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 still have high out-of-pocket costs with your insurance, or if you don’t have insurance, there may be ways to get help paying for Kyleena®.
How much does Kyleena cost?
95% of women were covered for a Bayer IUD, like Kyleena, 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 Kyleena is not covered by your insurance, the cost of Kyleena is $999.28. 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 Kyleena will be covered by your insurance
You may be able to get Kyleena 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 Kyleena is a healthcare professional‐administered method of birth control.
Ask them to check if Kyleena is covered at no cost* under the Affordable Care Act.
Provide them with the J code for Kyleena: J7296.
Ask if you will have any out-of-pocket costs, if Kyleena 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.
Enroll in the Co-pay Savings Program for Kyleena
If you have health insurance but still have high out-of-pocket costs for Kyleena, the Co-pay Savings Program for Kyleena may help. Eligible patients may be able to pay as little as $20 out of pocket for Kyleena.*
*Eligible patients may pay as little as $20 and save up to $950. Patients who are enrolled in any type of government insurance or reimbursement programs are not eligible. As a condition precedent of the co-payment support provided under this program, e.g., co-pay refunds, participating patients and pharmacies are obligated to inform insurance companies and third-party payers of any benefits they receive and the value of this program, and may not participate if this program is prohibited by or conflicts with their private insurance policy, as required by contract or otherwise. Void where prohibited by law, taxed, or restricted. Patients enrolled in the Bayer US Patient Assistance Foundation are not eligible. Bayer may determine eligibility, monitor participation, equitably distribute product and modify or discontinue any aspect of the Co-pay Savings Program for Kyleena at any time, including but not limited to this commercial co-pay assistance program.
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 Kyleena IUD.
INDICATION FOR KYLEENA
Kyleena® (levonorgestrel-releasing intrauterine system) is a hormone-releasing IUD that prevents pregnancy for up to 5 years.
IMPORTANT SAFETY INFORMATION
- If you have an untreated genital infection, get infections easily, or have certain cancers, don't use Kyleena. Less than 1% of users get a serious pelvic infection called pelvic inflammatory disease (PID).
- If you have persistent pelvic or stomach pain, excessive bleeding after placement or if Kyleena comes out, tell your healthcare professional (HCP). If Kyleena comes out, call your HCP and avoid intercourse or use non-hormonal back-up birth control (such as condoms or spermicide). Kyleena may go into or go through the uterus and cause other problems.
- Pregnancy while using Kyleena 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.
Kyleena does not protect against HIV or STIs.
Only you and your HCP can decide if Kyleena is right for you. Kyleena is available by prescription only.
For important risk and use information about Kyleena, please see Full Prescribing Information.