Financial support for patients | Mifeprex (mifepristone)

Private Health Insurance

We understand that dealing with insurance companies can be difficult particularly in times of stress. Many commercial insurance plans cover the Mifeprex*(mifepristone) regimen. You may wish to go to State Payer Policies for information specific to your state; however, everyone has different coverage, so it is important that you check directly with your insurance company to find out if Mifeprex is covered under your plan. For most patients, the office visits and lab tests will be covered and so will the medication. You will be responsible for any co-payments or deductibles that normally apply under your health insurance policy. There is usually a number on the back of your insurance card that you can call to check on your benefits. Your doctor or clinic might also be able to help you determine what level of coverage your policy provides.

Medicaid

Federal law only requires state Medicaid programs to cover abortion, including Mifeprex, in cases of rape or incest, or when the woman’s life is in danger. However, some states go beyond the minimum coverage set by the federal guidelines, and cover abortions, including Mifeprex, in other circumstances. The following states currently provide broader coverage for abortion services; click on the state to get more specific information.

Since it takes time to determine whether you qualify and to enroll in Medicaid, if you are not currently enrolled in Medicaid, you should ask about your eligibility for expedited enrollment or presumptive eligibility. These procedures allow pregnant women who do not have health insurance and who meet Medicaid income and asset limits to be enrolled in Medicaid more quickly than under the regular procedures. You should check with your State Medicaid program for more information.

For resources on Medicaid funding for abortions you may wish to visit State Law Resources.

Financial Support

Some providers charge a sliding scale for their services, depending on your ability to pay. To locate a provider in your area you may wish to contact:

National Abortion Federation (NAF) or 1-800-772-9100
Planned Parenthood Federation of America (PPFA) or 1-800-230-PLAN
Abortion Care Network (ACN) or 1-202-419-1444.

If you contact a provider through NAF, PPFA or ACN ask them if they have a sliding scale based on ability to pay. There is also an organization called the National Network of Abortion Funds (NNAF), which raises funds for women who cannot afford abortions.

Please note the following:
• All codes supplied by us are for informational purposes only and represent no statement or guarantee that these codes will be appropriate or that reimbursement will be made in a particular situation.
• It is always the provider’s responsibility to determine and submit appropriate codes, charges, and modifiers for services that are rendered.
• All coding and reimbursement information is subject to change without notice, and specific payers may have their own coding and reimbursement requirements and policies. Before filing any claims, providers should verify current requirements and policies with the payer. We also recommend that providers stay current with National Correct Coding Initiative (NCCI) coding manual narratives and edits.
• Current Procedural Terminology (CPT) codes are copyrighted 2016 by the American Medical Association, all rights reserved. No fee schedules, basic units, relative values, or related listings are included in the CPT. The AMA assumes no liability for the data contained therein. Applicable FARS/DFARS restrictions apply to government use. Payments may be subject to reduced payment when multiple procedures are performed on the same day.

Important Safety Information

What is the most important information I should know about Mifeprex?

What symptoms should I be concerned with?

Although cramping and bleeding are an expected part of ending a pregnancy, rarely, serious and potentially life-threatening bleeding, infections, or other problems can occur following a miscarriage, surgical abortion, medical abortion, or childbirth. Seeking medical attention as soon as possible is needed in these circumstances. Serious infection has resulted in death in a very small number of cases. There is no information that use of Mifeprex and misoprostol caused these deaths. If you have any questions, concerns, or problems, or if you are worried about any side effects or symptoms, you should contact your healthcare provider. Please see additional Important Safety Information and the Medication Guide.

Be sure to contact your healthcare provider promptly if you have any of the following:

Heavy Bleeding. Contact your healthcare provider right away if you bleed enough to soak through two thick full-size sanitary pads per hour for two consecutive hours or if you are concerned about heavy bleeding. In about 1 out of 100 women, bleeding can be so heavy that it requires a surgical procedure (surgical aspiration or D&C).
Abdominal Pain or “Feeling Sick.” If you have abdominal pain or discomfort, or you are “feeling sick,” including weakness, nausea, vomiting, or diarrhea, with or without fever, more than 24 hours after taking misoprostol, you should contact your healthcare provider without delay. These symptoms may be a sign of a serious infection or another problem (including an ectopic pregnancy, a pregnancy outside the womb).
Fever. In the days after treatment, if you have a fever of 100.4°F or higher that lasts for more than 4 hours, you should contact your healthcare provider right away. Fever may be a symptom of a serious infection or another problem.

