How Much Is Estarylla Without Insurance?
Key takeaways:
Estarylla (norgestimate / ethinyl estradiol) is a generic, prescription-only oral contraceptive. The medication is FDA approved for women to prevent pregnancy.
Without insurance, a 28-day supply of Estarylla can cost around $18.38. But the cost varies depending on your pharmacy, location, and other factors.
There are many ways to save on Estarylla (norgestimate / ethinyl estradiol), including using a GoodRx coupon or a flexible spending account.
Estarylla (norgestimate / ethinyl estradiol) is a prescription oral contraceptive. It’s FDA approved for women to prevent pregnancy. Estarylla is a combination birth control pill that contains both an estrogen and a progestin. These hormones decrease the risk of pregnancy by suppressing ovulation (the release of an egg) and thickening cervical mucus to make it harder for sperm to enter the uterus. They also thin out the uterine lining, making it more difficult for a fertilized egg to implant.
Estarylla should be taken by mouth at the same time once a day. The medication comes in a 28-day blister pack, which includes 21 blue active pills and 7 green inactive, hormone-free pills.
Estarylla is a branded-generic version of the brand-name medication Ortho-Cyclen, which is no longer available. There are several branded generics of Ortho-Cyclen — some which may have different costs — such as Mili, Mono-Linyah, Norgestimate / Ethinyl Estradiol, Sprintec, and VyLibra. How much you pay for Estarylla will depend on your pharmacy, medication quantity, location, and more. You may be able to save money on your prescription by comparing pharmacy prices and using a GoodRx coupon.
How much does Estarylla cost?
If you don’t have insurance, coupons, or discounts, Estarylla can cost around $18.38 for one 28-tablet blister pack, a 1-month supply. You may be able to pay less per pack for a larger supply. For example, a 3-month supply of Estarylla can cost about $45.90.
What factors affect the cost of Estarylla?
Several factors can influence how much you pay for Estarylla, which is one of many branded generics for Ortho-Cyclen. These factors include:
Location: The price of prescription medications varies by region. For example, GoodRx data shows that people in Little Rock, Arkansas, may pay more for prescription medications than those in Houston, who often pay below the national average.
Insurance: Even if your insurance covers Estarylla, you may still have out-of-pocket costs like copays, coinsurance, or deductibles.
Pharmacy: Prices can also differ between pharmacies, even within the same area.
Quantity: Each pack of Estarylla includes a 28-day supply. Buying multiple packs at once, such as a 3-month supply, may reduce the per-pack cost.
Does insurance cover Estarylla?
Under the Affordable Care Act (ACA), most commercial health insurance plans are required to cover at least one birth control option from each FDA-approved category at no cost. This doesn’t apply to all plans, and some plans may not cover certain brand or generic versions of birth control.
Many Medicare Part D plans cover birth control pills, but they may not cover every type. Coverage and costs can vary, so check the details of your health plan.
Most state Medicaid programs cover Estarylla, but coverage can differ between states. Some programs have specific rules, like quantity limits or age restrictions.
Looking for birth control without a medical visit? Find out which states let pharmacists prescribe contraceptives.
Don’t want to take a birth control pill? Here’s your complete guide to alternative types of birth control.
Curious about birth control side effects? Long-term birth control risk is generally safe, but it may have some risks.
How different insurance plans cover Estarylla
The following table shows your likelihood of coverage, as well as the need for prior authorization and step therapy, with different types of insurance plans for Estarylla:
Insurance type | Enrollees covered for this medication | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
67.5% | 3.61% | 0% | |
Commercial (not including plans purchased through an ACA marketplace | 96.8% | 3.08% | 0.26% |
Medicaid, including state-run and managed care plansMedicaid | 99.6% | 12.4% | 0% |
Medicare, including original Medicare and Medicare Advantage plans | 79.6% | 0% | 0% |
Source: Managed Markets Insight & Technology, as of September 26, 2024. (See methodology below)
If Estarylla isn’t covered by your insurance, here are some actions you can take:
Explore alternatives: Ask your prescriber about other types of birth control pills or alternative birth control options that may be covered under your plan.
