Argh! how much does your insurance cover for injectibles??anything for ivf? - Infertility Message Board

ams37 · 04-09-2003, 07:02 PM

Just curious. I could spit bullets right now>Now I am being told injectibles are NOT covered under my policy. I could cry. We will find out more tomorrow. We had gotten prior authorization for these things..and now wanted to make sure they were covered since the drug co. called us to set up meds to be delivered to our house..and now we find out its denied!!!! We didnt think IUIs were covered at first...actually were told flat out they werent, until my husband did some detective work..and found out we did get covered. We have EOBs showing they are covered..some resubmitted to be covered..which they wre.. If it cost s about1500 for one cycle. I have to do 2 amps..starting day3... I think id rather go ivf and just pay that way..since there is more of a chance with ivf.. I am beside myself..then I have that surgery in 48 hrs!!..We are calling back tomorrow...since eveyone was closing so we are hanging until tomorrow am..to find out.We were told we had full coverage for the injectibles..this is getting too draining for me.
Let me know what kind of coverage you all get with fertility drugs..procedures..etc. Sorry I needed to vent......... take care all!Anne

TessaL · 04-09-2003, 08:09 PM

Well, I work for the ins company, so mine gets covered at 100%. One of the perks of living there.

What state are you in? Some states have mandates regarding whether it's covered or not.

At the company where I work- if we quote benefits saying something is covered, we HAVE TO PAY the claim. Whether or not we were correct the first time or not.

(((Hugs)))

MaLaFo · 04-09-2003, 08:16 PM

O AMS! Keeps getting worse doesnt it? So you have IUI's covered now they are not? I was in no surprise to find out my scription has no fertility drugs... I ordered 20 vials of repronex, 2 HCG's and 2 centrotide's all for the small price of 979.00 which what i buy, last only 1 month now I am up to 3 vials a night so you see 20 gets me no where quick..so Ill spend another 1000. on meds...2000. for us/ blood and 500 for IUI...add that up...and call me an AS cus i jus spent 10500 for nothing but ups and downs when now Im stuck cus I cant afford to go for IVF to Ill save 2 years...So with the mind games, add money worrrys and its sucky...I hope you have better luck with insurance tomorrow and if you have to buy the meds, there are cheap fertility pharmacys out there...From what I understand, mine is 1 of them...People like me have to call around and get the cheapest or I would be broker than I am...Whens lap..4/11 im thinking? ooomy this Friday? You will be fine and thats just 1 more step to BS

I know you know all my abbreviations! Have a good night and good luck fighting and Lapping...LOL..Mare

ams37 · 04-09-2003, 08:57 PM

Mare and tess!
No matter how sucky a mood I am in...Mare you always come to the rescue.. You manage to make me laugh even in the .... of times. You deserve a medal for all you have gone through Mare.. I am handing you the Official MARE MEDAL! (its encased in gold ..see? lol)
I will let you know how lap goes..IF of course its covered... that too would be a joke if it isnt covered...Well see tomorrow!!
I ended up watching the Bachelor tonite..sort of sidetracked me a while..haha.
Tess. thank u too! I appreciate your comments!and support!!!!!!!!!stay tuned until tomorrow..
P.S>Tess., I have BC/BS(dh works here in Mass)but it is out of virginia..If it was automatically thru here i think mass picks up all fertility services..He is looking into a side job too!! just for meso he could get local ins. with all the bs were going through with the ins. co!! !!!!

[This message has been edited by ams37 (edited 04-09-2003).]

sunnytxgal · 04-09-2003, 09:53 PM

I ordered all my meds today***There is a mail order pharmacy that was highly recommended by the IVF hospital. It's called Freedom Pharmacy. I think they're in MI. I was skepical on using mail order since I have to start taking injections next week. My RE's office fax them the list of what I needed today and I was surprised to get a call this afternoon to verify insurance and such. My meds will be overnighted (no charge) and I will recieve them on Friday. They are supposed to be alot less expensive than going through your local pharmacy. Hope this helps.