Under very certain conditions, Medicare may pay for a procedural abortion or a pharmaceutical abortion with misoprostol.

The use of federal funds for abortion is restricted by the Hyde Amendment. Therefore, abortion cannot be covered by Medicare or other federal health programs unless:

• Rape or incest is the cause of the pregnancy.
• Your life would be at risk if you carried the pregnancy to term, according to a doctor’s certification.

California, Illinois, New York, Oregon, and Washington are among the states that utilize their own funds to expand Medicaid coverage for abortion.

Remember that regulations pertaining to abortion coverage are often changing as a result of new legislation, so availability and coverage may vary unpredictably from state to state.

Part A coverage and costs

Hospital insurance is covered by Part A. Any tests or services you require while inpatient are covered.

This can include procedural abortions under certain situations. You will be informed by your healthcare provider if you should anticipate an overnight stay.

The majority of persons are exempt from paying a monthly payment for Part A. You will pay $285 or $518 a month if you are not eligible for premium-free Part A.

In 2025, the following are the typical expenses for an inpatient hospital stay:

• $1,676 deductible for each benefit period
• $0 coinsurance for days 1 to 60 of treatment after you pay your deductible
• $419 coinsurance per day for days 61 to 90 of treatment
• $838 coinsurance per day for days 91 to 150 of treatment while using your 60 lifetime reserve days
• 100% of the treatment costs for days 151+

Part B coverage and costs

Medical insurance is covered under Part B. Outpatient medical care, including a qualified procedure abortion, is covered. This group includes the majority of procedure abortions.

Lab testing, pelvic exams, and doctor visits that might be necessary before or following a procedure abortion are all covered in Part B.

The majority of consumers will pay a $185 monthly premium in 2025. Your income may determine how much your premium is.

You will typically pay 20% of all Medicare-approved expenditures for covered procedures after paying a $257 deductible.

Part C coverage and costs

The same essential services that Original Medicare (parts A and B) must be covered under Medicare Advantage, generally referred to as Part C, including qualified inpatient and outpatient abortion care.

Prescription drug (Part D) coverage is a feature of many Part C plans. In these situations, a misoprostol-based medical abortion may also be covered under Part C.

Some Part C plans cover extra health and wellness benefits, such as transportation to doctor’s appointments, that could be helpful if you need abortion care.

Costs and coverage quantities are specific to each Part C plan. Your selected plan will determine your premiums, deductibles, copayments, and coinsurance amounts.

It is typically less expensive to stay in the network than to go out of the network, which entails receiving care from a list of authorized medical providers and institutions.

Part D coverage and costs

Mifepristone (Mifeprex, Korlym), which is frequently used as the first pill in a two-drug abortion procedure, is not covered by Part D.

Misoprostol (Cytotec), which can be administered alone to cause a medication abortion, is covered.

Painkillers and antiemetics are examples of medications that may be covered under Part D that can help with the healing process following a medication or procedure abortion.

Costs and coverage quantities are specific to each Part D plan. Each plan’s formulary and tier structure determine how much coverage it offers. Generally speaking, the cost of the prescription increases with tier.

As a lower-tier drug, generic misoprostol is typically less costly than its name-brand equivalent.

The bottom line

Medicare is not allowed by federal law to pay for abortions unless there is a life-threatening risk to the pregnant person, rape, or incest.

To find out if you qualify for abortion care, call Medicare at 800-633-4227 (TTY: 877-486-2048).

Consider calling the Repro Legal Helpline at 844-868-2812 or completing a secure online form to find out more about your legal rights.

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