Most Planned Parenthood locations accept Medicaid, but coverage depends on your state and the specific service
Planned Parenthood clinics across the country do take Medicaid, but not every location accepts it, and not every service is covered under every state's Medicaid program. Your state Medicaid agency decides which reproductive health services are covered, which means a procedure covered in one state may not be in another. Before you schedule an appointment, you need to confirm three things: whether your local Planned Parenthood clinic takes your Medicaid plan, whether your state covers the specific service you need, and whether you have any copayments or coinsurance.
The fastest way to find out is to call the Planned Parenthood clinic nearest you directly. They can tell you in one conversation whether they accept your Medicaid plan and what your out-of-pocket cost will be. You can also contact your state Medicaid office to learn which reproductive health services are covered under your plan, though that conversation may take longer.
Key Takeaways
- Call your local Planned Parenthood clinic first — they can confirm whether they accept your Medicaid plan and what you will owe out of pocket.
- Your state Medicaid program, not Planned Parenthood, decides which services are covered, so coverage varies by state.
- Common covered services include contraception, cancer screenings, STI testing and treatment, and pregnancy-related care, but your state may exclude some of these.
- If your local Planned Parenthood does not accept Medicaid, your state Medicaid office can direct you to clinics that do.
- Bring your Medicaid card and photo ID to your appointment, and ask about copayments when you call to schedule.
How to learn about your Planned Parenthood clinic accepts your Medicaid plan
Call the clinic directly. Have your Medicaid card in front of you when you call, because the staff will need your member ID number and your state. They will tell you whether they accept your specific Medicaid plan — some clinics accept certain plans but not others, even within the same state.
If the clinic does not accept your plan, ask them for a referral to another clinic in your area that does. Many Planned Parenthood locations keep a list of nearby providers who accept Medicaid. You can also call your state Medicaid office and ask for a list of reproductive health providers in your area who accept Medicaid.
What services Planned Parenthood typically covers under Medicaid
Most state Medicaid programs cover contraception (birth control pills, patches, IUDs, implants, and injections), cancer screenings (Pap tests and breast exams), STI testing and treatment, pregnancy tests, and prenatal and postpartum care. Many also cover abortion services, though this varies significantly by state — some states do not cover abortion under Medicaid at all, and others cover it only in cases of rape, incest, or threat to the pregnant person's life.
Your state Medicaid program sets the rules, not Planned Parenthood. To find out exactly what your state covers, contact your state Medicaid office or visit your state's Medicaid website. You can also ask the Planned Parenthood clinic when you call to schedule — they work with your state's Medicaid program every day and can tell you what is and is not covered.
What to bring to your appointment
Bring your Medicaid card and a photo ID. If you are a new patient at that clinic, you may also need to bring proof of your address (a utility bill or lease) and your Social Security number. Call ahead and ask what documents the clinic needs — requirements vary by location.
When you schedule your appointment, ask whether there is a copayment or coinsurance for the service you need. Some Medicaid plans charge a small copay (usually $0 to $5) for office visits, while others do not. Preventive services like contraception and cancer screenings are often free under Medicaid, but your plan may have exceptions.
If your local Planned Parenthood does not accept Medicaid
Contact your state Medicaid office and ask for a list of reproductive health providers in your area who accept Medicaid. You can also call 211 (a free referral service) and ask for reproductive health clinics near you that take Medicaid. Federally may have access to health centers (FQHCs) in your area almost always accept Medicaid and offer similar services to Planned Parenthood.
Some Planned Parenthood locations may not accept Medicaid because they are in states with very limited Medicaid programs or because they are in rural areas where Medicaid reimbursement rates are low. In those cases, Planned Parenthood may offer a sliding-scale fee based on your income instead.
How Medicaid coverage works at the appointment
When you arrive, the clinic will verify your Medicaid coverage by running your member ID number through the system. This usually takes a few minutes. If your coverage is active and the service is covered under your state's Medicaid program, Medicaid will pay the clinic directly. You will pay any copayment or coinsurance that your plan requires.
If there is a problem with your coverage — for example, if your Medicaid has lapsed or if the service is not covered in your state — the clinic will tell you before the appointment proceeds. Ask what your options are. Some clinics can work with you on payment if you are uninsured or if your Medicaid does not cover the service you need.
Frequently Asked Questions
Will Planned Parenthood bill me if my Medicaid is inactive?
If your Medicaid coverage has ended or lapsed, Planned Parenthood will not be able to bill Medicaid. The clinic will tell you before your appointment that your coverage is not active. Ask whether they offer a sliding-scale fee based on your income, or whether they can refer you to another provider. You can also reactivate your Medicaid by contacting your state Medicaid office.
Do I need a referral from my doctor to see Planned Parenthood?
Most Medicaid plans do not require a referral to see Planned Parenthood for reproductive health services. However, some managed Medicaid plans do require referrals for certain services. Call your Medicaid plan's customer service number (on the back of your card) and ask whether you need a referral for the service you want. If you do, ask your primary care doctor to send one to Planned Parenthood before your appointment.
What if I do not know my Medicaid member ID number?
Your member ID is on your Medicaid card. If you do not have your card, call your state Medicaid office and give them your name and date of birth — they can look up your member ID and tell you whether your coverage is active. You can also bring your Social Security number to the Planned Parenthood clinic and they can look it up in the system.
Can Planned Parenthood help me sign up for Medicaid?
Many Planned Parenthood clinics have staff who can help you understand whether you may be may be able to access for Medicaid and can direct you to your state Medicaid office to apply. They cannot submit your application for you, but they can answer questions about the process and provide contact information for your state's Medicaid program.