Initial Consult

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E-Koz's picture
Joined: 02/16/11
Posts: 411
Initial Consult

Well-we have a plan! And honestly, that's enough for me to be excited at this point. I'm starting BCP with my June period, and will likely undergo ER/ET in late July. It was a ton of information, but the good thing was due to all of our previous testing the only things I had to do were a blood test for HIV and/or Hep. (my hubby too) and they measured my uterus via ultrasound. We have an IVF class in two weeks and then it's just a waiting game for the June period. That will seem like the longest month ever! Kind of bummed out b/c we could have started with my period this month but my RE's office is closed for two weeks around the time we would be doing our ER due to a National IVF conference so we have to wait. Oh well.

Now to start calling my prescription carrier. Oddly, my insurance doesn't cover IVF, but the drugs ARE covered, so trying to get a handle on what we will be paying for those....

Joined: 04/21/08
Posts: 1063

That is great that the drugs are covered. That is a huge part of IVF expense. Congrats. You'll have to let us know what protocol they are going to do.

E-Koz's picture
Joined: 02/16/11
Posts: 411

"neoncandle" wrote:

That is great that the drugs are covered. That is a huge part of IVF expense. Congrats. You'll have to let us know what protocol they are going to do.

He said "normal Lupron" and then described it as BCP for two weeks, then one week of Lupron BCP overlap, then on to stims (Follistim and Repronex I believe) for 8 days, and assuming everything is where it should be ER after that. He does a 5 day transfer. I don't know for certain the drugs are covered--I'm waiting on a call back. They are on the list of meds available on my Rx plan, so they will be covered in *some* form, I just don't know what that is. So, fingers crossed b/c it will save us a TON!

I see you had 6 make it to 3 days--YIPPEE!! Good luck with everything!

DancingNancy's picture
Joined: 08/30/11
Posts: 520

Welcome! That's the same procotol we used this last time. Good luck with everything.

Joined: 04/21/08
Posts: 1063

We used a long lupron protocol... was a month of shots... so annoying. And things are going well, but the MD was hoping for more follicles. In reading, looks like I was "over suppressed." Such a fine line they have to walk between being over-suppressed and dealing with OHSS. It will be here before you know it.

Joined: 03/02/07
Posts: 473

Glad you have a plan. The waiting is tough once you decide to go forward. That helps a lot that insurance will pay for the drugs. The difference for me was about $6000 vs. $300. Good luck, keep us posted!

meggyrn's picture
Joined: 02/16/09
Posts: 2263

Anything is exciting once you get to the point of starting IVF. Things will move along quickly for you and ER will be here before you know. It's nice that you don't have to do much more testing since that's already been done. I agree, meds are the biggest expense of IVF, so it's nice that they are covered for you.

E-Koz's picture
Joined: 02/16/11
Posts: 411

Ugh! I hate insurance. And I WORK in insurance!!

Anyway, after multiple phone calls I was advised that yes, fertility drugs are part of our prescription benefit plan, but because my health insurance policy doesn't cover infertility they won't "sponsor" the drugs. When I asked what that means they said "well, it means you can get the drugs under your benefit policy with a 100% co-pay." I asked if that was a nice way of saying "out of pocket" and she said yes. Grrrrrrr.

meggyrn's picture
Joined: 02/16/09
Posts: 2263

100% co-pay? It's nice how they try to sugar coat things.

I got my meds for my 1st cycle from the hospital pharmacy at the hospital DH works at. It was cheaper than getting them at other pharmacies. For my 2nd and 3rd cycles I got them online and they were much cheaper, like $1000-$2000 cheaper. The clinic you are going to will try to get you to get your meds from a local mom and pop pharmacy in DSM. They say they've "worked out a deal with them" but the online place is much cheaper. After I figured out how much cheaper my micro-dose lupron was online I was shocked, even though they guarenteed it would be the cheapest at the pharmacy. I think I got charged $80/vial at the pharmacy and it was a small vial. Online it was a larger vial and only $10. I think the RE clinic must get a kick back from the pharmacy. The RE office acted inconvenienced by having to fax the orders to the online place and asked me if it was really worth the savings for more stress. Hello? The amount I was saving probably was the nurse's monthly salary. So yes, it was worth saving a couple thousand dollars.