Request a formulary exception: If Estarylla isn’t included in your plan’s formulary, request a formulary exception.
Obtain prior authorization: Your insurance might require prior authorization for Estarylla. If so, ask your prescriber to send a letter of medical necessity explaining why this medication is needed for your treatment.
File an appeal: If your insurance denies coverage, you can appeal the decision.
Consider a new plan: Think about switching to a plan that offers better coverage for your medication during the next open enrollment period.
Ways to save on Estarylla
Here are a few ways to save on your prescription of Estarylla.
1. Use a GoodRx coupon
A free GoodRx coupon may help you save money on Estarylla.
To get a free GoodRx coupon:
Visit goodrx.com, or download the GoodRx app.
Type “Estarylla” in the search box, and hit or tap return.
Select the correct quantity, location, and pharmacy.
Choose to receive your coupon via text or email, or print it out. To avoid delays in processing, show the coupon at the pharmacy before they fill your prescription.
2. Check with family planning centers
Nonprofit organizations like Planned Parenthood or community health centers often provide free or lower-cost birth control pills.
3. Consider telehealth
You may be able to save on Estarylla through telehealth rather than an in-person visit with a healthcare professional. You may need to pay a small fee (about $15), and the prescription can be sent to your pharmacy or mailed to you directly. GoodRx Care offers virtual birth control services that start around $19, and no insurance is required.
4. Use your HSA or FSA
You can use the money in your health savings account or flexible spending account to pay for your Estarylla prescription with tax-free money.
5. Ask for a 3-month supply
Depending on your insurance plan, a 3-month supply of Estarylla might be more cost-effective than a 1-month supply. You can compare the different prices for multiple packs of Estarylla at GoodRx.com. Ask your prescriber about a 3-month supply if it reduces your overall costs.
The bottom line
Without insurance, a 28-day supply of Estarylla (norgestimate / ethinyl estradiol) can cost around $18.38. Still, your actual price will depend on factors like your pharmacy and location, as well as your insurance coverage. You may save money by using a GoodRx coupon or tax-free money in a health savings account or flexible spending account. Additionally, telehealth services and family planning clinics may offer lower-cost options for your medication.
Why trust our experts?
Methodology
National prescription coverage data for each medication was obtained from Managed Markets Insight & Technology (MMIT), reflecting health insurance coverage as of September 2024. The percentage of enrollees in plans that cover each medication was calculated by dividing the number of enrollees covered for the drug within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel. Similarly, the percentage of enrollees in plans with a prior authorization requirement was determined by calculating the proportion of enrollees in plans that require prior authorization for the medication within each channel. The percentage of enrollees in plans with a step therapy requirement was calculated as the proportion of enrollees in plans that impose step therapy requirements for the medication in each channel. These estimates, derived from national MMIT coverage data, provide insight into the health insurance coverage landscape for each drug, taking into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total population of enrollees covered by insurance across various channels — including ACA; commercial insurance, excluding ACA plans; Medicare; and Medicaid (both state-run and managed care plans).
References
Freed, M., et al. (2024). Coverage of sexual and reproductive health services in Medicare. KFF.
Healthcare.gov. (n.d.). Birth control benefits. U.S. Department of Health and Human Services.
Medicaid.gov (n.d.). Managed care. Centers for Medicare & Medicaid Services.
Planned Parenthood. (n.d.). Birth control.
Proficient Rx. (2024). Estarylla- norgestimate and ethinyl estradiol.
Ranji, U., et. al. (2022). Medicaid coverage of family planning benefits: Findings from a 2021 state survey. KFF.
U.S. Food and Drug Administration. (n.d.). New drug application (NDA) 019653.
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