*wannalil1*

patchen30

Re: Cornell, I know you said that one Dr. accepted your insurance but you paid OOP for the procedures and were then reimbursed by BCBS.  I have IF coverage through BCBS, but they told me that b/c Cornell was an "out of network provider" they would only reimburse a portion of the procedures.  Is that what happened with yours?  Or are you covered 100% even when out of network?  I think that regardless of our individiual insurance packages, BCBS would be considered out of network for us both.  Also, do you know why your meds were covered 100%?  I'm just trying to figure out how much of a pain this would be before I switch. 

wannalil1

That is correct.  We were reimbursed 80% - and paid 20% which was worth it for me....we got the majority back - If I recall correctly we had 34,000 lifetime and that ran the course of 3 clomid iuis, 1 injectabile iui, and 2 ivf cycles. 

The billing is tough to keep track of but BCBS never gave me a hassle and I received my checks in the mail fairly quickly. 

HTH!

wannalil1

Oh and as for meds, I think the company I work for provides a special plan for infertility meds and  I think we had $8000 lifetime so all the meds were covered.  For our first IVF cycle, I took part in a Follistim study they were conducting and I got stimming meds for free from the clinic. 

patchen30

Great, thank you.  Good to know that $34K covered all of that - I wasn't sure if Cornell was going to be exorbitantly expensive. 

So what did you like about them so much, out of curiosity?

patchen30

Oh and also - our insurance plans sound very similar b/c mine will reimburse 70% - but they also said that 70% is what they will cover of the maximum allowable coverage for that particular procedure. 

In other words, if 1 cycle of IVF costs $15K and BCBS decides that the "maximum allowable coverage" for that is $10K, then they will only pay 70% of the $10K, and I'll be responsible for the remainder beyond that.  So, in this scenario I'd owe the $5K that's beyond their max coverage, plus the 30% they're not paying. 

I'm afraid it would wind up being very expensive and on top of that, BCBS won't quote me their "maximum allowable coverage" without jumping through a bunch of hoops.

Did you have to deal with all that too?

wannalil1

I never really thought about all the beaurocracy - I think that I wanted a baby so bad that all of that was unimportant and I was going to cross that bridge when i got to it.  All I knew was I wanted a baby and I wanted to go to the best place to have it happen.  We have a huge support system and my family was willing to chip in if we needed any financial help, thankfully it was "not that bad" and we were able to recycle our money.  Meaning cycle 1 didnt work out so we used what we got back from BCBS and added a bit to do cycle #2. 

Cornell was referred to me by a family friend who had difficulties.  She went to a number of clinics in NYC, was of advanced maternal age and literally spent over 100,000 in other places to get and stay pregnant.  Cornell was the only place that brought her dream into reality.  I figured that if they helped her they could surely work wonders on me (I was unexplanied and 30 years old).  Well, our journey there was over a year long but I never felt discouraged.  Dr. S was super encouranging and with each new treatment option before IVF he was optimistic.  Once my first tubal occured I felt deflated and we decided to do IVF.  All went well and then we had another suspected tubal.  At which point I was ready to give up.  Dr S was honest and frank and said that he is confident that IVF would work for us.  We never had a exuberant number of eggs, 7 or 8 max, but they "know" what they are doing.  They trigger you a bit earlier not to over cook the eggs and their motto is "quality over quantity".  So even with 5 or 6 embryos we got to put back 2 and each cycle we had something to freeze.  I did day 3 transfers each time.  They froze at 5 days. 

The monitoring sessions are a bit crazed when cycling but everyone is really nice.  I do not have any other clinic to compare to but Cornell had a great reputation and they gave me my Juliette so I really can not complain.