How Much Is Mirena Without Insurance?

For individuals who are sexually active but don’t want to get pregnant, there are several birth control options to consider. Among the most reliable are IUDs, which are more than 99% effective. Mirena (levonorgestrel) is one of those IUDs.

Mirena is an FDA-approved device that must be administered by a healthcare professional. It can prevent pregnancy for up to 8 years and treat heavy menstrual bleeding for up to 5 years. IUDs are not available at pharmacies. Instead, they are sold directly by your prescriber, who inserts one into your uterus.

Since Mirena must be inserted by a healthcare professional, the cost of the device includes visits before and after the procedure. The onetime expense for this IUD may be substantial, but birth control that lasts up to 8 years may be less in the long run than the cost of other birth control methods.

Mirena basics

The chart below provides a summary of basic information about Mirena.

Mirena basics

Is Mirena covered by insurance?

The Affordable Care Act (ACA) requires health insurance plans to cover preventive care — such as birth control, including IUDs — without cost sharing. That means you shouldn’t have a copay or coinsurance, even if you haven’t met your deductible. Health insurance plans may not cover all IUD brands, so find out which ones your health plan covers for specific conditions.

If you have insurance, check your plan’s summary of benefits and coverage and formulary to determine whether Mirena is covered.

How insurance covers Mirena

Mirena is covered for many people with commercial, ACA, and Medicaid plans and for less than 5% of people with Medicare. Most health insurance plans that cover this medication don’t require prior authorization or step therapy, but prior authorization is required for about 1 in 3 people with Medicaid. It’s important to note that certain religious employers do not have to cover birth control.

The following chart shows your likelihood of coverage, prior authorization, and step therapy with:

• Commercial insurance, not including plans purchased on an ACA national or state marketplace

• ACA plans

• Medicare, including original Medicare and Medicare Advantage plans

• Medicaid, including state-run and managed care plans

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• Explore your IUD options. See how Mirena compares with other intrauterine devices.

• Does Mirena have side effects? This long-term contraception method has common side effects, such as spotting, menstrual bleeding changes, and headaches.

• Mirena could provide emergency birth control. Although Mirena is not FDA approved for that purpose, at least one study suggests it could be effective.

Insurance coverage for Mirena

Source: Managed Markets Insight & Technology, as of September 26, 2024. (See methodology below.)

Savings with insurance

Bayer has a Mirena copay savings program for people whose insurance covers this IUD but with high out-of-pocket costs. If you’re eligible, you could pay as little as $20 for the device.

Tips if your medication isn’t covered by insurance

Here are a few options if your insurance does not cover Mirena:

• Talk to your prescriber about alternatives.

• Ask your prescription medication plan for an exception. Keep in mind that you may need to do step therapy or get a prior authorization to be covered.

• File an appeal with your plan if your exception is denied.

• Consider changing your prescription medication coverage during your next open enrollment period.

Because this treatment must be administered by a healthcare professional, you cannot use a GoodRx coupon.

How much does Mirena cost without insurance?

If you don’t have health insurance, what you’ll pay for Mirena will depend on the following factors:

• The cost of the device at your medical office

• The cost of your healthcare appointments, which may include visits for consultation, insertion, and follow-up

• Whether you qualify for a program that offers financial assistance

The cash price of Mirena was $1,156.79 at the time of publication.

How to afford Mirena without insurance

If your health insurance plan doesn’t cover Mirena, or you have no health insurance, you still may not have to pay full price for the IUD. Here are ways to save on Mirena without insurance.

1. See if you qualify for the patient assistance program

If you don’t have insurance, the Bayer U.S. Patient Assistance Foundation, a charitable arm of the company that makes the Mirena IUD, provides no-cost medications to people with financial need who qualify. You can check your eligibility on the screening website.

2. Compare prices with various healthcare professionals

Depending on where you live, you may be able to have your IUD inserted by a physician, a nurse, or another healthcare professional. The cost of the device and of your healthcare visit may vary depending on who provides the procedure and where.

3. Ask your prescriber about alternatives

If you are concerned about the cost of Mirena, talk to your prescriber. There may be another birth control option that adequately prevents pregnancy or treats heavy menstruation and better fits your budget.

4. Use tax-advantaged medical expense funds

If you have a health savings account, a flexible spending account, or a health reimbursement arrangement, paying for your medication with these funds reduces your out-of-pocket costs through tax savings.

5. Check with local healthcare organizations

If you don’t have insurance, you may be able to get financial assistance through a nonprofit organization. For example, Planned Parenthood may be able to provide you with an IUD at no cost or a lower cost.

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Written by:

Tamara E. Holmes

Tamara E. Holmes is a Washington, DC-based freelance journalist and content strategist who has been writing about personal finance, health, and health insurance for more than a decade. Her work has appeared in various print and online publications, such as USA Today, AARP, Working Mother, and Diversity Woman.

Edited by:

Cindy George, MPH

Cindy George is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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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 prior authorization 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 step therapy 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 plans, commercial plans (excluding ACA), Medicare, and Medicaid (both state and managed Medicaid).