I have insurance through my work. I've had an IUD for 9 years, and in my yearly today, I inquired about getting it replaced. I figured I'd share what I learned, because it wasn't what I expected. Not sure how what I learned today stacks up to the experience other people would have in other parts of the US, but I figure any info is good info to share. :)

My gynecologist said that I had to contact Paragard myself to get my IUD. Paragard will take my insurance info, find out how much they'll cover, let me know how much I owe, and after I pay, they will ship the IUD to my gyno. Once that happens, my gyno office will contact me about setting up an appointment to have them swapped out.

Actually getting the IUD in will take about 10 minutes, though since I'm getting anesthesia, it'll take a few hours overall. Because of the problems I had getting the first one in, she'll have an ultrasound ready to go, so that she can use that to help guide the new one into the right place.

I am opting to have my IUDs swapped out while under general anesthesia. My uterus is retroflexed (https://baby-pedia.com/uterus-position-size-change/), and getting the first one in was a nightmare (more about that later). I recommend being knocked out to get the IUD done, based on my experience with my first successful one. For the record, All the other women I know who have an IUD (at least four, not counting myself) did so awake, and though it was painful, were OK with it.

My experience getting an in IUD 9 years ago was that the doctor had the IUDs in the office. This doctor was also the doctor who performed my abortion. He had the IUDs already in his office. It cost $350, as it was not covered by my insurance.

Because of my retroflexed uterus, and not having kids, getting the first one up there was a nightmare. There is a kink above my cervical opening, on the way to my uterus, which he had to get it past. He injected my cervix with muscle relaxers (which sucked) and there was still a lot of...really hard pushing and straining on his part, to get it inside me. It was both scary and painful, watching a full grown man use a considerable portion of his muscles to ram something up inside me.

I'd tried to get an IUD about 5 years before this, and the doctor could not get it up inside me. I gave up part-way through, because the experience was really unsettling. Getting an IUD successfully 9 years was still a bad enough experience that I don't want to go through it again - not like that.

So that's it so far. If I find out anything else that's helpful (like the cost of the IUD with my insurance, which is a PPO through Aetna), I'll update.

Also happy to answer any other IUD-related questions.