Cost and insurance coverage
Bayer is committed to the reproductive health of women, and we work hard to ensure that every woman can feel empowered and confident when it comes to her reproductive decisions and health. This means supporting every woman’s access to effective contraception. So even if you don’t have insurance, there are ways to get help paying for Mirena®.
How much does Mirena cost?
95% of women were covered for a Bayer IUD, like Mirena, with little or no out-of-pocket costs (based on past benefit investigation submissions to Bayer in 2017). If you do not have health insurance, or if Mirena is not covered by your insurance, the cost of Mirena is $999.28. This comes to $13.87 per month over a 6-year period when using Mirena for contraception. If you are using Mirena for contraception as well as for the treatment of HMB, this comes to $16.65 per month over a 5-year period.
The Affordable Care Act (ACA) generally requires health plans to cover FDA-approved contraceptives, including intrauterine devices (IUDs) at low or no cost to the patient (eg, co-payment, coinsurance). Depending on the specific health insurance plan, patients may still be responsible for the cost of the product and/or product-related costs, such as insertion or removal procedure fees.
How to check if your insurance will cover Mirena
You may be able to get Mirena with no out-of-pocket cost.
Follow these steps to check:
- Call the phone number on the back of your insurance card
- Tell them that Mirena is a healthcare professional‐administered method of birth control
- Ask them to check if Mirena is covered at no cost* under the Affordable Care Act
- Provide them with the J code for Mirena: J7298; and the Current Procedural Terminology (CPT) code for Mirena placement: 58300
- Ask if you will have any out-of-pocket costs, if Mirena is only partially covered under your plan
*Please note: Other product-related costs may apply.
If you need help understanding your insurance coverage, visit CoverHer.org.
No insurance? Bayer may be able to help
The Bayer US Patient Assistance Foundation is a charitable organization that helps eligible patients get Bayer prescription medicines at no cost. Please contact the program at 1-866-228-2BUSPAF (228-7723) Monday–Friday, 8:30 AM–5:00 PM ET, or visit the foundation website for information to see if you may qualify for assistance.
If you have Medicaid
All Medicaid programs are required to cover family planning services without cost-sharing. State coverage decisions and patient out-of-pocket costs can vary. Most Medicaid patients have no out-of-pocket expense for the Mirena IUD.
INDICATION FOR MIRENA
Mirena® (levonorgestrel-releasing intrauterine system) is a hormone-releasing IUD that prevents pregnancy for up to 6 years. Mirena also treats heavy periods for up to 5 years in women who choose intrauterine contraception.
IMPORTANT SAFETY INFORMATION
- If you have an untreated genital infection, get infections easily, or have certain cancers, don't use Mirena. Less than 1% of users get a serious pelvic infection called pelvic inflammatory disease (PID).
- If you have persistent pelvic or stomach pain, or excessive bleeding after placement, tell your healthcare professional (HCP). If Mirena comes out, call your HCP and avoid intercourse or use non-hormonal back-up birth control (such as condoms or spermicide). Mirena may go into or through the wall of the uterus and cause other problems.
Pregnancy while using Mirena is uncommon but can be life threatening and may result in loss of pregnancy or fertility.
- Ovarian cysts may occur but usually disappear.
- Bleeding and spotting may increase in the first 3 to 6 months and remain irregular. Periods over time usually become shorter, lighter, or may stop.
Mirena does not protect against HIV or STIs.
Only you and your HCP can decide if Mirena is right for you. Mirena is available by prescription only.