The Female Condom and Reimbursement

NFPRHA and the National Coalition of STD Directors (NCSD) are pleased to release two new resources on the female condom. These resources are intended to inform providers and patients that the female condom is reimbursable with a prescription. 

Under the Affordable Care Act (ACA), all new insurance plans (both individual and employer-sponsored) are required to cover all FDA-approved methods of contraception, sterilization, and related education and counseling without cost-sharing, including the female condom. The contraceptive coverage requirement presents an opportunity to educate providers and patients on how to reduce cost barriers to the female condom through reimbursement. 

The materials below are available to download and print to NFPRHA members. In addition, hard copy materials will be available at NFPRHA’s Winter Meeting and National Conference. Limited materials can also be sent to members upon request.

Female condom billing fact sheet – intended for providers, this fact sheet provides information on how to seek reimbursement for the female condom, including billing codes and a sample prescription.

Female condom palm card - the palm card educates patients on how to obtain the female condom without cost-sharing and includes information to help them discuss the process with pharmacists and providers.

Female Condom Webinar - an overview of how the female condom is reimbursable with a prescription following the release of two new resources by NCSD and NFPHRA to publicize and educate on female condom reimbursability. With the female condom being reimbursable, there exists a tremendous opportunity to educate providers and patients that cost barriers have been significantly lowered. 

For more information or to request materials, please contact Melissa Kleder, Manager, Health Care Delivery, at mkleder@nfprha.org.