Thursday, November 19, 2009

Out of Pocket

On October 7 we met with our RE for the first time (at our clinic you start treatments and work with an NP long before you meet the actual RE). We had both just started meds for our first IVF cycle the day before, and after meeting with the RE it was recommended that we convert back to IUI and take a more conservative approach.

After we met with the RE we met with the finance coordinator to make sure that our insurance benefit would allow us to take a more conservative approach and still be able to cover a fresh IVF should it be necessary. At that time she recommended to us that we call the insurance company and get a full report of all charges against our IF coverage to date.

Our insurance is set up so that we each have a $10K lifetime max benefit which is applied toward the diagnosis and treatment of infertility. Our Rx plan is entirely separate from this.

We called Blue Cross Blue Shield and ordered a report on October 7 and we were told it takes up to 30 days to process such a report. In the meantime we went ahead with a Letrozole/IUI cycle (BFN) and we currently in the 2WW for our injectibles/IUI cycle now.

We got our insurance report in yesterday and as of the end of our Letrozole cycle I had already used up just over $7000 of my benefit. Turns out all of the diagnostic testing done at my GYN and all of the repeat testing at the RE's office used up the majority of my benefit just diagnosing the fact that, yes, we cannot make a baby on our own. Each monitoring appointment at the RE's office costs us just over $500 which means that my injectibles/IUI cycle during which I had 4 clinic appointments (=$2000) and one IUI (=???), will have eaten up the last of my insurance (or darn near close to it).

Joe had only used up $2400 of his benefit, so even with the wash and IUI this cycle he still has plenty of coverage.

I don't even know what to say. Our next step is IVF and we're going to be (almost) completely OOP for it. A fresh cycle at our clinic is $7000. And then there is the consideration of enrolling in IntegraMed, which we still have the option of doing. The insurance plan is $16,100 for 3 IVF and unlimited FETs. I'm not sure we'd need 3 IVFs, but I never thought we'd need IVF in the first place either...

I called the clinic's financial coordinator and my NP yesterday and so now I'm basically sitting to find out what to do next. This just sucks.

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