Getting the contraceptive implant is a straightforward process: you book an appointment with a provider who offers the service, and the insertion itself takes only a few minutes. The implant is a small, flexible rod placed just under the skin of your upper arm, where it releases a steady dose of hormone to prevent pregnancy for up to five years. It’s one of the most effective forms of birth control available, with a real-world pregnancy rate of just 0.02 per 100 women per year. Here’s what the process looks like from start to finish.
Where to Get the Implant
The implant can be placed at a wide range of clinics and offices. Your regular OB-GYN or primary care provider may offer it, and so do reproductive health clinics like Planned Parenthood, community health centers, and university health services. Some urgent care clinics also provide the service. If your current provider doesn’t do insertions, they can refer you to one who does.
Not every provider is trained in implant placement, so it’s worth confirming when you call to schedule. You can also search online through your insurance plan’s provider directory or through the implant manufacturer’s website to find a trained clinician nearby.
Who Can Get the Implant
Almost anyone of reproductive age is a candidate. The implant is approved for adolescents and adults alike, and according to CDC guidelines, healthy patients don’t need any exams or tests beforehand to qualify. People with conditions like high blood pressure, diabetes, iron-deficiency anemia, blood clotting disorders, or HIV can all safely use the implant.
Body weight doesn’t disqualify you either. The CDC confirms that BMI measurement isn’t required for eligibility, and patients with obesity can use the implant. The one absolute restriction is current breast cancer, which rules out use. People with certain liver cancers are also generally advised against it. If you have a complex medical history, your provider may want to review it first, but for most people, the path to getting the implant is uncomplicated.
How to Prepare for Your Appointment
On the day of your appointment, you’ll typically need to give a urine sample for a pregnancy test. This is standard practice before any implant or IUD placement. Beyond that, preparation is minimal. Wear a loose or short-sleeved top so the provider can easily access your inner upper arm. Eating a normal meal beforehand is a good idea, especially if you tend to feel lightheaded during medical procedures.
If you’re currently using another form of birth control, keep using it right up until your appointment. Your provider will tell you when to stop after the implant is placed. Some people find it helpful to bring a friend or support person along, though it’s not necessary.
What Happens During Insertion
The entire procedure takes about five minutes. You’ll lie back or sit with your arm extended, and the provider will mark the insertion site on the inner side of your non-dominant upper arm. They’ll clean the area and inject a local anesthetic to numb the skin, which is usually the most uncomfortable part of the process. Once the area is numb, you shouldn’t feel pain, though you may sense pressure or a tugging sensation.
The provider uses a preloaded applicator to slide the implant just beneath the skin. The needle enters at a shallow angle and stays in the layer right below the surface, not deep in the muscle. Once the rod is in place, the provider retracts the needle and removes the applicator. They’ll immediately feel for the implant under your skin to confirm it’s positioned correctly, and they’ll ask you to feel it too. You should be able to detect a small, thin rod about the size of a matchstick just under the surface.
After that, they’ll place a small adhesive bandage over the insertion site and wrap your arm with a pressure bandage to reduce bruising.
When the Implant Starts Working
Timing matters. If the implant is placed during the first five days of your period, it’s effective immediately. If it’s inserted at any other time in your cycle, you’ll need to use a backup method like condoms for seven days while the hormone reaches effective levels. Your provider will clarify this based on when your appointment falls.
Recovery and Aftercare
You can go about your day after the appointment, but your arm will likely be sore. Some bruising around the insertion site is normal and can look dramatic, sometimes spreading across a few inches of your upper arm. This typically fades within a week or two.
Keep the pressure bandage on for 24 hours. Underneath it, there’s a smaller adhesive bandage that should stay on for 3 to 5 days. Avoid heavy lifting or strenuous upper-body exercise with that arm for the first day or two to minimize swelling. Over-the-counter pain relief can help if the soreness bothers you.
How Long the Implant Lasts
The FDA approves the current implant (Nexplanon) for up to five years. This is an extension from the original three-year approval, based on clinical trial data showing zero pregnancies among nearly 400 women during years four and five of use. The implant must be removed by the end of the fifth year. At that point, a new one can be placed in the same appointment if you want to continue.
How Much It Costs
Under the Affordable Care Act, most health insurance plans are required to cover FDA-approved contraceptive methods, including the implant, with no copay, coinsurance, or deductible when you use an in-network provider. This means the device, the insertion, and the removal are all covered at zero out-of-pocket cost for most insured patients.
The main exception is if you work for a religiously exempt employer, in which case you may need to pay out of pocket. Without insurance, the implant and insertion together can cost anywhere from roughly $400 to $1,300 depending on the clinic. Many reproductive health clinics offer sliding-scale fees or can help you find financial assistance programs if cost is a barrier.
How Effective the Implant Is
The implant is the most effective reversible contraceptive available. In a large real-world study (not a controlled lab setting), the pregnancy rate during use was 0.02 per 100 women per year. That translates to roughly 1 in 5,000 users per year. Unlike the pill or the ring, there’s nothing to remember daily or monthly, which means real-world effectiveness and perfect-use effectiveness are essentially the same. Previous studies have measured the failure rate anywhere from zero to 0.06 per 100 women-years, making it more effective than sterilization procedures in some analyses.
The implant is fully reversible. Fertility returns quickly after removal, often within days. One study measured a return to ovulation-level hormones within the first two weeks after the implant was taken out.