Did you see the story on the news channel 13 last night about the lady donating her embryos from Grimes?

E-Koz's picture
Joined: 02/16/11
Posts: 411

I know what pharmacy you're talking about! Smile I didn't see the story (I get up at 4:30 in the morning to work out so I NEVER make it to 10:00 pm!) but saw the preview and was completely intrigued.

Would you mind PM'ing me the pharmacy you used? At this point I will be doing whatever I can to save money!

DancingNancy's picture
Joined: 08/30/11
Posts: 520

Hope you are able to get everything straightened out.

yipeeladybug's picture
Joined: 01/18/06
Posts: 1214

Erin, I'm so excited for you!! That's a bummer your plan claims to cover your drugs when really they don't. I agree with other ladies, waiting is really, really hard...but once you are ready to go, man, does it go fast and ever so busy!!

megeyre's picture
Joined: 10/29/09
Posts: 194

Erin- I've been following your story so excited for you that your IVF cycle is right around the corner! Hopefully time will fly by.

I totally understand what you are saying about the cost. We will have to pay out of pocket as well. I picked up the paperwork from my RE today to start filling out the forms and I got the paper with the cost breakdown. Yikes. In the end- it will be so worth it! Smile

kadibug's picture
Joined: 07/17/11
Posts: 247

It is so hard to make it from the consultation to the ER... *sigh*... then the few days of waiting to find out about the ones left behind in the lab... will they make it? how many?

IVF is so full of stress. I really admire women that have gone through it multiple times.

My insurance sucked with coverage. I too had 100% co-pay but on everything. Super fun.

E-Koz's picture
Joined: 02/16/11
Posts: 411

I know, I'm not alone at all. I just think---it's so unfair what is covered and what is not and the basis for those decisions. And like I said, I'm a corporate lawyer--I work for an insurance company (agricultural, not health) so I *understand* the policies, but I am grouchy at my employer for not realizing this is an important enough issue to at least offer the coverage. I would happily pay more for it. But--I digress! My husband is great and keeps reminding me "it's only money" and he's right--BIG PICTURE.

Meg--I'm watching you too! Smile We've been around for about the same length of time. I think you're right--I think the time will go quickly. It already has a little because now I know when we will start and so time is not longer measured for me in two week increments. I get to have a normal sex life for two months! Smile It's actually made it a lot easier in that regard!

celticbandgeek's picture
Joined: 06/14/10
Posts: 950

I think (although you need to check with your insurance company to be sure) that by saying they are covered with 100% copay, it means that although you have to pay OOP (which definitely stinks) it will count towards your OOP max. It is still a big chuck of change to GET to whatever that number is for you, but once you go over it, it sounds like they will start paying then.

Check with them and see what they say.

Jean

mrs.doolittle's picture
Joined: 02/18/08
Posts: 1335

Erin, there was a thread at the top of the clomid board with some pharmacies you may want to get a quote from since you have a little time. I didn't use the local pharmacy either (except for some PIO one time). Also, check online with the company that produces Follistim. Sometimes they have discounts for OOP customers. And remember to hold onto all your receipts for tax time. I think medical costs have to be 7% of your income before they really matter, but IF costs add up fast!

I hope your first cycle is a success!

E-Koz's picture
Joined: 02/16/11
Posts: 411

Jean--thanks, that's a good point. I've left a message with them to ask. The issue might be that my health plan covers exactly zero for fertility, so it's possible that the "cap" that applies to everything else doesn't exist as to fertility drugs. But, it's worth asking, for certain!

Beth: Thanks, I'll check it out. Yes, I'm counting on tax time because I know we will have no issues meeting that threshold. I already had one surgery this year! :/

JKfmAustin's picture
Joined: 12/07/10
Posts: 2421

Erin, I wish you the best of luck on this exciting journey! I'm going to be stalking you for sure! Good luck! Biggrin

Joined: 07/26/04
Posts: 1595

Hey sounds like a plan!!!! Good luck!! Insurances suck! I hope you can find a way to get them cheaper.

E-Koz's picture
Joined: 02/16/11
Posts: 411

Thanks everyone! I'm sure I will have more to say once I actually get things underway! For now it's like, the longest 5 week wait of my life.