If you have a pelvic infection, get infections easily, or have certain cancers, don’t use Kyleena, Mirena and 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
Proof of Annual Household Income Requirements
In addition to the Application Form, proof of annual household income is required. This can be provided either by sending an acceptable form of documentation to the ARCH Program, or by presenting an acceptable form of documentation to a health care provider or administrator who will certify that the patient’s income as reported on the ARCH Application Form is accurate.
Acceptable forms of documentation include (please provide one of the following):
Instead of sending their documentation to the ARCH Program, patients may instead request a health care provider or administrator to certify their reported income is accurate, by providing the following information on the Application Form:
If you have questions about any of the above requirements, please contact one of the ARCH Program case coordinators at 1-877-393-9071.
*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.
Kyleena does not protect against HIV or STDs.
Only you and your healthcare provider can decide if Kyleena is right for you. Kyleena is available by prescription only.
For important risk and use information about Kyleena, please see the Full Prescribing Information.
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. Mirena is recommended for women who have had a child.
INDICATION FOR SKYLA
Skyla® (levonorgestrel-releasing intrauterine system) is a hormone-releasing IUD that prevents pregnancy for up to three years.
Mirena and Skyla do not protect against HIV or STDs.
Only you and your HCP can decide if Mirena or Skyla is right for you. Mirena and Skyla are available by prescription only.
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.