SUMMARY: How much does an IUD cost? Like anything else in the health-care marketplace, the answer is: it depends. Birth control. So many choices! There are so many birth control methods out there, it can be hard to keep them all straight — and choose one that’s right for you. Also, what’s covered under the Affordable Care Act? Read on for details, or …
Many women choose birth-control pills. Increasingly though, women are opting for an IUD or intrauterine device, which is inserted directly into the uterus.
IUD’s have had a complicated history in this country. They have come in many different shapes and sizes, and some have been relatively unsafe, including the Dalkon Shield, which was the subject of an enormous class-action lawsuit for the damages it caused to women who used them.
For a period, they were FDA-approved only for women who had undergone childbirth due to the threat of side effects, including pelvic inflammatory disease. But in July, 2011, the American College of Obstetrics and Gynecology officially endorsed IUDs, commonly small T-shaped plastic devices laced with either copper or hormones to quell pregnancy, for healthy women and teenagers.
O.K., so how much does an IUD cost?
The prices vary dramatically.
First and foremost, know what you’re buying. Most women’s health clinics offer two different types of IUDs: ParaGard and Mirena.
ParaGard, which lasts for up to 10 years, is wrapped with tiny coils that release small amounts of copper, which is an irritant, creating a reaction that is toxic to sperm.
Mirena, which lasts up to five years, releases small amounts of the progestin hormone Levonorgestrel, which impairs sperm motility and viability, so it can prevent fertilization.
Excellent resource: Here’s a list of the upsides and the downsides, from our friend Carey Goldberg over at Commonhealth, the health-care blog at WBUR public radio in Boston.
Apart from the cost of the devices themselves, always be sure to ask about an insertion fee, which is sometimes included in the cost of the device, and sometimes extra.
At one Manhattan women’s health clinic, ParaGard costs $700, and Mirena costs $800, insertion fee included; at one Brooklyn clinic, ParaGard runs just $550 and Mirena $650, insertion fee also included. And at one Waterbury, Ct., clinic, ParaGuard costs $680 and Mirena between $7-800, plus an additional $300 insertion charge.
Many places have a sliding scale depending on your income and size of family, plus other factors.
So is the same Mirena IUD going to cost you $650, or $2,600? It all depends on where you go.
Here at clearhealthcosts.com, we do pricing surveys for the self-pay prices for common procedures. What we have found nationwide is a range from $55 to $2,600 for an IUD if you ask in advance and pay cash; here’s our price list for New York and here’s one for the Los Angeles area. Here’s an IUD price list for the San Francisco area.
Pro tip: Use our search tools to see Austin and San Antonio providers. Also check out the notes field: the notes will tell you if it’s Mirena or Paragard, and the charge for each, if the provider offers both.
Are IUDs covered under the Affordable Care Act?
That depends. Gretchen Borchelt of the National Women’s Law Center wrote this piece, which we saw on Bedsider: “Plans must cover all FDA-approved birth control methods with no out-of-pocket expense. That includes implants, IUDs, the shot, the pill, the patch, the ring, diaphragms, cervical caps, and sterilization procedures. (Birth control you can buy without a prescription probably won’t be covered under this law.)
“For some types of birth control, there is only one option available in the United States, so plans should cover them; for example, Ortho Evra is the only patch and NuvaRing is the only ring, so they must be covered. But there are many kinds of pills, and many health insurance companies cover only some of them, so which pills are covered without co-pay will vary by plan.
“Unfortunately some insurance plans are not following the law yet. At the National Women’s Law Center, we hear from women whose plans are only covering the pill, but not the ring or the patch. Other women have been told that only generic brands are covered…. Health plans have been given some leeway to determine what is covered, but they should not be able to stop you from getting the birth control that is right for you.
“The bottom line is that you have to call your insurance plan to find out whether your particular birth control is covered without out-of-pocket expenses. Here’s a guide to what to ask the human you eventually get on the phone, and what their answers mean for you.”
How much does Depo-Provera cost? Most clinics also offer Depo Provera contraceptive injection, a shot of progestin that prevents the ovaries from releasing eggs. We’re covering this in another piece.
Not sure which one is right for you? Birth control is a personal decision. Money also matters, and other issues — protection from STD’s, side effects and so on. Here’s a handy chart from Bedsider, giving you the lay of the land.
The takeaway: Questions to ask
As we always say, know before you go.
Questions to ask:
- Paragard or Mirena? And why?
- Will I have to bring the device or do you supply it?
- If I have to bring it, where would I find it? Is there anything I need to know about how to buy it?
- Is this covered by insurance without a copay? If not, why not?
- How much will it cost? How much will it cost ME?
- Do you have a sliding scale based on income, family size and other factors? How does that work?
- Are there insertion fees? Other fees or charges?
Is there a separate charge for the doctor’s visit, or is it all included in the price you just named?
Call before you go. Ask how much you will be charged. Take notes. Take names. Take numbers.