Washington
Contraceptive Access Laws
Private plans are required to cover an extended supply of contraception.
Washington requires most private plans to cover a 12-month refill of contraception at one time. Beginning January 1, 2026, the requirement will apply to the initial prescription and not just the refill (as it currently does).
- To prescribe an extended supply of birth control, write the prescription with the appropriate total quantity (e.g., three packs for three months) and indicate the correct number of refills to cover a full year (typically 11 refills). For a full 12-month supply at once, write for a quantity of 13 packs with zero refills.
- Because not all pharmacists are aware of this policy, let patients know that they can ask to try running it through their insurance, even if the pharmacist initially says it won’t be covered.
Medicaid is required to cover an extended supply of contraception.
Washington requires Medicaid to cover a 12-month supply of contraception at one time.
- To prescribe an extended supply of birth control, write the prescription with the appropriate total quantity (e.g., three packs for three months) and indicate the correct number of refills to cover a full year (typically 11 refills). For a full 12-month supply at once, write for a quantity of 13 packs with zero refills.
- Because not all pharmacists are aware of this policy, let patients know that they can ask to try running it through their insurance, even if the pharmacist initially says it won’t be covered.
Private plans are required to cover contraceptive methods without cost-sharing beyond the federal requirement of the ACA.
Under the federal Affordable Care Act (ACA) contraceptive coverage mandate, most private plans are required to cover at least one contraceptive in each of the FDA-approved contraceptive method categories for women, as prescribed, without copays or deductibles.
Washington goes beyond the federal requirement by requiring private plans to cover all contraceptives, with an exception for therapeutic equivalents.
- Most patients should not be charged copays or deductibles for the full range of FDA-approved contraceptive methods. If your patient is having an issue with their coverage, you can direct them to the National Women’s Law Center CoverHer resource so they can find out if their insurance company is incorrectly charging them and how to get these services covered.
- State contraceptive coverage laws do not apply to self-insured plans, which are regulated at the federal level. Approximately 57% of private sector enrollees in the US are in self-insured plans. Be prepared to support patients with alternative access options if needed.
- For more information on the states that have enacted state laws that require private health insurers to cover the full range of contraceptive methods, without additional cost-sharing, or go beyond the federal ACA requirement, visit Power to Decide’s map.
- The Health Resources and Services Administration (HRSA) maintains a comprehensive list of sexual and reproductive health services and contraceptive methods that insurance plans are required to cover without copays or deductibles.
Private plans are required to cover over-the-counter (OTC) contraception without a prescription.
Washington requires most private plans to cover OTC contraception without a prescription. Specifically, the law covers contraceptive drugs, devices, and products.
- Let patients know that insurance coverage protocols vary by plan. Some insurers require checkout at the pharmacy counter. Others may require patients to pay for the contraception and then submit a claim for reimbursement.
- State contraceptive coverage laws do not apply to self-insured plans, which are regulated at the federal level. Approximately 57% of private sector enrollees in the US are in self-insured plans. Be prepared to support patients with alternative access options if needed.
Medicaid is required to cover over-the-counter (OTC) contraception without a prescription.
Washington Medicaid covers OTC contraception without a prescription. Specifically, the law covers all FDA-approved OTC contraceptives, including condoms, spermicide, emergency contraception (EC), and Opill.
- State Medicaid programs that cover OTC contraception without a prescription still require patients to check-out at the pharmacy counter in order for their prescription to be covered.
- Counsel patients on this step to avoid unnecessary costs.
Pharmacists can prescribe contraception.
Washington allows pharmacists to enter into collaborative practice agreements (CPAs) with prescribers, which may authorize pharmacists to initiate, modify, or discontinue medication therapy–including contraception.
- To see a map of pharmacies where this service may be available, visit Birth Control Pharmacist.
Abortion Access Laws
Abortion is permitted.
Abortion is permitted in Washington until viability.
- For a list of abortion providers in Washington, visit AbortionFinder.org.
A waiting period is not required for abortion.
Parental involvement is not required for abortion.
Telehealth is permitted for medication abortion.
Washington permits all virtual telehealth for the provision of medication abortion.
Medicaid is required to cover abortion beyond federal requirements.
Washington Medicaid covers abortion beyond the federal Hyde requirement of cases involving life endangerment, rape, and incest.
- Medicaid can help pay for abortion services. Patients do not need to meet the federal requirements.
- The National Network of Abortion Funds has more information to help patients who are interested in applying for Medicaid.
Shield Laws
Some health care provision is protected by shield laws.
Washington has some legal safeguards for reproductive and gender-affirming health care.
- For details, visit UCLA’s State Shield Law Tracker.
Shield law protections apply regardless of patient location.
Washington offers protection to providers who may be using telehealth and conducting visits with patients in other states.
- For example, shield laws would offer protection for an abortion provider who lives in Washington but provides care to individuals in restrictive states via telehealth.
- This may include protections from extradition and arrests; from the issuance of subpoenas, search warrants, and witness summons; and barring state agencies and employees from expending resources for such an investigation.
- For details, visit UCLA’s State Shield Law Tracker.
Shield laws protect from out-of-state investigations and prosecutions.
Washington offers protection to providers who are practicing and seeing patients within their home state.
- For example, shield laws would offer protection for an abortion provider who is providing care in Washington to someone who traveled from another state.
- This may include protections from extradition and arrests; from the issuance of subpoenas, search warrants, and witness summons; and barring state agencies and employees from expending resources for such an investigation.
- For details, visit UCLA’s State Shield Law Tracker.
Shield laws protect from professional discipline.
- Health care providers may be protected from losing their license or facing board discipline as a result of performing, recommending, or providing legally protected care—even if they had been penalized for it in another state.
- For details, visit UCLA’s State Shield Law Tracker.
Shield laws protect against civil liability.
- This may prevent the enforcement of civil lawsuits or judgments from other states that try to punish a health care provider for providing, seeking, or supporting abortion or gender-affirming care. It may also allow for “clawback” actions, which allow providers to sue to recover damages from litigation in another state as a result of providing, receiving, or assisting in the provision of certain health care.
- For details, visit UCLA’s State Shield Law Tracker.
Shield laws do not include protections related to professional liability insurance and health plans.
- Shield laws do not prevent malpractice and liability insurers from dropping a health care provider, raising rates, or denying coverage because they provide abortion, contraception, or gender-affirming care.
Shield laws include protections against disclosure of medical information for lawfully protected health care.
- Providers may be prohibited from releasing medical information about abortion or gender-affirming care in response to subpoenas or investigations from other states that are trying to punish patients or providers.
- For details, visit UCLA’s State Shield Law Tracker.
