Medicaid Family Planning Services

  1. How do I get Medicaid Family Planning Services? If you have Medicaid managed care in New York State, you can go to any provider inside or outside your health plan for family planning and reproductive health services, as long as that provider accepts Medicaid and offers the services you need.
  2. Do I need prior approval from my health plan or regular doctor? No. You do not need a referral from your primary care provider (PCP) or anyone else in your health plan to see any family planning provider inside or outside your plan that offers these services and accepts Medicaid.
  3. What kind of services can I get? You have free and confidential access to:
    • all types of birth control: pills, condoms, diaphragms, IUDs, Depo Provera, Norplant, and contraceptive foams;
    • emergency contraception;
    • pregnancy tests;
    • sterilization (tubal ligations and vasectomies);
    • testing and treatment for sexually transmitted diseases (STDs) including colposcopy, cryotherapy and LEEP;*
    • HIV testing and pre test and post test counseling;*
    • Pap smears; testing for cervical cancer, pelvic problems, breast disease, anemia, and high blood pressure;*
    • abortion.

    • *As part of a family planning visit
  4. If I am under 18 years of age, can I still get these services? Yes. When making the appointment, ask if the doctor or clinic will see someone your age.
  5. Can I get tested for HIV outside my plan? Yes. You can go to any Medicaid provider for HIV testing and counseling, as part of a family planning visit.
  6. Will I have to use my own money if I go outside the plan? No. Medicaid will pay for all family planning services, no matter who you see, as long as that provider accepts Medicaid. Take your Medicaid card to the visit.
  7. Will my services be confidential? Yes. All services are confidential.
  8. What if my plan doesn't pay for birth control or any of those other services? You can go to any doctor, clinic or health center inside or outside your plan that accepts Medicaid and offers family planning and reproductive health services. Take your Medicaid card to the visit.
  9. How can I find out where I can go for family planning and reproductive health services? You can ask your managed care health plan or ask your doctor or nurse.
  10. Where can I get more information?
         Growing Up Healthy Hotline: 1-800-522-5006
         New York City Medicaid Managed Care Helpline: 1-800-505-5678