I didn't have to pay anything to have mine removed. I hear that the para guard is a good alternative, and it doesn't have the hormones. I actually did a diaphram (yes they're still out there) for a while just to give my body a rest and try to get rid of some of this weight. I've lost 6 lbs (I had gained 18 in the 4 months I had mirena in!!!), but I have since decided to switch to the nova ring. I now have Acne like I did when I was a teenager without any hormons lurking in my system, and I'd rather deal with the hormones than have acne...it seems that as women, we are damned if we do and damed if we don't!