Cost of Abortion Pill in New Jersey

Before you can receive a prescription for the abortion pill there are three questions that need to be answered:

  • Is the pregnancy viable?
  • How far along is the pregnancy?
  • Will insurance cover the procedure?

An ultrasound exam can help answer these questions and determine if you are a candidate for the abortion pill. Keep in mind, a doctor or abortion clinic may charge you a large fee for an ultrasound even if you do not proceed with their services.

Is the Abortion Pill Available Over-The-Counter?

Abortion Pill Not Over-The-Counter

You cannot pick up at the abortion pill over-the-counter or order it online in New Jersey. It is not available without a prescription. You must follow a government-mandated regimen. The Food and Drug Administration lists the requirements for obtaining abortion-inducing medications across the United States.4

  • Must be ordered, prescribed, and dispensed by or under the supervision of a healthcare provider who is licensed to prescribe and meets certain qualifications.
  • May only be dispensed in clinics, medical offices, and hospitals by, or under the supervision of a certified healthcare provider.
Cost of the Abortion Pill without Health Insurance

Abortion Pill Cost Without Insurance

The financial cost for the abortion pill regimen in New Jersey without insurance can reach as high as approximately $800 and may include some or all of the following medical services.5

  • 2 doctor office visits
  • Ultrasound
  • Methotrexate/Misoprostol
  • Pain medications
  • Antibiotics

A free ultrasound could help you avoid a significant portion of your expected expenses.

Cost of the Abortion Pill after Insurance Pays

Abortion Pill Cost After Insurance

Your share of the cost of the abortion pill regimen after insurance pays depends on the plan. Every plan has cost-sharing elements. In addition, some plans exclude coverage for any abortion-related procedure.

Read more about insurance for elective abortions in New Jersey on a separate page. This page answers these general questions and others.

  • What does it cost after insurance pays?
  • Will my parents plan cover the services?
  • Will my parents find out if I take the abortion pill?
  • Do I qualify for Medicaid if uninsured?

Since the abortion pill is a prescription medication, your insurance plan’s drug formulary is an additional topic to cover on this page in more detail.

Formulary Tiers

Health insurance plans with prescription drug coverage publish a formulary. A formulary is a listing of coverage levels for a long list of commonly prescribed medications. Most formularies contain tiers, which determine the member’s out-of-pocket cost for the drug.6

  1. Preferred generic: lowest cost tier
  2. Generic: lower cost tier
  3. Preferred brand: middle-cost tier
  4. Non-preferred brand: higher-cost tier
  5. Specialty drugs: highest cost tier

The abortion pill is actually two separate prescription medications – Methotrexate followed by Misoprostol (also known as Cytotec). You will need to look up each medication on your plan’s formulary to determine your cost-share for this component of the protocol.

Keep in mind that your plan will have separate cost-sharing features applied to your office visits, ultrasound, and other medications.

Medicaid Formulary

With New Jersey Medicaid, you will have to choose between plans offered by five different insurance companies, each with a separate and unique formulary.7 Research the formulary for each company to determine your cost-share amount.

Our free ultrasound provides the positive proof of pregnancy needed to enroll in Medicaid. Use the chart below to identify which insurance company offering Medicaid plans in New Jersey list both abortion pill drugs on its formulary. Also look up the tier level to determine your out-of-pocket cost-share.

Company Methotrexate Misoprostol/ Cytotec
Aetna Yes Yes
Amerigroup Yes No
Horizon BCBS Yes Yes
United Healthcare Yes Yes
Wellcare Yes Yes
Sources Used in This Article

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