If you have a pelvic infection, get infections easily, or have certain cancers, don’t use Kyleena, Mirena or Skyla. Less than 1% of users get a serious pelvic infection called pelvic inflammatory disease (PID). If you have persistent pelvic or stomach pain or if Kyleena, Mirena and Skyla comes out, tell your healthcare provider... continue reading below
The patient must meet all of the following ARCH Program eligibility requirements:
Please note, income eligibility is based on a percentage of the Federal Poverty Limit and household size. The specific eligibility requirements are subject to change without notice. All applications are reviewed on a case by case basis.
Product replacement may be available through ARCH for uninsured patients or patients who do not have coverage for Kyleena, Mirena or Skyla, provided the patient meets certain financial, medical, and insurance criteria.
To request a replacement, please ensure the following are submitted with this completed form:
*The Access and Resources in Contraceptive Health (ARCH) Patient Assistance Program provides Bayer IUDs (Kyleena, Mirena, and Skyla) at no cost to women in the United States who do not have either private health insurance or Medicaid coverage for Bayer IUDs and who meet all other program eligibility requirements. Please note that while Bayer provides Bayer IUDs at no cost to patients, patients may incur other costs, such as insertion and removal costs. Please speak with your insurance company or your healthcare provider for more information.
If you are unsure of your health insurance status, check with your health insurance provider or your healthcare professional. To better understand eligibility for the ARCH program, please click here for details and learn how you can apply.
INDICATION FOR KYLEENA
Kyleena® (levonorgestrel-releasing intrauterine system) is a hormone-releasing IUD that prevents pregnancy for up to 5 years.
INDICATIONS FOR MIRENA
Mirena® (levonorgestrel-releasing intrauterine system) is a hormone-releasing IUD that prevents pregnancy for up to 5 years. Mirena also treats heavy periods in women who choose intrauterine contraception.
INDICATION FOR SKYLA
Skyla® (levonorgestrel-releasing intrauterine system) is a hormone-releasing IUD that prevents pregnancy for up to 3 years.
Kyleena, Mirena and Skyla do not protect against HIV or STDs.
Only you and your HCP can decide if Kyleena, Mirena or Skyla is right for you. Kyleena, Mirena and Skyla are available by prescription only.
For important risk and use information about Kyleena, please see the Full Prescribing Information.
For important risk and use information about Mirena, please see the Full Prescribing Information.
For important risk and use information about Skyla, please see the Full Prescribing Information.
Reference: 1. Affordable Care Act Implementation FAQs - set 12. Centers for Medicare and Medicaid services website. https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs12.html. Accessed February 27, 2015.