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yay! drugs are covered!!!

SweetieShellieHSweetieShellieH member
in Infertility
Yesterday I went on my hubby's health insurance website to submit a claim for massage therapy that I had last week. In his booklet, it says fertility drugs are NOT covered. As far as I know, Ovidrel is only used for fertility purposes, so I paid OOP and purchased at my clinic instead of the pharmacy the 2 shots for my IUIs a few months back. I never actually looked it up on the site. Since I was on it yesterday, I decided to enter the DIN # just to see it say NOPE, but instead it was eligible for 80% coverage!! I was like what????? Luckily I still had my receipts and then submitted those too! :) Then I entered in every fertility drug I could think of, and ALL of them were eligible! 

I just hope they don't deny the claim!
*** If you want to know where I (and soo many others) have gone, click here ***
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Re: yay! drugs are covered!!!

  • AimothyAimothy member
    My insurance says they don't cover infertility, but we've been submitting claims for our IVF cycles and they've been covering a lot of the items. What they don't know won't hurt them, right?
    Siggy/Ticker Warning


    IVF #1: August 2012 Lupron Protocol | 8R 8M 8F |Transfer 2|BFN
    IVF #2: April 2014 Antagonist Protocol|12R 11M 10F|Transfer 2|BFP | m/c 5.8.14 
    FET#1: Transfer Day 8/29 | BFP | Beta 1: 302 Beta 2: 732
    U/S shows two beautiful heartbeats at 122!!
    Lost Baby B at 9 weeks 
    Baby A is our stubborn little fighter with a heartrate of 169!

    Team BLUE!
    image




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  • megwill126megwill126 member

    Great news!

    @aimothy I'm so trying that!

    Married 8/6/2011 Me (26) DH (33) SA normal,HSG clear TTC since August 2011 7/2012 50mg Clomid+Trigger+IUI+progesterone =BFN 8/2012 100mg Clomid+estrogen+Trigger+IUI+progestrone=BFN 10/2012 100mg clomid+Gonal+Lupron+Trigger+Progestrone+IUI=BFP but ectopic.
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  • RunCC37RunCC37 member
    Woohoo!!
    **SIGGY WARNING**

    Me: 32 DH: 35  TTC#1 since March 2012
    Dx: Poor Embryo Quality, Arcuate Uterus, Poor Uterine Blood Flow, Mild Endo, 
           Protein S Deficiency, Sjorgen's Syndrome 

    IUI #1-5: BFN
    Laparoscopy & Hysteroscopy: minimal endo, partial septoplasty
    IVF #1: 10R/6M/6F ~ Day 3 ET = BFN
    IVF #2: 14R/9M/5F ~ transfer canceled ~ all embryos arrested at 1-2 cell stage
    IVF #3: 9R/5M/5F ~ 1 frosty!
    IVF #4 (FET #1): BFN

    IVF #5 (DE IVF #1 with Dr. KK protocol): Currently PREGNANT!!!!!!
    Synthroid + Prednisone + Metformin + Baby Aspirin + Supplements Galore = 15+ pills a day
    Lupron + Lovenox + Delestrogen + IVIG + B/W = 2-5 pokes a day
    19R, 17M, 17F - transferred two Grade A blasts 11/16, four frosties!!!
    Beta #1 11/24 (13dpo/8dp5dt) = 367 ~ Beta #2 11/26 (15dpo/10dp5dt) = 709
    Beta #3 11/29 (18dpo/13dp5dt) = 1,997 ~ Beta #4 12/1 (20dpo/15dp5dt) = 3,403

    imageimageimage

    My Blog: Running and Dreaming for Two ~ All are Welcome!
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  • Lillovebug79Lillovebug79 member
    edited June 2014
    My insurance only covers fertility drugs at 30%, but it covered my Pregnyl and Lupron at 80% (like all other drugs). I guess because they aren't solely "fertility" meds like FSH drugs which are only used for fertility.
    Edited to add that I did have to have them filled though my insurance's specialty pharmacy to be coved at all though. I learned that after I paid full price the first month with Pregnyl.



