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Ordering and Reimbursement

Cost and insurance coverage

Bayer is committed to the reproductive health of women, and we work hard to ensure every woman has access to effective contraception. Bayer may be able to help if your patients are uninsured or underinsured, or if they have high out-of-pocket costs.

 

    The Confidence In Coverage program replaces IUDs at no cost for eligible patients who are denied coverage* by their plan after IUD insertion.

    *Does not apply for patients who have co-pay, insertion and removal costs, or any other costs.

    Bayer US Patient Assistance Foundation is a charitable organization that helps eligible patients get their Bayer prescription medicine at no cost. Please have your patient contact the program at 1-866-2BUSPAF (228-7723), Monday to Friday, 9 AM to 6 PM EST, or visit the foundation website https://www.patientassistance.bayer.us/

    The Kyleena® Co-Pay Savings Program may help eligible commercially insured patients to pay as little as $20 for Kyleena.*

    95%

    OF PATIENTS HAD COVERAGE FOR A BAYER IUD WITH LOW OR NO OUT-OF-POCKET COSTS BASED ON BENEFIT INVESTIGATION SUBMISSIONS TO BAYER IN 20171

    Other products costs may apply; N=291,664.

    *Eligible patients may pay as little as $20 and save up to $999. Patients who are enrolled in any type of government insurance or reimbursement programs are not eligible. As a condition precedent of the co-payment support provided under this program, e.g., co-pay refunds, participating patients and pharmacies are obligated to inform insurance companies and third-party payers of any benefits they receive and the value of this program, and may not participate if this program is prohibited by or conflicts with their private insurance policy, as required by contract or otherwise. Void where prohibited by law, taxed, or restricted. Patients enrolled in the Bayer US Patient Assistance Foundation are not eligible. Bayer may determine eligibility, monitor participation, equitably distribute product and modify or discontinue any aspect of the Co-pay Savings Program for Kyleena at any time, including but not limited to this commercial co-pay assistance program.

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    We’re for health.
    We’re for access.
    WE’RE FOR HER.

    We’re for Her

    • CONTRACEPTIVE ACCESS through the donation of more than 277,000 IUDs in the US for women in need since 2001
    • COLLABORATION in the form of funding to Direct Relief
    • EDUCATIONAL TOOLS for healthcare professionals who provide care to women in underserved communities

     

    WE’RE FOR HER is in line with Bayer’s goal to provide 100 million women across the world with access to contraception by 2030 through 2 key programs in the US:

    Bayer US Patient Assistance Foundation

    A charitable organization that helps eligible patients get their Bayer prescription medicine at no cost. Please have your patient contact the program at 1-866-2BUSPAF (228-7723) Monday to Friday, 9 AM to 6 PM EST, or visit the foundation website at www.patientassistance.bayer.us to see if they might qualify for assistance.

    Partnership with Direct Relief

    In 2020, we committed to a partnership with the humanitarian medical organization Direct Relief to provide IUDs to health facilities caring for women in need across the country.*

     

    *Interested health facilities can learn more by visiting www.directrelief.org or by contacting Direct Relief at 1-805-964-4767.

    IUD=intrauterine device; US=United States.

    There are 2 ways to order Kyleena

      Bayer WHC Support Center

       

      • Place orders online, by phone, or by fax
      • Check account status and track orders
      • Access 24-hour online support 

       

      Go to WHC Support Center

      Bayer WHC Specialty Pharmacy Program

       

      Depending on a patient's insurance plan, offices can order Kyleena through a Specialty Pharmacy.

       

      Specialty Pharmacies may be able to bill the insurance company directly for Kyleena. In this case, the office bills only for the clinical services related to insertion. The remaining share of the cost is billed by the Specialty Pharmacy.

       

      Contacting your Specialty Pharmacy
      CVS Specialty (in the Continental US)
      (866) 638-8312

       

      CVS Specialty (in Hawaii-Neighbor Islands)
      (800) 896-1464

       

      CVS Specialty (in Hawaii-Oahu)
      (808) 254-2727

       

      AllianceRx Walgreens Prime
      Phone: 1-877-686-4633
      Fax: 1-800-830-5292

       

      Cigna Specialty Pharmacy Services
      (800) 351-3606

       

      Humana Specialty Pharmacy
      (800) 486-2668

       

      Magellan Rx
      Phone: 1-866-554-2673
      Fax: 1-866-364-2673

      Visit the Bayer WHC Support Center for additional ordering resources and support

      Coding and reimbursement

        HCPCS codes (Kyleena J-code)
        The alphanumeric codes are used to report drugs, supplies, and services. HCPCS codes starting with the letter “J” are used for products, supplies and services administered by the provider.

         

        Table of HCPCs codes for Kyleena®, Mirena® and Skyla®

         

        NDC codes
        Note that some payers, including Tricare and Medicaid, require the 11-digit NDC format when billing for Kyleena. Confirm NDC billing instructions with each payer, as requirements may vary.

         

        Table of NDC codes for Kyleena®, Mirena® and Skyla®

        HCPCS=healthcare common procedure coding system; NDC=national drug codes.

         

        Request a Rep

        Stay up to date with clinical information and virtual trainings for Kyleena.

         

        Download the Compass Guide

        Ordering, billing, and reimbursement resources for your staff.

         

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