How Much Is Xulane Without Insurance?
Key takeaways:
Xulane is a branded generic version of the discontinued birth control patch, Ortho Evra. The patch contains two hormones, ethinyl estradiol (estrogen) and norelgestromin (progestin), that work to prevent pregnancy.
Xulane is 99% effective at preventing pregnancy with perfect use and 93% effective with typical use. The patch works best for people who weigh less than 198 lbs, and it should not be used by people who have a body mass index greater than 30.
Without insurance, a 28-day package of Xulane is as low as $46.97 with a GoodRx coupon.
Access savings on related medications
Table of contents
Xulane (norelgestromin / ethinyl estradiol) is a branded generic version of the discontinued birth control patch, Ortho Evra. Zafemy is another branded generic version of Ortho Evra.
Xulane contains two hormones: ethinyl estradiol (an estrogen) and norelgestromin (a progestin). The medication works to prevent pregnancy by stopping your ovaries from releasing an egg (ovulation), thinning the uterine lining, and thickening cervical mucus to make it harder for sperm to reach an egg.
The birth control patch is designed for a 28-day (4 week) cycle. The product comes in a package of three patches. You’ll apply 1 patch per week over 3 consecutive weeks. You’ll skip wearing a patch for the fourth week, which is when you should have your period. Patches can be applied on the outside of your upper arm, your bottom, your back, or your stomach. It’s important to wear only one patch at a time and to change the patch on the same day every week.
With perfect use, Xulane is 99% effective at preventing pregnancy. But it’s closer to 93% effective with normal use. The patch works best for people who weigh less than 198 lbs. It should not be used by people with a body mass index (BMI) of 30 or greater.
Xulane exposes you to more estrogen than a typical birth control pill, which can increase the risk of side effects, including blood clots. Because of this, you shouldn’t use Xulane if you have a BMI of 30 or greater, are a smoker over age 35, or have a health condition that increases your risk for blood clots.
Xulane basics
The chart below provides a summary of basic information about Xulane.
Xulane basics
Brand name | Ortho Evra (discontinued) |
Branded generic | Xulane, Zafemy |
Active ingredients | Norelgestromin (150 mcg/day), ethinyl estradiol (35 mcg/day) |
How supplied | 1 package of 3 patches |
FDA-approved uses | Hormonal contraceptive |
How to use | Apply a patch to clean, dry skin on the upper outside arm, buttock, back, or stomach once weekly for 3 weeks. Your fourth week is patch free; that’s when you’d have your period. |
Benefits | • Prevents pregnancy |
Possible side effects | • Stomach pain |
Is Xulane covered by insurance?
Under the Affordable Care Act (ACA), most insurance plans, including ACA marketplace plans, must cover at least one birth control option from each FDA-approved category with no cost sharing. This means you don’t have to pay coinsurance or a copay with most plans. Some plans may not cover specific generic or brand-name birth control options, but a majority of plans cover Xulane.
If you have insurance, check your plan’s summary of benefits and coverage and formulary to determine whether Xulane is covered. Some plans may prefer Zafemy or norelgestromin / ethinyl estradiol, and the pharmacy can automatically substitute for either of these since they’re equivalent generics.
How insurance covers Xulane
Xulane is covered for most people with insurance. Most health insurance plans covering this medication don’t require prior authorization or step therapy, but prior authorization will be required for nearly 1 in 5 people with Medicaid.
What is Xulane? Xulane is a hormonal birth control patch that is applied to the skin once a week for 3 weeks every month.
Birth control patches are convenient but costly. Using a birth control patch may be more costly than other reversible contraceptive options, but it doesn’t require you to take a daily pill.
Your costs for birth control with insurance. You can typically fill a prescription for FDA-approved birth control without cost sharing, unless your plan has a religious coverage exemption.
The following chart shows your likelihood of coverage, or your chances of facing restrictions such as prior authorization and step therapy based on your type of insurance.
Insurance coverage for Xulane
Insurance type | Enrollees covered for this medication | Enrollees required to get a prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
Commercial (not including plans purchased through the ACA marketplace) | 97.3% | 4.6% | 0% |
76.1% | 0% | 0% | |
Medicare, including original Medicare and Medicare Advantage plans | 69.4% | 0% | 0% |
Medicaid, including state-run and managed care plans | 99.6% | 18.3% | 0.4% |
Source: Managed Markets Insight & Technology, LLC™, as of October 17, 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 Xulane:
Ask your prescriber about alternatives. You may want to consider a birth control pill, an injection, or an intrauterine device (IUD).
Ask for an exception from your prescription medication formulary. Keep in mind that you may be required to do step therapy or get a prior authorization to be covered.
File an appeal with your plan if your exception is denied.
Use a GoodRx coupon for potential savings.
Consider changing your prescription medication coverage during your next open enrollment period.
How much does Xulane cost without insurance?
If you don’t have health insurance, what you’ll pay for Xulane will depend on the following factors:
Days supply
Geographic location
Specific pharmacy or health clinic
Without insurance, the cost for 1 package (a 4-week supply) of Xulane is as low as $46.97 with a GoodRx coupon.
How to afford generic Xulane without insurance
Here are five ways to save on generic Xulane without insurance.
1. Use a GoodRx coupon
With a GoodRx coupon, you may be able to pay a lower price for your Xulane prescription.
Here’s how to get a coupon:
Visit www.goodrx.com, or install the GoodRx app on your mobile device.
Type “Xulane” in the search field
Choose the correct quantity and location.
Click or tap on “search prices” to find prices at pharmacies near you.
Choose to receive your coupon via text or email, or print it out.
Show the coupon at the pharmacy when you pick up your medication. Or present the coupon to your pharmacy staff early on in the filling process, such as when you first receive your prescription, to help prevent delays at the pick-up counter.
2. Request a larger quantity
To compare costs, ask your prescriber for a prescription for 3 packages of Xulane (an 84-day supply) instead of a 1-package, 28-day supply. Filling a larger quantity may lower your cost per patch and reduce your trips to the pharmacy.
3. Compare prices at various pharmacies
GoodRx can easily compare costs at different pharmacies to help you find the best Xulane price.
4. Ask your prescriber about alternatives
If you are concerned about the cost of Xulane, talk to your prescriber. There may be another contraceptive medication that better fits your budget.
5. Use your tax-advantaged healthcare funds
If you have a health savings account, a flexible spending account, or a health reimbursement arrangement, using those funds to buy your medication can reduce your out-of-pocket costs through tax savings.
The bottom line
Xulane (norelgestromin / ethinyl estradiol) is a branded generic version of Orth Evra, a birth control patch. The cost of Xulane depends on many factors, such as the pharmacy or health clinic you buy it from or your geographic location. The majority of people with insurance will have some coverage for Xulane. Without insurance, the cost for 1 package (a 4-week supply) of Xulane is as low as $46.97 with a GoodRx coupon.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflect health insurance coverage as of October 2024.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including the ACA, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
A-S Medication Solutions. (2024). Xulane- norelgestromin and ethinyl estradiol patch [package insert].
Healthcare.gov. (n.d.). Heath benefits & coverage.
Latwal, B., et al. (2021). Authorized generics vs. branded generics: A perspective. Journal of Generic Medicines: The Business Journal for the Generic Medicines Sector.
Medicaid.gov. (n.d.). Managed care.
Planned Parenthood. (n.d.). How effective is the birth control patch?
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