Birth Control Refills (Oral Contraceptive Pill, Patch, and Ring Refills)

Birth Control Refill Telehealth Eligibility Checklist

You are likely eligible for a TeleDirectMD video visit if ALL of these are true:

How Online Birth Control Refills Work

Telehealth Regulations Across Our Licensed States

TeleDirectMD is currently licensed to provide telehealth services in 41 states. Each state has its own telehealth regulations, prescribing guidelines, and scope-of-practice rules. Our physicians follow all applicable state and federal regulations for every patient encounter.

When you book a visit, you will be matched with a physician licensed in the state where you are physically located. This ensures your care meets all regulatory requirements for that jurisdiction. Select your state below to see specific telehealth regulations for your location.

TeleDirectMD vs Other Care Options for Birth Control Refills

Here is how TeleDirectMD compares to common settings for birth control refill care:

Bottom line: TeleDirectMD is a strong fit for stable, established users of the oral contraceptive pill, patch, or ring who need a refill with contraindication screening and do not have new red flags. For new starts, IUDs, implants, or complex evaluations, an OB/GYN or PCP is the appropriate provider.

Should I Use TeleDirectMD for Birth Control Refills? Decision Guide

What Is a Birth Control Refill Visit?

Oral contraceptive pills, the contraceptive patch, and the vaginal ring are combined hormonal contraceptives (CHCs) that use estrogen and progestin — or progestin alone in the case of the mini-pill — to prevent pregnancy. They are among the most commonly used reversible contraceptive methods in the United States. Approximately 25% of women aged 15 to 44 who use contraception report using the pill as their method of choice. These methods require a prescription and periodic renewal to ensure they remain appropriate as a patient's health status may change over time.

A birth control refill visit is not a comprehensive well-woman exam or a new contraceptive counseling visit. It is a focused clinical encounter designed to confirm that the patient's current method remains safe and appropriate, screen for any new medical conditions that would contraindicate continued use (per the CDC US Medical Eligibility Criteria, or US MEC), and renew the prescription. The CDC US MEC 2024 classifies conditions by whether they represent a restriction (Category 3) or an unacceptable health risk (Category 4) for combined hormonal contraceptive use. Key Category 4 absolute contraindications include migraine with aura, history of DVT or pulmonary embolism, stroke, ischemic heart disease, breast cancer, decompensated cirrhosis, and smoking 15 or more cigarettes per day at age 35 or older.

TeleDirectMD's refill visits are designed for adults who are already established on their current OCP, patch, or ring method. This is not a new start service. Patients who have never been on hormonal contraception, who want to switch methods, who need IUD or implant management, or who have new complex medical conditions affecting contraceptive eligibility should see their OB/GYN or primary care provider for an in-person evaluation. Telehealth refill visits are appropriate and evidence-supported for stable, established users where the clinical history can be thoroughly reviewed by video.

Why Periodic Refill Screening Matters

Even for patients who are stable on their contraceptive method, periodic screening is important because new medical conditions can develop that affect the safety of continued combined hormonal contraceptive use. The following are key areas reviewed at each refill visit:

