.

Intrauterine Device (IUD)

The Intrauterine Device (IUD) is a type of birth control that is inserted into the uterus to prevent pregnancy. The device is a small, T-shaped plastic or copper device that can be left in place for up to 3 to 12 years depending on the type used. The IUD works by preventing fertilization and implantation of eggs in the uterus. However, the device can cause side effects such as cramping, bleeding, pain, and discomfort, especially during the first few weeks following insertion. It is recommended that anyone considering using an IUD should consult with a healthcare provider to discuss the pros and cons of this method of birth control.

Patch

A contraceptive patch is a form of birth control that utilizes a hormonal patch placed on the skin weekly. It contains synthetic estrogen and progesterone, which are absorbed through the skin and work to prevent pregnancy. The patch must be applied to a clean, dry, and hairless area of skin on the abdomen, buttock, upper arm, or torso. It is important to change the patch every week on the same day to maintain its effectiveness. Benefits include shorter, lighter periods and reduced cramping. However, it is not recommended for everyone and may cause side effects such as headaches, nausea, weight gain, and mood changes. It is important to discuss the use of the contraceptive patch with a healthcare provider to determine if it is suitable for individual needs.

Ring

The contraceptive ring is a type of hormonal birth control that is a flexible, plastic ring that contains synthetic estrogen and progesterone, which are slowly released over time. The ring is typically inserted into the vagina and left in place for three weeks, before being removed for a week during which menstruation occurs. The ring prevents ovulation and thickens cervical mucus to block sperm from reaching the eggs. The contraceptive ring can also have non-contraceptive benefits such as a reduction in menstrual cramps and a lighter menstrual flow. However, the use of the contraceptive ring may also cause side effects such as headaches, nausea, breast tenderness, and mood changes. It is important to discuss the use of the contraceptive ring with a healthcare provider to determine if it is suitable for individual needs.

Condoms

Condoms are a popular and widely used form of contraception and protection against sexually transmitted infections (STIs). Made from latex, polyurethane, or other materials, condoms are designed to be worn over the penis during sexual intercourse. The use of condoms helps prevent unwanted pregnancy and lower the risk of STIs, including HIV. Additionally, condoms are easy to find, inexpensive, and do not require a prescription. However, it is important to note that condoms are not 100% effective and can break or slip off, which is why it is often recommended to use them in combination with another form of contraception. It is also important to choose the right size and be careful when using them to ensure maximum effectiveness.

Cost of Birth Different Birth Control

The cost of birth control in Canada is dependent on the type of birth control. For example:

The average monthly price of pills is $22/month; hormonal IUDs cost $350+ up front; non-hormonal IUDs cost $50, and injectable contraceptives cost $45 according to Action Canada.

The cost of different contraceptive methods can vary widely depending on the type of method and a person’s insurance coverage. In general, long-acting reversible contraceptives (LARCs) such as intrauterine devices (IUDs) and implants tend to be more expensive upfront but are cost-effective in the long run as they can last for several years. The costs of LARCs can range from a few hundred to a few thousand dollars. Birth control pills, on the other hand, are usually relatively inexpensive but require a monthly prescription refill, which can add up over time. Other forms of contraception, such as condoms and diaphragms, are typically affordable and do not require a prescription.

Does OHIP cover birth control?

25 years and older

If you are 25 or older then there may be coverage if you are considered “low-income” and qualify for a specialty drug program. Besides that you will need to have private insurance or pay for your birth control out of pocket.

If you are 24 or younger

If you are 24 or younger then some birth control is covered for you. You would be covered under the OHIP+ program.

The OHIP+ program in the province of Ontario, Canada is an extension to the OHIP that was introduced in January 2018. This program provides free coverage of more than 5000 drug products for anyone age 24 of younger who is not covered by a private plan. The birth control that will be covered by this program are pills, IUDs, and injectables.

To search for a specific drug use this tool: Check Medication Coverage

Is Birth Control Covered Outside of Ontario?

No. The province of Ontario is the only province that covered the cost of birth control for those under 25 years old. All other provinces and territories do not cover birth control regardless of your age.

Are Birth Control Pills Covered By Individual Health Plans?

For those over 25 years old the only option to get birth control covered is to get a private health insurance plan. But make sure to read all the plan details as not all health insurance plans will covered birth control. For example, Sonata health plans have no coverage for birth control pills

Which Health Insurance Plans Cover Birth Control

Manulife Flexcare

The first plan that covers birth control is Manulife Flexcare enhanced plans. More specifically, either the DrugPlus Enhanced plan or the ComboPlus Enhanced plan.

Blue Cross

All health plans under Blue Cross that have prescription coverage will cover birth control.

Sun Life Financial

Similar to Manulife Flexcare, only the enhanced plan from Sun Life Financial will cover the cost of birth control pills. Specially the Sun Life Personal Health Insurance Plan

The bottom line – no for the adult population (over 25) in Ontario OHIP does not cover your birth control. You will need to have private insurance. If you’re under 25 and don’t have private insurance, then you’re in luck as the OHIP+ program will cover you birth control.

Regardless it’s always best to have some sort of private insurance as it helps you prepare for unforeseen medical emergencies that can cost you thousands of dollars. Use our instant quoting tool or contact our offices if you’re looking to talk to an expert!