Paying for FAM

How much does FAM instruction cost?

Learning a Fertility Awareness Method (FAM), sometimes called Fertility Awareness-Based Methods (FABMs) or Natural Family Planning (NFP), can cost between $120 and $500 depending on the method and how much personal support you may need.

Can I use my HSA or FSA to pay for FAM supplies?

Many methods require minimal supplies beyond low-cost paper charts or app subscriptions, and/or a basal body thermometer. However, the Marquette Method utilizes the ClearBlue Fertility Monitor, and is developing protocols for the Mira monitor. Both types of at-home fertility monitors, as well as Inito and Kegg devices, can be paid for with Health Savings Account (HSA) or Flexible Spending Account (FSA) funds.

Are scholarships available?

Click here to request a scholarship of up to $150 to learn a fertility awareness method at a cost-free or reduced rate. [Note: At this time, scholarships are only available to participants in the United States.]

Will my insurance cover my FAM instruction?

Some insurance plans may offer reimbursement for instruction in a FAM, also referred to as Fertility Awareness-Based Methods (FABM) under federal law.

In 2016, for the first time ever, “instruction in fertility awareness-based methods” was included under the Contraceptive coverage heading in the “Women’s Preventive Services Guidelines” established by the Health Resources & Services Administration (HRSA) of HHS. These Guidelines mandate certain services to be covered in group health plans and coverage, and have specific requirements for the coverage of contraceptive services. 

On December 20, 2020, a ruling made by the Affordable Care Act (ACA) came into effect that required all insurance providers complying with the ACA to reimburse FABM instruction.

Practically speaking, the inclusion of FABMs within the Contraceptive heading in the Guidelines means that FABM instruction became a covered expense under the ACA. Even better, this change applies to state and local government employee insurance plans, private employee plans, Medicare and Medicaid insurance plans, and ACA exchange insurance plans. Under the 2016 ACA Guidelines, additional assistance from instructors (which costs around $50 a session) can also be covered as women and couples navigate medical issues (such as the treatment of infertility, or menstrual cycle-related issues), as long as the instructor is a licensed medical professional, or covered under the license of a medical professional. Practically speaking, this allows medical professionals , such as OB/GYNs, family practice doctors, physician’s assistants, or nurse practitioners, to partner with non-medically licensed instructors to provide FABM instruction for their patients. (In these cases, the license of the OBGYN, etc., is used to procure reimbursement for instruction via insurance).  

You can ask your healthcare professional to check with your insurance provider about coverage for these services, using the appropriate treatment codes (footnote 1). Note, however, that application of the Guidelines under state Medicaid programs could vary by state (footnote2). 

Footnote 1: The 2016 change may or may not have applied to certain non-ACA compliant, “grandfathered” plans, and one would need to check ACA compliance before filing a FABM instruction claim. (According to this podcast transcript published by National Clinical Training Center for Family Planning and the Family Planning National Training Center, the correct CPT code for someone learning FABM for Family planning would be H1010, along with the diagnosis code Z30.02 if it is to avoid pregnancy, or Z31.61 if it is to achieve pregnancy. Note that different codes would be used if the purpose is different such as a well exam or a problem-focused treatment, according to the same podcast transcript.) 

Footnote 2: Another coverage hurdle concerns whether one’s state Medicaid plan covers FABM training. According to the CDC, any State that adopted the ACA Medicaid expansion that “extends Medicaid eligibility to non-elderly individuals with annual incomes at or below 133 percent of the federal poverty level ($16,611 for an individual or $34,247 for a family of 4 in 2019) are required to cover the full range of preventive services required in the essential health benefits (EHB) final rule.”  According to the Kaiser Family Foundation (KFF), 39 states and DC have adopted Medicaid expansion. In states that did not implement the ACA’s Medicaid expansion, patients would need to check what their state Medicaid plan covers under the umbrella of women’s preventive services. 

Of note is the State of Maryland, which adopted a code in 2018 that specifically defines and requires coverage for FABMs, listing the various methods covered, which plans are subject to this code, and who benefits (licensed health professionals). There is no mention of coverage for FABM tools such as hormone tacking monitors. 

Did the Biden Administration try to illegally rescind coverage for FAM instruction?

In a word: Yes.

In November 2021, the Department of Health and Human Resources under the Biden Administration proposed a new draft that would remove FABM insurance coverage, without explanation, and without first allowing for a public comment period, as required by law. In response, Natural Womanhood submitted an official comment to the Women’s Preventive Services Initiative to try to prevent the change and help maintain coverage for these methods. At the same time, Texas nurse practitioner Dr. Cami Jo Tice-Harouff (represented by attorneys at the Alliance Defending Freedom) sued the Biden Administration to prevent the illegal removal of FABM coverage as mandated by the ACA.  

In December of 2022, a federal court rejected the Biden administration’s illegal attempt to end insurance coverage for FABM instruction. In July of 2023, that same court ordered the Biden administration to cover $65,000 in attorney’s fees incurred by Dr. Cami Jo Tice-Harouff while the case was litigated.

This page was updated on March 21, 2024.