How Much Is Norethindrone Without Insurance?

Norethindrone is a progestin-only form of birth control known as a mini-pill. Progestin is the synthetic form of progesterone, a naturally occurring hormone that prevents pregnancy. The medication is also sold as several branded generic medications, such as Heather, Incassia, Emzahh, Jencycla, and Errin.

This medication helps prevent pregnancy by suppressing ovulation, thickening the cervical mucus to block sperm movement, and making the uterine lining less hospitable to a fertilized egg. 

Norethindrone has similar side effects to combined birth control pills (those that contain both progesterone and estrogen). Norethindrone has a lower risk of causing blood clots than pills with estrogen. But it may be more likely to cause irregular periods and spotting. Side effects are generally mild and may improve over time.  

When taken exactly as directed — once daily at the same time each day — norethindrone can prevent pregnancy up to 99.7% of the time. But with normal use, it’s typically about 91% effective.

In some states, pharmacists can prescribe birth control, so you don’t need to see another healthcare professional to get a prescription first.

Norethindrone basics

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

Norethindrone basics

Is norethindrone typically covered by insurance?

Birth control methods approved by the FDA, including norethindrone, are considered preventive care under the Affordable Care Act (ACA), also known as Obamacare. Most commercial and ACA marketplace plans cover birth control with no cost-sharing, which means you don’t pay a copay or coinsurance. This is true even if you haven’t met your yearly deductible.

Most Medicare Part D prescription plans cover norethindrone. Most Medicaid programs also provide some family planning benefits, including prescription contraceptives.

Check your plan’s summary of benefits and coverage and formulary to determine your plan’s exact coverage.

EXPERT PICKS: WHAT TO READ NEXT

• Understanding norethindrone: Norethindrone is a progestin-only birth control pill. It helps prevent pregnancy by thickening the cervical mucus, changing the uterus lining, and suppressing ovulation.

• Norethindrone may have side effects. Common side effects include irregular periods and spotting. Some women may also experience headaches, nausea, breast tenderness, or dizziness.

• Who should avoid norethindrone? If you are pregnant or have breast cancer, liver disease, or lupus, a progestin-only pill such as norethindrone may not be right for you.

How insurance covers norethindrone

Norethindrone is covered for most people with insurance. And most health insurance plans that cover this medication don’t require prior authorization or step therapy. However, prior authorization for norethindrone is required for nearly 10% of people with Medicaid. It’s also important to note that certain religious employers have the option not to cover birth control.

The following chart shows your likelihood of coverage, as well as the potential need for 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

Insurance coverage for norethindrone

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

Tips if your medication isn’t covered by insurance

Here are a few options to try if your insurance does not cover norethindrone:

• Talk to your prescriber about alternatives to norethindrone. Other birth control options include other oral contraceptives, injections, or the patch. You also may want to consider nonhormonal options, such as a copper IUD or cervical cap.

• Request an exception from your prescription medication plan. You may need to get a prior authorization in order to be covered.

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

• Check to see if you qualify for a patient assistance program.

• Use a GoodRx coupon for potential savings.

• Consider switching to a new prescription plan during the next open enrollment period. Make sure the new plan provides the coverage you need.

• Purchase Opill (norgestrel), the first birth control pill that's available over the counter — no prescription or office visit required.

How much does norethindrone cost without insurance?

If you don’t have health insurance, what you’ll pay for norethindrone depends on several factors, including:

• Geographic location

• Specific pharmacy

• Fill amount (1 month vs. 3 months)

The chart below contains current retail prices for norethindrone and some of its other versions.

How to afford generic norethindrone without insurance

Here are five ways to save on generic norethindrone without insurance.

1. Use a GoodRx coupon

With a GoodRx coupon, you may pay a lower price for your norethindrone prescription.

Here’s how to get a coupon:

• Visit www.goodrx.com or install the GoodRx app on your mobile device.

• Type “norethindrone” in the search field. Alternatively, type in the name of the version you need (e.g., Heather). It may help to ask the pharmacy which branded generic(s) it carries.

• Select the “Prescription” box and choose the quantity and location.

• Click or tap on “Search prices” to find prices at pharmacies near you.

• Choose to receive your coupon via email or text, print it out, or save your coupon on the GoodRx app.

• Show the coupon at the pharmacy when you pick up your medication. If possible, send the coupon information to your pharmacy staff early in the filling process, such as when you first get your prescription. This can help prevent delays at the pickup counter.

2. Request a 90-day supply

Ask your prescriber to write you a prescription for a 3-month supply of norethindrone, instead of a 28-day supply, to compare costs. Filling a 3-month supply may get you a better value than refilling your prescription each month. It could also cut down on your trips to the local pharmacy.

If your insurance covers norethindrone, ask about potential discounts for using your plan’s mail-order pharmacy.

3. Compare prices at various pharmacies

GoodRx can easily compare costs at different pharmacies to help you find the best norethindrone price in your area. 

4. Talk to your prescriber about alternatives

If you are concerned about the cost of norethindrone, reach out to your prescriber. They may be able to suggest another medication that adequately addresses your needs and fits your budget.

5. Use your HSA or FSA funds

Most health savings accounts (HSAs) cover FDA-approved birth control medications (provided they’re prescribed by a healthcare professional). If you have an HSA or flexible spending account  (FSA), consider using one of them to cover the cost of your medication. Paying for your medication with funds from either of these accounts can reduce your out-of-pocket costs through tax savings.

Why trust our experts?

Written by:

Angela Mae Watson

Angela Mae Watson is a freelance personal finance and health writer. She has more than 8 years of experience educating about financial awareness and literacy.

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:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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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 (PA) 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 (ST) 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 and managed care plans).