Wow, my meds for IVF just cost me $4K

vballbaby

Gotta love the way insurance works. So for my Jan IVF cycle, I'm taking Menopur, Gonal-F, Ganirelix, Crinone, Novarel..it's costing me out of pocket just under $4K. My prescription drug plan has a lifetime cap on fertility meds of $5K. What's crazy is the Menopur alone billed out at $5,436 so that maxed me out right there, however paying cash for the Menopur would have been $2,800. Between insurance companies and Big Pharm, I don't know which I hate more!  Tough pill to swallow today....guess that'll be Christmas present to self. (
Edit: purchased through Freedom if anyone is curious...

Twinkie0612

I'm not sure if you have had everything shipped, but it might be better to split your order and only order what is covered by insurance through freedom and look for better deals on your OOP portion.  I think Freedom is high on menopur, ganirelix , and generic HCG triggers.  I don't know how they compare on Crinone and Gonal-F since I never used those meds, but I thought they were reasonable for gonal-f. 

My meds for IVF #4 would have been $4,600 (cash price, OOP) if I hadn't had a discount through first steps and some left over and donated meds.

Smootiepie

Re: the insurance company charging a lower price for cash vs. covered meds, that's completely a normal practice (although it's absolute bullshit if you ask me). I have absolutely zero IF coverage, and I was quoted a cash price for my HSG that was less than half of the price if we submitted it to insurance.

((Hugs)) @vballbaby‌. I'm with PP, maybe see if you can save some money by doing all or part in cash.

katers79

Oy. ((HUGS)) to you. What a bitch to deal with, especially at this time of year.

shadiddynyc

Yes it is good to shop around. That's what I did for my first cycle as I am 100% oop. I used the discount program called IVF Green light, it saved me the most $ although I'm still waiting for my reimbursement to come in the mail.

vballbaby

@lemonliz yes that's right, if you pay cash you can get it for roughly 50% of the cost. If it's billed through insurance, they bill it @ 100%. What a racket huh? If I would have paid cash for all the drugs through Freedom, it would have been $6,800. Billed 100% it would have been over $12,000. So while it wasn't all paid, I did get it cheaper than having to pay completely OOP. They worked it out and the best way was to bill insurance for everything except the Gonal F. I paid $2,736 for the Gonal F alone....cash price OOP and the only rebate available was $350 for Gonal F. They asked me if I could use Bravelle instead of Gonal-F as they had rebates through IVFGreenlight for Bravelle and Menapur (could have saved $2,000!!), but my Dr.'s words were "no way, that's a terrible drug" so I said forget it. I'm not interested in saving money in the short run for something he feels won't work as well for me. It just came as a shocker because I thought I had better coverage than that. The $5,000 cap is specifically for "specialty fertility drugs." Thanks for commiserating with me though ladies... I told my DH we better have a 24Kt gold baby! ha

saysjess

This kills me!

vballbaby

@sunshinelady15, you're right different meds may work better for some people, and I think Bravelle includes LH whereas Gonal-F does not. I just wonder why it was so much cheaper.. like I said I could have gotten a 50% rebate on Bravelle... I'm glad it worked for you!

Spring78

So sorry you've had such a whammy! The cost of meds is crazy!

I just wanted to second the defense of Bravelle. It worked a little too well for me (31 eggs and mild OHSS). But, yes, everything works different for everybody and Dr's have their own favorites and preferred protocols. I'd just hate for someone to read what your doctor said and walk away questioning their own doctor's plan if it involved Bravelle. It can & does work for many women. But as with any med, there are many factors to consider and each case is different. :-)

vballbaby

Thanks and you're right, I'm sure my dr must just think it's no good for my personal situation since it contains LH. Not sure on that but I certainly will be asking him for further explanation! I know the menopur also contains LH. Don't even know how the LH comes into play I wish I did! Guess this will be my research for the day. Seems to be something new each day that I need to learn about.

shadiddynyc

I don't know why your DR. would say Bravelle is a trouble med! I also used it last month & it worked fine for me. My egg quality was good & I have 5 in the freezer.

vballbaby

Yea I don't know either. But I'm def going to pick his brain. I know bravelle is extracted from the urine of menopausal women and gonal f is chemically made. I won't be seeing him for a while but I'll def let you k ow what he says about it.

vballbaby

@lemonliz‌ I'm not sure what my dosage is just yet, I know it's 75 IU of both Gonal F and Menopur, just don't know how much of each per day. I know it'll be more of one in the am and the pm, alternating. I know we're pretty much on the same timeline though so we'll have to keep in touch! I start stimming Jan. 2nd. I'm on BC now and I hate it, I blew right up and gained 5 lbs in a week and have continued to eat healthy, even juicing some and I cannot shed not one pound! So annoying...:)

afsalinas

I feel ya.  Mine cost 4K when I did my IVF cycle, too.  Then at the end I had a whole fresh unopened box of Follistim!  $800 worth of meds I didn't use.  Luckily, I had a friend who could use it so it didn't go to waste.

vballbaby

@lemonliz well it makes me eat cookies!  and it doesn't help that my husband is notorious for heating one up in the microwave and bringing it to me when I don't even ask for it. I've gained about 12 lbs since starting this fertility journey, and I would say it's about half the meds and half my own fault. The only plus side is that I finally have boobs now! haha. @afsalinas, was that because they monitored you by U/S and decided you were ripe enough??

afsalinas

@vballbaby, Yes, that is why.

browncoatjr

Sorry to hear, but at least you're not alone. I just order my meds for my first IVF.  The clinic's pharmacy said that our insurance would only cover Menopur, Ganirelix, and Folisim if they were filled through Freedom.  Then when Freedom got the prescription, they told me that the insurance wouldn't cover any of those three and it was going to be cheaper to go through the clinic's pharmacy.  So that's what I did.  In the end it cost me $2500. Just wish I hadn't had to waste so much time calling two different pharmacies, my insurance, and the clinic so many times apparently for no reason.