Let the insurance headaches begin...

gabbagal

Just a little vent if you all don't mind...So after putting it off for a couple of cycles, I finally decided to go through with the Clomid challenge test that my RE wanted me to do. They had originally called in the prescription to my local CVS a couple of months ago, so I finally went in last night to pick it up only to find out it was rejected and the tech told me I have to get it through a specialty pharmacy and will need to call my insurance to find one that covers it. So I'm now 20 minutes into a call with Blue Cross as this nice man on the phone has me on hold as he tries to call all these places that only send meds via the mail. He originally told me it could take a few days, but I have to start taking it in two (CD5). He's called a bunch of places already with no luck and I'm just waiting with awful hold music. I just don't understand why the clinic didn't warn me that some insurances may not cover it in the traditional "walk in and get it" way or why CVS didn't alert me in when I dropped it off or maybe sometime in the last two months that it couldn't be filled. Had I known it would be this difficult, I would've picked it up weeks ago "just in case". Blergh! Call time now 27 minutes and counting...

kelley72

ugh frustruating, I hope it gets settled quickly!

gabbagal

good question, I didn't even ask. I'll call CVS since the nice insurance man finally released me from hold and said he'd call me back when he gets more info

gabbagal

ok, that call was only 10 minutes of sporadic holding - things are looking up! Turns out they do have it and can fill it for about $40 out of pocket. Thanks so much @IFinTN for pointing out something so simple that my stressed out mind didn't even think of! I'm still waiting for the insurance guy to call me back to see what my options are there, but I feel so much better knowing I have a back-up and don't have to push this out for yet another cycle!

PrivateOne

Just in case you may still need advice on the specialty pharmacy route.....I've always used Apothecary by Design and they are fantastic.  Great customer service and very helpful.  They ship meds overnight on a regular basis.  If you still need or want to use a specialty pharmacy give them a call.

https://www.apothecarybydesign.com/ - ph: 877-814-8447

ksgsmu

I use freedomfertility.com  -- they ship overnight

gabbagal

Thank you for the recommendations! The guy from Blue Cross said he found one (Briova) that was covered and had it, but they usually take a couple of days and only ship to arrive on Saturdays for real emergencies (and don't ship on Sundays). I'll try freedomfertility or Apothecary by Design before I officially cede to CVS

Davie813

Glad you'll be getting your Clomid on time one way or another!  Hope the challenge goes well!

shannonm97

Not sure how many pills you need for the clomid challenge test, but you could also check Target or Walmart pharmacy.  We found Target was much cheaper than Walgreens for Clomid.

gabbagal

Thanks for the tip! I only need 10.