• Migraine with aura: New-onset migraine with aura is a Category 4 contraindication to combined hormonal contraceptives (CHCs) per CDC US MEC 2024. Combined hormonal contraceptives are associated with an increased risk of ischemic stroke, and migraine with aura independently increases stroke risk. If a patient develops new migraines with aura since their last prescription, CHCs should be discontinued.
• Blood pressure and cardiovascular risk: Uncontrolled hypertension with blood pressure consistently at or above 160/100 mmHg is a Category 4 contraindication to CHCs. Systolic blood pressure 140 to 159 or diastolic 90 to 99 is Category 3 (risks usually outweigh benefits). Patients should know their current blood pressure before a refill visit. Multiple cardiovascular risk factors together can also elevate risk.
• History of blood clots (DVT/PE), stroke, or ischemic heart disease: A history of deep vein thrombosis, pulmonary embolism, stroke, or ischemic heart disease is a Category 4 contraindication to CHCs. If a patient has developed any of these conditions since their last prescription, CHCs must be discontinued and alternative non-estrogen methods should be considered.
• Breast cancer: Current breast cancer is a Category 4 contraindication to all hormonal methods including CHCs, the progestin-only pill, implant, and DMPA per CDC US MEC 2024. Patients with a new breast cancer diagnosis since their last prescription should not continue combined or progestin-only hormonal contraceptives without specialist guidance.
• Active liver disease: Decompensated cirrhosis, acute hepatitis flare, hepatocellular adenoma, and malignant hepatoma are Category 4 contraindications to CHCs. Patients with newly diagnosed or worsening liver disease should be evaluated in person before continuing combined hormonal contraceptives.
• Smoking and age: Smoking 15 or more cigarettes per day at age 35 or older is a Category 4 contraindication to CHCs due to significantly increased risk for cardiovascular events. Smoking fewer than 15 cigarettes per day at age 35 or older is a Category 3 condition. Screening for smoking status and age is a required part of every refill encounter.

At a refill visit, the physician also reviews adherence to the current method, any side effects, significant drug interactions (particularly with enzyme-inducing anticonvulsants or rifampin), and whether the patient's goals and satisfaction with the current method remain consistent. If new contraindications are identified, the physician will stop the refill and direct the patient to appropriate in-person care.

Situations and Red Flags for Birth Control Refills

Use this table to understand which situations are appropriate for a telehealth refill visit and which require urgent in-person or emergency evaluation.

What TeleDirectMD Refills vs What Requires In-Person Evaluation

Not every birth control-related question is appropriate for a telehealth refill visit. TeleDirectMD focuses on a specific and limited scope: refilling an existing prescription for a stable patient. The following describes what fits this telehealth scope and what does not.

If your situation does not fit a straightforward refill of an established, stable method, or if new contraindications are identified during the TeleDirectMD visit, we will direct you to in-person care with the appropriate provider.

When Is a Video Visit Appropriate for Birth Control Refills?

What TeleDirectMD Refills

TeleDirectMD provides refill prescriptions for patients who are already established on one of the following hormonal contraceptive methods and who meet eligibility criteria after contraindication screening. This is a continuation service — not an initiation service.

What TeleDirectMD Does Not Manage

• New contraceptive starts — patients who have never been on hormonal contraception should see their OB/GYN or PCP
• IUD or contraceptive implant management, insertion, or removal
• Emergency contraception (levonorgestrel/Plan B is available over the counter; ulipristal acetate requires a prescription and should be obtained promptly from a pharmacy or clinic)
• Infertility evaluation or fertility planning
• Complex contraindication evaluation requiring physical exam, labs, or pelvic ultrasound
• Depot medroxyprogesterone acetate (DMPA/Depo-Provera) injections — requires in-person administration

Common Birth Control Medications — Continuation and Refill

The following are common oral contraceptive pills, patches, and rings that may be refilled via telehealth for established, stable patients. The actual medication and dose refilled will be the patient's current prescription. These are continuation refills, not new starts. Dose and formulation are determined based on the patient's existing prescription.

Important: These are continuation refills of a patient's existing prescription only. The MD confirms the exact medication, dose, and formulation from the patient's current prescription before renewing. Dose or formulation changes require a discussion of clinical rationale. TeleDirectMD does not prescribe controlled substances. Oral contraceptives are not controlled substances.

