Nexplanon financials in 2025: Discounts and additional savings options
The Nexplanon birth control implant, a brand-name drug, is a popular choice for women seeking long-term contraception. But how much does it cost? The price of Nexplanon can vary significantly, influenced by factors such as healthcare provider or clinic fees, geographic location, insurance coverage, and whether insertion and removal are included.
Without insurance, the implant insertion alone can cost up to $13,000, with removal costs up to around $300. However, with insurance, it is often either free or low-cost under most commercial insurance plans because contraceptives are commonly covered as preventive care under the Affordable Care Act (ACA) in the US.
Key factors influencing the cost include:
- Clinic or provider charges: Different clinics may charge varying fees for the procedure.
- Insurance type and coverage details: Most commercial insurance plans cover FDA-approved contraceptives like Nexplanon fully when obtained in-network. However, coverage may vary if out-of-network benefits are used or if the plan is grandfathered and does not comply with ACA mandates.
- Region or country: For example, in Korea, the contraceptive implant cost is about $600, but exact pricing depends on the clinic and insurance.
- Additional services: Cost can include consultation, insertion, follow-up, and removal procedures.
To find out the actual out-of-pocket cost you would pay, it's essential to:
- Check your insurance policy documents or formulary: Look under “Preventive Services” or “Contraceptive Coverage” sections to confirm if Nexplanon is covered with zero cost-sharing.
- Contact your insurance provider directly: Call member services to get exact information about copayments, coinsurance, coverage limits, and network restrictions for Nexplanon.
- Consult your healthcare provider or clinic: They can provide detailed pricing and help verify the insurance coverage for the procedure and any associated visits.
- Request a prior authorization or cost estimate: If your insurance requires it, your provider may obtain prior approval or a cost estimate for you.
It's important to note that the cost of Nexplanon without insurance coverage may be higher than with insurance. However, some websites provide details about drug assistance programs and savings cards, such as Medicine Assistance Tool and NeedyMeds.
Nexplanon belongs to a drug class called progestins and is not available in a generic version. When a brand-name drug's patent expires, multiple manufacturers can create generic versions, which tend to cost less due to marketplace competition and reduced testing costs.
When considering any medication, always consult your doctor or another healthcare professional before taking it. For details about Medicare coverage for drugs, see articles about Medicare prescription drug plans, drug coupons and Medicare, and the Medicare drug list.
For more information about preventing pregnancy, see our hubs on women's health and sexual health.
- The cost of Nexplanon, a popular long-term contraception choice, can significantly vary based on factors like healthcare provider or clinic fees, geographic location, insurance coverage, and whether insertion and removal are included.
- In Korea, the cost for a contraceptive implant like Nexplanon is roughly $600, but it can vary depending on the clinic and insurance provider.
- With insurance, the Nexplanon implant is often free or low-cost under most commercial insurance plans, as contraceptives are commonly covered as preventive care under the Affordable Care Act (ACA) in the US.
- To determine the actual out-of-pocket cost for a Nexplanon implant, it's essential to check insurance policy documents, contact member services, consult the healthcare provider, and request a prior authorization or cost estimate, when necessary.
- Websites such as Medicine Assistance Tool and NeedyMeds may provide information about drug assistance programs and savings cards that could help reduce the cost of Nexplanon without insurance.
