Information for providers about ACCESS to birth control and emergency contraception

If you are a health care provider who prescribes birth control or provides sexual and reproductive health services, learn about the ACCESS law in Massachusetts.

Birth control supply

• ACCESS, a Massachusetts law, means eligible patients can be prescribed and receive 12 months of birth control at one time, with no deductible, copayment or coinsurance, after an initial three months on the same prescription birth control.
  • The law covers a 12-month supply of the pill, patches, rings, or injectable birth control.
  • Most types of birth control are covered under this law at no cost to the patient, except male condoms and vasectomies (male sterilization). The 12-month supply does not apply to the types of contraception that last for extended periods of time, like IUDs or implantable rods.
  • Health insurance plans must cover at least one contraceptive drug, device or other product within each FDA-approved contraceptive method category with no form of step therapy or prior authorization.
• To be eligible, patients must be on a health insurance plan that is subject to Massachusetts law and complete a three-month trial of the same prescription birth control if they have not been on it already.
  • Plans subject to Massachusetts law include fully insured health insurance plans, like MassHealth and those purchased on the MA Health Connector, as well as plans purchased through the MA Group Insurance Commission (GIC). Patients can find out if they are on an eligible health insurance plan by contacting their health insurance company.
• According to a market research survey conducted in January 2022, 86% of eligible people polled are interested in receiving a 12-month supply of birth control at one time, but only half were aware that this is an option for them.*
  • A 12-month supply means fewer gaps in patient care and contraceptive coverage.

Emergency contraception

• According to the ACCESS law, providers can prescribe eligible patients emergency contraception at no cost to the patient.
  • This includes levonorgestrel (e.g., Plan B One-Step®, Next Choice™, My Way®, etc.), but in some cases, providers may want to prescribe ulipristal acetate (ella®) instead of levonorgestrel. Ulipristal acetate is more effective for people that weigh over 165 pounds and up to five days after unprotected sex.
• According to a market research survey conducted in January 2022, 84% of eligible people who learned about getting emergency contraception at no cost were more likely to get it.*
  • Providing a prescription to patients will alleviate their costs and could be offered to patients in advance of need.

Female sterilization

The ACCESS law covers female sterilization (tubal ligation) at no cost to patients, as long as they are on an eligible health insurance plan.

More resources

• The MA Department of Public Health launched an online course on ACCESS with the MGH Institute of Health Professions. This course offers 2.5 continuing education credits at no cost for MA physicians, nurse practitioners, physician associates, and pharmacists. Enroll at learnmore.mghihp.edu/ACCESS. 
• Providers can learn how to write the prescription by reviewing the FAQ written by the MA Division of Insurance: Massachusetts ACCESS Law Common Questions and Answers (Q&A)
  • The following chart clarifies prescription amounts commensurate with a 12-month supply. Because different types of oral contraceptives come in different amounts of pills per pack, the Insurance Carrier should ensure plans cover a 12-month supply:
    Quantity required for a 12-month supply

    Contraceptive type	Quantity
    Oral contraceptives (i.e., the pill)	364 pills
    Combined pill (e.g. Aranelle)*	28 pills per pack x 13 packs
    Extended cycle (e.g. Seasonique)	91 pills per pack x 4 packs
    Rapid cycle (e.g. Microgestin)	21 pills per pack x 18 packs
    Transdermal contraceptives (i.e., the patch)	39 patches (3 patches per pack x 13 packs)
    Intra-vaginal contraceptives (i.e., the ring)	13 monthly rings or 1 yearly
    Injectables (e.g., DMPA-IM and subQ)	4 shots

• Pharmacy regulations do not permit a prescription to be written for a term of more than one year—the patient will need separate prescriptions for the trial period and the 12-month supply
• Some providers write the prescriptions for the 12-month supply and it gets denied at the pharmacy or by the health insurance plan. In case your patients experience any issues with filling their prescription at no cost, share our talking points for patients to use at the pharmacy.
• Download and/or print a flyer for providers on the ACCESS law

*A market research survey was conducted in January 2022 by the Massachusetts Department of Public Health.