SUMMARY: How much does an IUD cost? Well, either $0 or $500, or much more, one woman learned, after a 5-1/2 month research project –- much of it wrangling over the money. You knew that your IUD was covered under the Affordable Care Act, right? Well, in theory it is, but sometimes it’s not as simple as it sounds. Finding out what the law says and how it applies to you can be incredibly time-consuming, or it can be very easy indeed. Read on for details of three women’s experiences, and some helpful hints about winding your way through the maze of conflicting or exceedingly straightforward steps toward finding what you’re entitled to, or …
A friend wrote recently on an online list I’m on about how hard it was for her to find out how much an IUD costs, and to get it covered by her insurance. After she wrote, others chimed in. I am telling their stories here, with permission, and without using their names.
Sister A writes
“Last fall, at 36, I found that my new GP reacted in shock when I told him I was on the Nuvaring, and basically refused to renew my prescription. You have no idea how sad I am that I can’t use the Nuvaring anymore. It was the easiest birth control I have ever used.
“I have been using it without incident for many years. It was my savior, frankly. … Apparently, my doctors had seen seen this article in Vanity Fair about the Nuvaring (I hadn’t)….
“That was back in October. I will finally get an IUD on April 7, God willing and the creeks don’t rise.
“Here are all the steps since October.
“1. You have to be tested for gonorrhea and chlamydia. My GP handled this, and this is where I decided he would not be the one to do the insertion. It’s too late to start changing the routine and ask me to hold the speculum. Plus I couldn’t take him seriously after he referred to the drape as a “modesty blanket.” You’re staring at my ladyparts, dude. No modesty here. Nice guy, though.
“2. After that was sorted, I went to my OB/GYN (which took three weeks to get an appointment, with one of her PAs), for a little more advice and to book an insertion. She of course wanted to do her own pelvic exam.
“3. The PA recommended the Mirena, then sent me a form to fill out ordering the device from CVS. I filled out the form…. The doctor told me to schedule my appointment, so I did, for about three weeks later.
“4. The OB/GYN’s office called me to cancel the appointment because they didn’t have the device yet and didn’t know when they would get it. The office assistant told me I shouldn’t have scheduled the appointment yet, and that she could not even speculate on when the IUD would arrive…. At this point, I’m thinking I should have stayed with my GP because he could get the IUD in a week.
“5. A month later, I got a call from CVS asking me for about $500. They ran my insurance and that’s what they thought the cost would be to me. I was shocked because my GP told me it was $0 on my policy.
“6. I called [my insurance company] and had a wonderful guy, Mike, explain that my benefits did in fact cover my IUD 100%, but under the medical coverage, not the pharmaceutical. He told me how to explain this to CVS, and made a note in my file, and assured me that he’d heard that IUDs were great. <3
“7. I called back CVS and explained what Mike told me; they said they’d have to look into it, that maybe the insurance guy at the insurance company was wrong about the insurance, and that I’d be stuck with 100% of the cost then. I said, that makes no sense – at MOST I’m stuck with the $500, but thanks for your concern, I’ll roll the dice with my insurance company since they assure me they’ll cover it 100%. Click.
“8. A month later, CVS called again and said that Mike and I were right, it was 100% covered and they would ship the IUD to my doctor. This would take a week.
“9. 2 weeks later, my doctor’s office called to schedule the appointment. I can get in to see my OB/GYN in three more weeks. …
“Anyway, after 5 and 1/2 months to get birth control, most of the admin handled by yours truly, I have this to say:
“Know your body. Know your insurance policy.”
Sister B writes
“I cannot use any kind of hormonal birth control without serious side effects, and I keep putting off getting an IUD even though I know I should — I’ve been on 4 different insurance plans in the past year and have been concerned about similar logistical hell.”
Sister C writes
“I went through the same realization with Nuvaring / switching to IUD on Mirena — but going through [Provider A] my steps were:
“1. My doc suggested it at my annual appointment after the research that the Vanity Fair article was based on came out. She also mentioned it would be free under my insurance because she researched it before I came in.
“2. Went in for pregnancy / gonorrhea test 1 week in advance.
“3. Went in for actual insertion. They covered getting the device. They covered all of the paperwork. I walked out 20 minutes later with no out of pocket costs.
“Total time / effort from start to finish: 1 month, maybe 1 hour of my attention was required.”
Are IUDs covered under the Affordable Care Act?
The answer is yes, but, as always, you may encounter problems. 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 an IUD cost?
If you are uninsured and want an IUD, or if for any other reason you are paying cash, or a percentage of the price as co-insurance, you might be interested in our 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.
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. There are two main kinds: Mirena, which dispenses hormones, and ParaGard, which does not.
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.
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.