Starting in mid-December, Oregon Health Plan (OHP/Medicaid) members began being able to get over-the-counter birth control pills, including Opill, and emergency contraception at no cost at pharmacies across the state. Oregon Health Authority (OHA), in collaboration with the Oregon Board of Pharmacy, made this possible through a standing order, which allows pharmacists to provide these medications to OHP members and bill OHP.
“Access to reproductive health care should not depend on how much money you make or what kind of insurance you have,” Governor Tina Kotek said. “This step ensures that Oregon Health Plan families can get timely, affordable birth control.”
In Oregon, these medications were already covered without a prescription for people with private insurance. Federal law, however, requires that all medications for Medicaid enrollees be prescribed by a licensed practitioner who is enrolled in the state’s Medicaid program. Oregon’s new standing order means that OHP members will no longer have to get a prescription to access these contraceptives at no cost.
“This change removes a real and unnecessary barrier to care,” said OHA Director, Dr. Sejal Hathi. “By allowing Oregon Health Plan members to get safe, effective contraception directly from pharmacies—without a prescription and at no cost to themselves—we are closing a longstanding gap between private insurance and Medicaid and ensuring all people in Oregon have greater control over their own reproductive health.”
Over-the-counter emergency contraception has been widely available for several years, and the FDA approved Opill as the first birth control pill for over-the-counter use in 2023. Previously, however, OHP members were required to pay out of pocket or seek a doctor’s appointment for a prescription for these medicines.
Oregon’s Reproductive Health Equity Act (RHEA) requires that many health plans offered in Oregon, including all plans offered through the Marketplace, cover over-the-counter contraceptives at no cost. Some private insurance plans that are not subject to Oregon insurance laws may not include this coverage, so people with private insurance should contact their insurance company for information about their coverage.
Most OHP members get their benefits through a local Coordinated Care Organization (CCO); OHP members can call their CCO and ask which pharmacy to go to. OHP members not in a CCO (known as OHP Open Card), or who do not know which CCO they’re in, can call OHP Client Services for help at 800.273.0557.