If you cannot reach your healthcare provider, go to the nearest hospital emergency room. Take the Medication Guide (PDF)(link to Medication Guide) with you. When you visit an emergency room or a healthcare provider who did not give you your Mifeprex, you should give them your Medication Guide so that they understand that you are having a medical abortion with Mifeprex.

What to do if you are still pregnant after Mifeprex with misoprostol treatment. If you are still pregnant, your healthcare provider will talk with you about a surgical procedure to end your pregnancy. In many cases, this surgical procedure can be done in the office/clinic. The chance of birth defects if the pregnancy is not ended is unknown.

Talk with your healthcare provider.

Before you take Mifeprex, you should read the Medication Guide (PDF) and you and your healthcare provider should discuss the benefits and risks of your using Mifeprex.

What is Mifeprex?

Mifeprex is used in a regimen with another prescription medicine called misoprostol, to end an early pregnancy. Early pregnancy means it is 70 days (10 weeks) or less since your last menstrual period began. Mifeprex is not approved for ending pregnancies that are further along. Mifeprex blocks a hormone needed for your pregnancy to continue.

When you use Mifeprex on Day 1, you also need to take another medication called misoprostol 24 to 48 hours after you take Mifeprex, to cause the pregnancy to be passed from your uterus.

The pregnancy is likely to be passed from your uterus within 2 to 24 hours after taking Mifeprex and misoprostol. When the pregnancy is passed from the uterus, you will have bleeding and cramping that will likely be heavier than your usual period. About 2 to 7 out of 100 women taking Mifeprex will need a surgical procedure because the pregnancy did not completely pass from the uterus or to stop bleeding.

Who should not take Mifeprex?

Some women should not take Mifeprex. Do not take Mifeprex if you:

Have a pregnancy that is more than 70 days (10 weeks).
Are using an IUD (intrauterine device or system) (must be taken out before you take Mifeprex).
Have been told by your healthcare provider you have a pregnancy outside the uterus (ectopic pregnancy).
Have problems with your adrenal glands.
Take medicine to thin your blood.
Have a bleeding problem.
Have porphyria.
Take certain steroid medicines.
Are allergic to mifepristone, misoprostol or other prostaglandins.

Mifeprex cannot be used in cases of confirmed or suspected ectopic pregnancy as MIFEPREX is not effective for terminating those pregnancies. If you are using an IUD, it must be taken out before you take Mifeprex.

What are the possible side effects of Mifeprex and misoprostol?

Mifeprex may cause serious side effects. See “What is the most important information I should know about Mifeprex?” above.

Cramping and Bleeding. Cramping and vaginal bleeding are expected with this treatment. Usually, these symptoms mean that the treatment is working. But sometimes you can get cramping and bleeding and still be pregnant. This is why you must follow-up with your healthcare provider approximately 7 to 14 days after taking Mifeprex. See “How should I take Mifeprex?” in the Medication Guide (PDF) (link to Medication Guide) for more information on your follow-up assessment. If you are not already bleeding after taking Mifeprex, you probably will begin to bleed once you take misoprostol, the medicine you take 24 to 48 hours after Mifeprex. Bleeding or spotting can be expected for an average of 9 to16 days and may last for up to 30 days. Your bleeding may be similar to, or greater than, a normal heavy period. You may see blood clots and tissue. This is an expected part of passing the pregnancy.

The most common side effects of Mifeprex treatment include: nausea, weakness, fever/chills, vomiting, headache, diarrhea and dizziness. Your provider will tell you how to manage any pain or other side effects. These are not all the possible side effects of Mifeprex.

Call your healthcare provider for medical advice about any side effects that bother you or do not go away. You may report side effects to FDA at 1-800-FDA-1088.

General Information about the safe and effective use of Mifeprex.

Medicines are sometimes prescribed for purposes other than those listed in the Medication Guide (PDF). The Medication Guide summarizes the most important information about Mifeprex. If you would like more information, talk with your healthcare provider. If you would like information about Mifeprex that is written for healthcare professionals you may download the Mifeprex Prescribing Information (PDF).