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Mirena® May Be Covered by Your Healthcare Plan
Mirena (levonorgestrel-releasing intrauterine system) may be covered under your health insurance. To find out, call your insurance provider, talk to your company's human resources manager or check your employee handbook.
What to tell your insurance provider
When calling to confirm that Mirena is covered by your healthcare plan, have your policy and group numbers available and provide them with the Healthcare Common Procedure Coding System (HCPCS) code (often called "the J code") for Mirena which is J7302 and the Current Procedural Terminology (CPT) code for having Mirena placed which is 58300.
The more your employer knows about Mirena, the better
If your plan doesn't cover Mirena, don't give up. With some information from us—and a little help from you—your employer and your insurance provider might learn more about Mirena and decide to provide coverage for it.
PATIENT PRESCRIBING INFORMATION
Flexible payment plans put you in control
If you have to cover the cost of Mirena, you can select from one of several flexible payment plans that can help make birth control affordable.
| PAYMENT PLAN* | PAYMENT | TOTAL COST |
| SINGLE PAYMENT | $843.60 | $843.60 |
| 4 MONTHLY PAYMENTS** | ||
| 1st payment | $337.44 | |
| 3 additional payments | $168.72 | $843.60 |
| 24 MONTHLY PAYMENTS** | $35.15 | $843.60 |
* Prices subject to change. Valid only for qualified patients with a valid prescription for Mirena. Offer valid only in the United States. Void where prohibited by law.
** By participating in this program you certify that you are not reimbursed, nor will you submit a claim for reimbursement, nor will you seek to have any portion of this prescription counted toward your out-of-pocket costs (e.g., TrOOP) under any federal, state, or private programs for this or other prescriptions for Mirena to which this offer may apply. Bayer HealthCare Pharmaceuticals reserves the right to change or discontinue this program without notice at any time.
Just The Facts
Find out why Mirena might be a good choice for women who don't want to think about taking birth control every day.
INDICATIONS & USAGE
Mirena (levonorgestrel-releasing intrauterine system) is a hormone-releasing system placed in your uterus to prevent pregnancy for as long as you want for up to 5 years. Mirena also treats heavy periods in women who choose intrauterine contraception.
IMPORTANT SAFETY INFORMATION ABOUT MIRENA
Only you and your healthcare provider can decide if Mirena is right for you. Mirena is recommended for women who have had a child.
- Don't use Mirena if you have a pelvic infection, get infections easily or have certain cancers. Less than 1% of users get a serious infection called pelvic inflammatory disease. If you have persistent pelvic or abdominal pain, see your healthcare provider.
- Mirena may attach to or go through the wall of the uterus and cause other problems. If Mirena comes out, use back-up birth control and call your healthcare provider.
- Although uncommon, pregnancy while using Mirena can be life threatening and may result in loss of pregnancy or fertility.
- Ovarian cysts may occur and usually disappear.
- Bleeding and spotting may increase in the first few months and continue to be irregular. Periods over time may become shorter, lighter or even stop.
Mirena does not protect against HIV or STDs.
You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
For important risk and use information, please see the patient prescribing information.
BAYER, the Bayer Cross, and Mirena are registered trademarks of Bayer.
myMirena and Keep Life Simple are trademarks of Bayer.
