Insurance and Medicaid
Most of the commercial payers and State Medicaid programs across the country have developed reimbursement policies for Mifeprex*. In general, if surgical abortions are covered, the payer will most likely cover Mifeprex.
Since everyone has different coverage, it is important that you remind patients to check directly with their health insurance company to find out if Mifeprex is covered. For most patients, office visits and lab tests will be covered as will the medication. In addition, you may wish to remind patients that they are responsible for any copayments, deductibles or coinsurance that normally apply under their health insurance policy.
The federal Medicaid program will only provide funding for abortion 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 fund abortions, including Mifeprex. The following states currently provide some coverage for abortion services.
|Connecticut||Minnesota||New York||West Virginia|
Since it takes time to qualify for Medicaid, some women may be eligible for Emergency Medicaid. Emergency Medicaid covers pregnant women who do not have health insurance and who meet Medicaid income and asset limits. Emergency Medicaid may cover the cost of an abortion. Check with your state Medicaid program for more information on coverage and policies.
For information on reimbursement codes for Mifeprex click here.