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"Abortion pill" generally covered by health insurers
Mifeprex, also called RU-486 or the "abortion pill," was approved for use by the FDA in September 2000. When it's used together with another medication called misoprostol, Mifeprex can end an early pregnancy — a process called a "medical abortion" (as opposed to a surgical abortion). For more on how the drug works, see the FDA's Patient Information Sheet on Mifeprex.
The FDA issued a public health advisory about Mifeprex in 2004 after reports of severe adverse affects. The FDA has tallied several deaths from sepsis, an illness caused by infection of the bloodstream, and ectopic pregancies after the use of Mifeprex. However, the FDA notes that it is unknown whether there is a causal relationship between these and the use of Mifeprex and misoprostol.
Do not buy mifeprex over the Internet
The FDA warns that you should not buy Mifeprex over the internet because you will bypass important safeguards designed to protect your health.
In addition, Mifeprex has special safety restrictions on how it is distributed to the public. Drugs purchased from foreign internet sources are not the FDA-approved versions of the drugs and are not subject to FDA-regulated manufacturing controls or FDA inspection of manufacturing facilities.
Most health insurers that cover abortion will also cover Mifeprex. For example, under CIGNA HealthCare and Aetna plans that cover elective abortion, Mifeprex is covered, along with related medically necessary services such as office visits, ultrasounds and misoprostol. For CIGNA HealthCare and Aetna, Mifeprex is considered part of "medical benefits" and not pharmacy benefits.
According to Danco Laboratories, the maker of Mifeprex, most private health insurers and state Medicaid programs will cover Mifeprex if they also cover surgical abortions. Danco has a "Reimbursement Facts" page that includes a state-by-state list of payers for Mifeprex.
Before making any doctor appointment, you should contact your plan to find out about coverage. Also, find out if there will be a deductible or co-pay for the procedure. If you have a managed care plan, you may need to receive a referral from your physician before you can receive an abortion, including a medical abortion with Mifeprex.
While insurers generally cover Mifeprex, it will be up to employers to decide whether to offer the benefit to their employees. Because employers pay part or all of their employees' health insurance premiums, they can pick and choose which benefits they will offer, unless state law otherwise mandates coverage.
Employers that already cover contraceptives and surgical abortions are likely to cover Mifeprex as well.
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