Adherence, Monitoring, and Follow-up for Birth Control

What to Do Now After Your Refill Visit

• Pick up your refill prescription promptly to avoid a gap in coverage — a gap of more than 7 days may require backup contraception when restarting
• Continue taking your pill at the same time each day, changing your patch on the same day each week, or inserting a new ring on the scheduled day
• If you have a home blood pressure cuff, check your BP periodically and contact your provider if readings are consistently above 140/90
• Do not start new medications without checking for drug interactions — enzyme-inducing anticonvulsants (phenytoin, carbamazepine, oxcarbazepine, topiramate), rifampin, and some antifungals can reduce hormonal contraceptive effectiveness
• Keep track of your current pill pack or method start date so you know when to seek your next refill

What to Watch For — When to Seek Care Promptly

• Any new visual symptoms with headaches (zigzag lines, blind spots, flickering lights before a headache) — this suggests migraine with aura and requires immediate provider evaluation and discontinuation of combined hormonal methods
• Sudden severe headache unlike any previous headache, especially with vision changes or neck stiffness
• Leg pain, swelling, warmth, or redness — possible DVT requiring urgent evaluation
• Chest pain, shortness of breath, rapid heart rate, or coughing blood — possible pulmonary embolism requiring emergency evaluation
• Positive pregnancy test while on hormonal contraception — requires prompt OB/GYN evaluation
• Significant mood changes, depression, or new-onset anxiety — discuss with your provider at next visit, though evidence linking hormonal contraceptives to mood disorders is mixed

Follow-up and Annual Care

• TeleDirectMD is a refill bridge — it is not a substitute for annual well-woman care with an OB/GYN or primary care provider
• Annual well-woman visits should include blood pressure check, discussion of any new medical history, and assessment of ongoing contraceptive needs
• Pap smear screening (every 3 years from age 21 to 65, or every 5 years with co-testing after age 30) should be maintained with your regular OB/GYN or PCP
• If you want to switch methods, stop hormonal contraception to try to conceive, or discuss long-acting reversible options like an IUD or implant, schedule with your OB/GYN or primary care provider

When Not to Use TeleDirectMD for Birth Control Refills

TeleDirectMD provides a specific, limited refill service for stable, established users of the oral contraceptive pill, patch, or ring. We are direct about when telehealth is not appropriate.

You Should Not Use TeleDirectMD If

• You are under 18 years old
• You have never been prescribed hormonal contraception and want to start for the first time
• You have developed new migraines with aura since your last prescription
• You have a new diagnosis of DVT, pulmonary embolism, stroke, or ischemic heart disease
• Your blood pressure is consistently above 160/100 mmHg
• You have a new or active breast cancer diagnosis
• You have active liver disease, decompensated cirrhosis, or hepatocellular adenoma
• You are 35 or older and smoke 15 or more cigarettes per day
• You are currently pregnant or have a positive pregnancy test
• You are looking for IUD, implant, injection, or emergency contraception
• You are not physically in one of our covered states at the time of visit

Alternative Care Options

• Emergency room: sudden severe headache, chest pain, shortness of breath, severe leg swelling, vision loss, or any concern for stroke, pulmonary embolism, or DVT
• OB/GYN: new contraceptive starts, method switching, IUD or implant management, complex contraindication evaluation, new medical conditions affecting contraceptive eligibility, annual well-woman exam
• Primary care: new contraceptive starts if OB/GYN is not accessible, management of underlying conditions (hypertension, diabetes, migraine) that affect contraceptive eligibility
• Pharmacy (OTC): progestin-only norgestrel (Opill) is now available over the counter for adults and adolescents; levonorgestrel (Plan B) is available OTC for emergency contraception

References

• CDC — U.S. Medical Eligibility Criteria for Contraceptive Use, 2024 (MMWR)
• CDC — Appendix D: Classifications for Combined Hormonal Contraceptives (US MEC 2024)
• CDC — Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use (2024)
• ACOG Committee Opinion No. 788 — Over-the-Counter Access to Hormonal Contraception (2019)
• Oral Contraceptive Pills — StatPearls (NCBI Bookshelf, 2024)
• ACOG Committee Statement — Access to Contraception (2025)

Get Birth Control Refills in Your State

TeleDirectMD treats birth control refills via telehealth in 41 states. Select your state for a page tailored to your location, including local telehealth regulations and pharmacy options.