IUIs and Meds

MDBeachbride

So, I have mentioned that I am waiting for my preauthorization for an IUI.  I sent over my new insurance cards the last week in Dec.  Today, I received a call from a company that was getting ready to fill the order to ship to me.  She went over my coverage and listed that several of the drugs were not covered but they had a "deal" for me.  In total, 5 different Rx's would total $400 for a month.  Now, I know for some of you that's a good deal BUT I am suppose to have coverage up to 10K for my meds.

So, I called the Rx insurer and they agreed with what the person told me -yeah, not covered.  But oh wait...your meds are "fertility" and that's covered by a different division of us...call this number.  I call and it turns out that they are covered but I do have a small co-pay each month.  I didn't have all the names of the new medications but I remembered a few and they verified coverage.

So now, I have to call the RE's office and provide them with a new number to call in the Rx. 

I guess this looong post was a PSA for some to check in detail with your insurance company-yourself.

NowDNAtoo

Thankfully when I was going through my IUIs my REs office knew enough that for fertility meds (except clomid) you had to go through a different pharmacy.  Best of luck to you with your IUI--I hope this is it for you!

MDBeachbride

Hey, I just emailed you back from the weekend. 

Yeah, you would think Medco would have explained it too the REs office when they did the preauthorization. 

Jilliesmomma

Thanks for the heads up.  You wouldn't happen to have Anthem Blue Cross would you?  I think I will give them a call.

FrannyS

With many of the big plans (United, Cigna, Aetna, Medco) fertility meds are covered by the "speciality" pharmacy division of your Rx plan. Also some meds are covered under pharmacy and some under medical.  It may take awhile to sort out but ALWAYS call your insurance company first.  For me, it took about 3 phone transfers around to different areas to get this straight.

I would never rely on what the RE office tells me about my coverage.

hollymichael

For my IUIs, I got my ovidrel from Walgreen's and it wasn't covered. I didn't know why b/c I thought I had coverage, but never asked.  For the IVF, I had to order the meds from a specialty pharmacy and everything was covered (even the ovidrel).

MDBeachbride

Jilliesmomma:

Thanks for the heads up.  You wouldn't happen to have Anthem Blue Cross would you?  I think I will give them a call.

No, I have Unicare.  

QE2

What a headache, but glad it all worked out for you.