How to Help Your Patients Save Money on Mifepristone: A Provider's Guide to Savings Programs

Cost is one of the most significant and underaddressed barriers to mifepristone access for patients. Without insurance coverage, mifepristone for abortion ranges from $50 to $800 depending on the channel, while Korlym for Cushing's syndrome can exceed $15,000 per month at retail. Providers play a critical role in connecting patients with savings resources — but doing so effectively requires knowing what's available, who qualifies, and how to initiate the process efficiently. This guide provides everything your clinical team needs to help patients manage mifepristone costs.

Part 1: Cost Assistance for Mifeprex (Medical Abortion)

Understanding Insurance Coverage for Medication Abortion

Coverage for medication abortion is highly variable and depends on the patient's state of residence, their insurance type, and their plan specifics. In states where abortion is legal, many ACA-compliant insurance plans cover medication abortion as part of reproductive health benefits, reducing patient cost to $0-$30. However, important exceptions apply:

• The Hyde Amendment prohibits use of federal Medicaid funds for abortion (with limited exceptions for rape, incest, and life endangerment). Some states fund abortions through state Medicaid funds, but this varies.
• Some states specifically prohibit private insurance from covering abortion — meaning even commercially insured patients in those states may not have coverage.
• Self-insured employer plans (common for large employers) are governed by ERISA and may have different benefit structures than fully-insured plans.

Practical step: Build a protocol for your intake team to verify abortion coverage early in the patient encounter — before the visit — so patients know their financial obligation upfront and can be connected with assistance resources before they become barriers.

Abortion Funds: The Primary Safety Net for Uninsured Patients

For patients without coverage or with high out-of-pocket costs, abortion fund organizations are the most important financial resource available. Every clinical team serving abortion patients should have these contacts readily available:

• National Abortion Federation Hotline Fund: 1-800-772-9100. Provides financial assistance for abortion services including medication abortion, and can refer patients to providers in their region. Can be called by both patients and providers.
• National Network of Abortion Funds (abortionfunds.org): A directory of local abortion funds organized by state. Many can also assist with travel, childcare, and lodging. Particularly valuable for patients who need to travel to access care.
• Aid Access: A European-based telehealth service that provides mifepristone and misoprostol on a sliding-scale fee — as low as $0 for patients who qualify based on income. Particularly relevant for patients in states with telehealth restrictions who seek mail services.
• Planned Parenthood sliding-scale fees: Planned Parenthood centers apply sliding-scale fees based on income. Patients who are uninsured or underinsured should ask at booking about the income-based fee scale.
• Plan C (plancpills.org): A regularly updated guide to affordable abortion pill options by state. Useful to share directly with patients navigating cost and access simultaneously.

Part 2: Cost Assistance for Korlym (Cushing's Syndrome)

Prior Authorization for Korlym: Setting Patients Up for Success

Korlym retail pricing exceeds $15,000 per month — insurance is not optional for most patients, it's essential. Prior authorization (PA) is required by virtually all insurance plans for Korlym. The PA process typically takes 2-4 weeks. To avoid treatment delays, initiate the PA process at the time of prescribing — not after the patient tries to fill it at the pharmacy. Key elements of a strong Korlym PA submission include:

• Confirmed diagnosis of endogenous Cushing's syndrome with laboratory evidence of hypercortisolemia
• Documentation of type 2 diabetes or glucose intolerance secondary to Cushing's syndrome
• Evidence that surgery was attempted and failed, or documentation of why the patient is not a surgical candidate
• Documentation of other failed or contraindicated treatments if applicable (step therapy requirements vary by plan)

Set a PA renewal calendar alert — Korlym PAs typically require annual renewal, and a lapsed PA is the most common cause of specialty pharmacy supply disruptions for Korlym patients.

Corcept Therapeutics Patient Assistance Program

Corcept Therapeutics (the manufacturer of Korlym) offers a patient assistance program for commercially insured patients with high out-of-pocket costs, as well as uninsured or underinsured patients who qualify based on income. The prescribing provider's office typically initiates this process. Contact Corcept Therapeutics at 1-855-844-3270 to discuss enrollment, eligibility requirements, and the application process. Hub services from Corcept can also assist with PA submission, benefits investigation, and specialty pharmacy coordination — a significant resource for endocrinology practices managing Cushing's syndrome patients.

GoodRx and Discount Drug Programs for Mifepristone

GoodRx coupons are available for generic mifepristone 300 mg (used as Korlym for Cushing's) and can reduce costs significantly at participating retail or specialty pharmacies. GoodRx reports savings of up to 81% off retail for generic mifepristone 300 mg. For Mifeprex (200 mg for abortion), GoodRx is less applicable because it's dispensed through specialized REMS channels. However, it's worth checking for any mifepristone formulation at any pharmacy your patient might use. Additionally, some specialty pharmacies negotiate their own contracted rates that may be lower than GoodRx — encourage patients to ask the specialty pharmacy about all available pricing options.

Managing PA Appeals and Coverage Denials

Insurance denials for Korlym are common and should not be accepted as final without attempting an appeal. Clinical teams should be prepared to:

1. Request a peer-to-peer review with the plan's medical director — endocrinologists who can articulate the clinical rationale directly often have success reversing initial denials.
2. Submit a formal written appeal with supporting clinical documentation, peer-reviewed literature, and any applicable clinical guidelines.
3. Contact Corcept Therapeutics hub services — they have experienced teams that support PA appeals and can provide appeal letter templates and supporting materials.

How medfinder Supports Patient Access — Beyond Cost

Even when cost is resolved through assistance programs, patients still need to find a pharmacy that can fill the prescription. medfinder for providers can call pharmacies in the patient's area to identify which ones are REMS-certified and can fill their mifepristone prescription — reducing calls your clinical staff have to make. Combined with the savings resources in this guide, this creates a more complete support system for patients facing access barriers. See our related guide: How to Help Your Patients Find Mifepristone In Stock.