    ********Siggy/Ticker Warning***********



    Me (35) no known issues DH (37) MFI. TTC 21 months (24 cycles)
    Dx MFI with low to normal count, low motility, morphology 3%
    HSG normal, ultrasound and labs on me all normal. 

    1 cycle of Clomid 50mg and TI, unmonitored by OBGYN= BFN
    1 cycle of Clomid 50mg and IUI, unmonitored by OBGYN= BFN
    Started seeing an RE!!
    2 more cycles of clomid 50mg (great response), with IUI and Pregnyl trigger (4.8-8 mil good ones after wash) = all BFN
    1 cycle of clomid 50mg (3-7) followed by Follistim 75iu (7-11) + IUI = BFN
    December 2013 DH saw urologist and is taking Anastrozole, CoQ10, and L-Carnitine
    IUI #5 natural cycle (needed a med break) = BFN
    IUI #6 Follistim 75iu (CD3-10) + Pregnyl (CD11) + IUI (final count after wash 300K) = BFN
    IUI #7 Follistim 75iu (CD3-9) + Pregnyl (CD11) + IUI on 2/20 (post wash count 12.5 million)= BFN
    IUI cancelled (DH OOT) Clomid 50mg (CD3-7) 1 follicle +(not well timed) TI = BFN
    IUI #8 and last one!! Clomid 100mg (CD3-7) +OPK before US + IUI 4/17 (post wash 8.5 mil)= BFN

    Pre-IVF testing complete! SHG great and measurements taken! Labs for infectious diseases completed, FSH (5.4), TSH (1.6), Prolactin (11), AMH (2.6), Estradiol (40).

    Started BCP 5/29 and Lupron 6/11 prep for IVF #1! Started follistim 225u/day on 6/28. Monitoring on 7/2 >15 follicles measuring 11-14, E2 758. Monitoring on 7/5 all ready to go!! Great follicle sizes and lining is at 9. Tigger 7/5, ER 7/7 16R 9M 3F. Stimmed too fast in just 7 days. 7/10 3dt of 2 8-cell grade 2 & 4. 7/14 P4 >60.
    Holy crap BFP!!!
    Beta #1 (14dpo) 7/21 112 Beta #2 (16dpo) 7/23 286 a Beta #3 (18dpo) 7/25 761 Beta #4 (21dpo) 2631!!! Hold on tight little embies!!      First Ultrasound 8/7- 1 perfect little bean with a beating heart 117bpm!! EDD 3/30.
    Second ultrasound 9/2 Little bean measuring a few days ahead with a heart rate of 161!


    PAIF/SAIF/All Welcome!

    image




    Pregnancy Ticker} 




    March 15 Siggy Challenge: You had one job

    image
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  • sweetsurrender9sweetsurrender9 member
    Hooray!  This is great news for you!


    image

    image     image

    Me (34): MTHFR, PCOS, Endo, left salpingectomy due to hydrosalpinx, 
    hypothyroidism, low AMH (0.26)/normal FSH/average AFC of 12

    Him (33): No known issues

    November 2013-March 2014: Natural cycles
    April 2014: Clomid 100mg and Ovidrel trigger -- BFN
    May 2014: Clomid 100mg and Ovidrel trigger -- BFN
    July 2014:  IVF class -- Check!
    Holy crap.  Unmedicated BFP 7.22.14.  EDD 4.01.15.
    Best April Fool's Day ever!
    Now on Lovenox, prenatals, Vitamin D,
    Folic Acid, and Synthroid.
    Please be our take home baby.

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  • Sunny BSunny B member
    That's fabulous news!
    TTC since May 2012
    Me: 32 H: 31
    DX: MFI-Very Low Count, I have Hashimotos.
    IVF prep September 2013 cancelled due to Ovarian Cyst
    IVF #1 October 2013 Antagonistic Protocol with ICSI  ER 10/31/13 (18R 16M 11F- 6 blasts to freeze)
    ET delayed due to OHSS 
    FET scheduled for July 8. Delayed due to a crazy high TSH (it had been under control for YEARS!)
    FET #1 8/5/14 sET BFN 

    All welcome!
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  • Sigh202Sigh202 member
    Awesome!
    Ready to take the road less traveled. 
    Report Reply
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