Mifepristone, the first pill in a two-drug medication abortion regimen, typically costs between $25 and $600 out of pocket depending on how and where you get it. The national median for a complete medication abortion at a physical clinic was $563 in 2023, while virtual (telehealth) clinics charged a median of $150.
Clinic vs. Telehealth Pricing
The biggest factor in what you’ll pay is whether you visit a clinic in person or use a telehealth service that mails the pills to you. In-person medication abortion prices have actually risen over the past few years, going from a median of $580 in 2021 to $600 by 2023. Telehealth pricing moved in the opposite direction, dropping from $239 in 2021 to $150 in 2023.
That telehealth price generally covers the consultation, both medications (mifepristone and misoprostol), and follow-up care. Some online pharmacies listed on the resource site Plan C offer pills by mail for as little as $25 without a clinician consultation, or around $150 with one. At a brick-and-mortar clinic like Planned Parenthood of Illinois, a telehealth abortion pill appointment runs $470, which includes the medications, the virtual visit, and follow-up. Prices vary significantly by provider and state, so the range is wide.
What the Price Typically Includes
When a clinic or telehealth service quotes you a price for medication abortion, that number usually bundles several things together: the initial medical consultation, both pills, and at least one follow-up contact to confirm the abortion is complete. You’re rarely buying mifepristone alone as a standalone prescription the way you’d pick up an antibiotic at a pharmacy.
Shipping costs are sometimes built into the telehealth price and sometimes added separately. If complications arise and you need additional care, such as an ultrasound or an in-person visit, that could mean extra charges. Ask upfront what’s included so you’re not caught off guard.
Insurance and Medicaid Coverage
Whether insurance covers mifepristone depends heavily on your state and your plan type. Thirteen states require both private insurers and ACA Marketplace plans to cover abortion. On the other end, 10 states prohibit private insurance policies from including abortion coverage at all, and 25 states ban it from Marketplace plans. In those states, you may be able to purchase a separate insurance rider for abortion coverage, but many people end up paying out of pocket.
Medicaid coverage is similarly uneven. As of the end of 2024, 35 state Medicaid programs covered mifepristone for medication abortion. Thirteen programs did not, with nine of those refusing to cover the drug for any medical use whatsoever. Federal law (the Hyde Amendment) restricts Medicaid funding for abortion to cases of rape, incest, or life endangerment, so in states that haven’t expanded coverage beyond that minimum, most Medicaid enrollees pay out of pocket.
A Government Accountability Office review found that all 52 Medicaid programs (50 states, D.C., and Puerto Rico) are legally required to cover mifepristone at least in Hyde-eligible circumstances, yet some programs were not doing so as of late 2024.
Sliding-Scale and Low-Cost Options
If cost is a barrier, several paths can bring the price down significantly. Aid Access, an online abortion service, uses a sliding-scale model that lets patients choose to pay anywhere from $0 to $150. While most patients paid the full $150, more than 25% of users needed the discounted rate or Medicaid billing, suggesting the option makes a real difference for people who wouldn’t otherwise be able to afford care.
Abortion funds are another resource. These are nonprofit organizations that help cover both the cost of the procedure and, in some cases, related expenses like travel. Eligibility typically depends on your income, household size, and what programs operate in your area. The National Abortion Federation hotline and local fund networks can connect you with assistance specific to your state.
Why Prices Vary So Much
The $25-to-$600 range can feel confusing, but it reflects genuinely different service models. A $25 online option may send pills without any clinician interaction, placing more responsibility on you to manage the process. A $150 telehealth visit usually includes a virtual consultation and follow-up support. A $500+ clinic visit includes an in-person exam, the medications, and hands-on clinical oversight.
Geography matters too. States with fewer remaining clinics often see higher prices due to limited competition and increased demand. Clinics in states that border restrictive states have reported surges in out-of-state patients, which can strain capacity and affect pricing. Your gestational age also plays a role. Medication abortion is approved through 10 weeks of pregnancy, and costs for any type of abortion rise with gestational age, exceeding $1,000 later in pregnancy.