Infertility

insurance is already really annoying

so for the past three years we had $40K in fertility treatments.  of course, the year we need it, my husband's company switches plans and now it's $25K.  how many IVF cycles to you ladies typically see in a year?  i know this can range per person.  but do you usually see some doing 3 IVF cycles within a year? 2?  more than three?  i know it depends on the response/cancelled cycles and all that.  from what i have seen, on boards and IRL, i dont see someone doing more than 3 in a year.  either RL gets in the way, there are cancelled cycles, a natural cycle, etc. We can really only afford to do 2 this year with that insurance cap, between now and June of next year, before we have to pay some out of pocket....i guess i should be happy we have at least that, but for years we knew that we had $40K if we needed it so just finding out that the plan changed and it's only $25K is frustrating.

Re: insurance is already really annoying

  • I unfortunately cannot add to this b/c I am fully OOP. I do see how hard it would be if you mentally were hoping for $40K and now only get $25K but as I mentioned I am OOP and just went through IVF #1 for $17,000 with no success and now that money is gone. But if I was you I would try to keep in my mind how fortunate I was to have insurance help and that can soften the change from $40k to $25K. Best of luck to you and I hope that you $25K will be plenty for you and your DH to get a family!!
    ME- 35    DH- 40
    TTC #1 
    IVF#1 w ICSI- 4/20/11 ER, 6 Eggs, 4 Fertilized, 4/25/11 5 day ET, 2 blasts- 5/4- Beta= BFN- No Frosties 

    IVF #2 w ICSI-6/21/11 ER, 4 Eggs, 2 Fertilized, 6/24/11 3 day ET 2 embryos- Beta 7/5/11- BFN- No frosties.
    NEW RE
    IUI #1- started 50ius of follistim 1/25, IUI 2/3/12 - BFN
    AMH-0.73- DOR 2/2012

    IUI #2- 3/17/12 started 200ius of Follistim , 3/24/12 added ganirelix, 225ius Follistim and 75ius of repronex, IUI- 3/30/12, Beta April 13, 2012-BFN

    Appointment with Dr. Schoolcraft at CCRM July 18, 2012
    WAITING ON A MIRACLE AT THIS POINT
    AMH tested again 1/2013- 1.4!!!!
    IUI #3- 1/14/13 started 200ius of Follistim, 1/20/13 added menopur and ganirelix, IUI 1/25/13. Positive HPT 2/6/13- Beta #1- 193- BFP!!! 2/8/13-Beta#2-426.6
    2/26 ultrasound #1- TWINS!
    Delivered a healthy beautiful baby boy on 10/17/13 10ls. 2 ounces

    TTC #2 
    AMH .75 VERY POOR RESPONDER
    IUI #4 cancelled due to only one egg responding 
    IUI#5 cancelled on CD 10,  (3) follicules were still very small even on 300 IU's of Follistim. Also found fluid in my uterus from C-section scar
    BFP- 8/9/15 
    Beta #1 8/10/15 13DPO-   9.2 (fingers crossed this sticks)
    Beta #2 8/12/15 15DPO   39- progesterone 18 
    Beta #3 8/14/15    111- progesterone 17.5
    Ultrasound August 31- 


    PAIF or SAIF Welcome


    image



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  • It makes a difference if your meds and diagnostics are not included in that $ cap, and if your clinic has adjusted rates for insurance carriers.

    We did 3 IVFs between July and December, so we could feasibly do 5-6 per year if that was where our priorities lay. We had a 5 month break because I had a chemical, we switched clinics, I had a lap, etc.

    You have no idea why people cycle when they do, you need to talk to your clinic directly about it. Some clinics only cycle 4 times a year. Some REs require a recovery month (or more) between cycles. Etc.

    Considering that most people here are paying OOP for their treatments, having $25k is a blessing. I know it's disappointing when you're expecting more, but every open enrollment is a gamble.

    +++
  • that's a good point about separate coverage for the meds...there is an extra $10K for the meds.  i have not started any meds at this point so i have no idea how much meds might cost.  im assuming $10K for the meds is okay?

    we will have to talk to the RE anyways though bc the place i am going is out of network insurance.  so we have to see if they will give us a discount.  it wasnt a big deal last time since i was only there for a month, but we might have to switch anyways due to the out of network insurance, which stinks.

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