Trouble TTC

Actual cost of IUI with insurance...

I am incredible lucky to live in a state with mandated IF coverage, and I try to remind myself this everyday.  With that said, if we had to be OOP we would probably not be able to be here as neither DH nor I have well paying jobs. 

I was just looking over my insurance account online to see if they had posted a decision yet on my next requested IUI cycle.  I came across the info for my 1st cycle.  I know there is a lot of discussion on the boards about the cost of procedures in different locations of the country  and think of IUI (the washing and procedure) as about a $300 procedure based on what I have read.  I was disgusted to see that  the negotiated rate between my insurance and my clinic is $35.35!!!  Yes, you read that correctly thirty five dollars and thirty five cents!!!  I can't help but believe that if they can do it for that cost for insurance that they could do it for OOP. 

Married: 7/2/11 TTC: 12/2011
Me: 31, PCOS DH: 37, low morph and low counts

4 medicated TI, 1 IUI+Femara, 1 IUI+GonalF = BFNs
IVF #1 Lupron/GonalF (Dec 2012)= 30R, 21M, 21F with ICSI, 18 HIP frosties!!!
FET in August 2013

Re: Actual cost of IUI with insurance...

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    Yeah it's pretty nuts.  The cost of sperm washing plus IUI (no monitoring, drugs, etc.) at my place is $200 but insurance only gives them $70 and I give them $20.  A bunch of people travel from out of state to go to my practice so it's sad to think they are all basically subsidizing my care.  I wish more states would change their insurance laws.
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    Yeah, living in a state with no mandated coverage sucks. We thought our baby savings would be to support the baby, not to conceive the baby... :/
    *** Trigger Warnings ***

    TTC #1 since March 2011
    Dx = Unexplained IF
    1 medicated TI cycle & 4 clomid IUIs = all BFNs
    June 2013 IVF #1 = 6 frosties + BFP!
    DS1 born 2/14

    TTC #2 since December 2014
    May 2015 unassisted BFP ended in m/c at 7wks
    April 2016 FET #1 = BFN
    June 2016 FET #2 = c/p
    August 2016 FET #3 = BFP!
    DS2 born 4/17
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    Being OOP sucks.  I live in a state with some mandatory coverage, but unfortunately I work in a neighboring state with no coverage.  We haven't even started treatment yet and we have already spent over $1700 just on testing and I still have 7 DPO blood work to do (scheduled for Monday).  I knew treatment would be expensive, but I never imagined how expensive the testing alone could be.




    TTC #1 since August 2011

    My Blog

    September 2012: Start IF testing

    DH (32): SA is ok, slightly low morph, normal SCSA  Me (32): Slightly low progesterone, hostile CM, carrier for CF, Moderately high NKC, High TNFa, heterozyogous mutated Factor XIII, and +APA

    October 2012-May 2014: 4 failed IUIs, 3 failed IVFs, and 1 failed FETw/donor embryos

    November 2014: IVF w/ICSI #4 Agonist/Antagonist with EPP and Prednisone, Baby Aspirin, Lovenox, and IVIG for immune issues.  Converted to freeze all due to lining issues.  2 blasts frozen on day 6!

    January 2015: FET #2 Cancelled due to lining issues

    April 2015: FET #2.1

    PAIF/SAIF Welcome!

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    State mandated coverage doesn't = wonderful all the time.  I live in IL and we have mandated coverage.  But there are tons of small print.  So for me ours covered testing only.  Any and all procedures are 100% OOP.  So yes, it was nice to get testing out of the way it's like "We'll pay to tell you your eff'd up, but not one cent to help you overcome it!"  over $4,000 in treatments later OOP and I really wish I could pay the insurance negotiated rates.  Make my 5% cash discount sound like crap.

    TTC since July 2009. Dx MFI & LPD. 
    IUI#1&2&3 (2011 & 2012) BFN
    IUI#4 1/23/13 on 75iu x9 Follistim = BFP then chem preg m/c (Feb 2013)
    IUI#5 BFN (April 2013)
    IVF w/ICSI Oct. 2, 2012 - 13R, 11M, 7F, 1 frozen blast 4BB grade - - - FET Nov 15, 2013
    BFP! Beta 1:104 @ 10dp6dt, Beta 2:178 @ 12dp6dt,  beta 3:366 @ 14dp6dt
    Saw heartbeat twice before missed M/C at 8w3d on 12/27/13, missing my little angel boy
    JUNE 2014 IVF#2;  5R, 2M, 1F Three day transfer 6/7.  Beta 6/18 - BFN
    Child Free Now?

    My Blog


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    My insurance pays about $100 for an IUI.  The whole thing is crap.  For IVF at least my clinic has a negotiated rate for OOP clients that brings the price closer to insurance prices.  But the health care billing system in this country is completely and totally broken. 
    TTC with PCOS since July 2011.
    IVF Oct/Nov 2012
    Beta #1 = 77, Beta #2 = 190, Beta #3 = 1044
    Cautiously optimistic.
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    Yeah, living in a state with no mandated coverage sucks. We thought our baby savings would be to support the baby, not to conceive the baby... :/

    This exactly. We are completely OOP even for testing. DH's SA cost us $300 and I was told the HSG would be up to $1800. That's over 2 weeks pay for me so we're having to think about putting it off for a couple months. We technically "have" the money, but that was money we saved for me to take time off work with a newborn and hospital bills for an actual pregnancy and it took us over a year to save that up.

     My coworker was just complaining that she paid $1500 OOP for her live birth, and I'm like WTF I will pay more than that just for one damn test to see if I'm alright.

    TTC from May 2011 to Jan 2013. Due 9/11/13
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    That's completely insane. A factor of 10 difference in price for OOP is not OK. Our experience agrees with yours in that the IUI procedure itself and the sperm washing is usually $300 (and this article on IUI cost in 2012 seems to agree). I really don't know what to suggest concerning what to do except shop around more, or perhaps bring the issue up at your RE and see if they will negotiate with you too like the do the insurance company. I'd be surprised, but it can't hurt to try.

    Good luck.

    TTC since October 2011. No luck yet :( But am learning lots and happy to share stuff we learn. Trying to Conceive Ticker
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