TTC After a Loss 6 Months+

Help! Insurance Decisions

Hey ladies - it's that time of year where we select our health plan for next year.  My DH and I are very fortunate to have a lot of options, but we feel very torn.  One one hand is my current plan which has no deductible, and I pay a copay for doc visits, and they cover the rest.  The maternity benefits are awesome, and they cover IF testing and meds (although not sure about injectibles - I need to look into that).  They will not cover any meds associated w/ ART procedures (i don't think), nor the actual procedure itself - so no IUI, IVF, etc.   Our other option costs more, has a 1500 deductible, but it covers 80% of all IF treatment and meds, up to 25k.  So if we needed IUIs or IVF - that could save us a ton of money.   So I'm torn, should we pay more up front with the idea that it might save us money in the long run, or go with the smaller plan and roll the dice.   I think I'm leaning towards the 2nd plan just b/c it could save us so much.

WWYD?  Anyone in the same boat?

PGAL/PAL welcome
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Trying to start our family since 2010
BFP #1 11.4.10, EDD 7.12.11, HB 12/9/10, MMC 12/27/10; 11w6d
BFP #2 9.12.12, EDD 5.24.13, Baby Boy Born 5.15.13!!
My Ovulation Chart
3 Clomid (100mg) cycles + TI + Trigger = BFN's, Femara + Trigger + IUI#1 = BFN
Femara + Trigger + IUI#2 = BFP!
"Strength does not come from physical capacity. It comes from an indomitable will." ~Gandhi

Re: Help! Insurance Decisions

  • Has your doctor has given you any incling that you may need iui or ivf?  I would base my decision on that.
    3 ectopic pregnancies (EDD's 1/30/12-tube removed, 6/2/12-methotrexate and 10/2/12-methotrexate)
    IVF and Natural FET resulted in BFN's and a hole in our wallets
    Natural BFP #4 on 9/7/12 gave us our miracle on 5/18/13
    Lilypie First Birthday tickers
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  • We're dealing w/ borderline MFI - morph (4.5), so IUI could defn be in our future.  RE said we can try one or two more cycles w/ TI and then we should really consider IUI.  He'd let us do IUI now, but we wanted to try TI first. 

    PGAL/PAL welcome
    Image and video hosting by TinyPic

    Trying to start our family since 2010
    BFP #1 11.4.10, EDD 7.12.11, HB 12/9/10, MMC 12/27/10; 11w6d
    BFP #2 9.12.12, EDD 5.24.13, Baby Boy Born 5.15.13!!
    My Ovulation Chart
    3 Clomid (100mg) cycles + TI + Trigger = BFN's, Femara + Trigger + IUI#1 = BFN
    Femara + Trigger + IUI#2 = BFP!
    "Strength does not come from physical capacity. It comes from an indomitable will." ~Gandhi
  • You should sit down and do some serious math...increase in premium plus deductible vs. potential cost of iui.  Without the numbers I am no help...sorry.
    3 ectopic pregnancies (EDD's 1/30/12-tube removed, 6/2/12-methotrexate and 10/2/12-methotrexate)
    IVF and Natural FET resulted in BFN's and a hole in our wallets
    Natural BFP #4 on 9/7/12 gave us our miracle on 5/18/13
    Lilypie First Birthday tickers
  • Does your place of employement have a flex spending account for health benefits?  I know a lot of companies do where you pay so much a month and they put the full amount that you will wind up paying over the year in an account you can start using on Jan 1st for medical cost.

    My company does this so I have a fairly high deductable too ($1000) and so I put $1500 in the account this year and I use it toward my deductable.  Might be worth looking into if it will save you money. 

    TTC since June 2009 DX: PCOS October 2010
    6 medicated cycles, 2 pregnancies, 1 ectopic April 2011, Early Miscarriage August 2011
    7 more cycles, 1 IUI, No success after last pregnancy
    7/1/2012 No more fertility coverage
    8/17/2012 started pursuing domestic infant adoption!
    11/26/2012 HOME STUDY APPROVED!!!
    Lilypie Waiting to Adopt tickers
    When relaxing didn't work is my new blog!
  • BTW did I miss an update from you?  How did your follie check go?
    TTC since June 2009 DX: PCOS October 2010
    6 medicated cycles, 2 pregnancies, 1 ectopic April 2011, Early Miscarriage August 2011
    7 more cycles, 1 IUI, No success after last pregnancy
    7/1/2012 No more fertility coverage
    8/17/2012 started pursuing domestic infant adoption!
    11/26/2012 HOME STUDY APPROVED!!!
    Lilypie Waiting to Adopt tickers
    When relaxing didn't work is my new blog!
  • If IUI is in your future, I would go with the 2nd option.  If IUI or IVF is not in the future, stick with what you have.  I am not sure about where you work, but we get open enrollment twice a year.  If you think you wouldn't use IUI or IVF within a year, stick with what you have and switch then...???  GL hun!
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    TTC #1 since 6.10
    SA #1=Agglutination SA #2= Everything perfect
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  • imageRawr08:
    If IUI is in your future, I would go with the 2nd option.  If IUI or IVF is not in the future, stick with what you have.  I am not sure about where you work, but we get open enrollment twice a year.  If you think you wouldn't use IUI or IVF within a year, stick with what you have and switch then...???  GL hun!

    I was thinking this as well!  However, Delino raises some good points as well as AllieJo.  I know we're currently debating opening a flex spending account since we have no IF coverage. 


    image image imageimageimage  

    CFNBC after 8 losses and IF || History || My Angel Babies

  • Thanks ladies!!  After crunching all the numbers, I think we're going to go with the 2nd option.  A couple IUI's and we'll recover the increase in cost. 

    We do have a flex spending account option and we'll use that as well (great suggestion Allie!).  I had one this year and it worked out really well!

    Thanks again!

    PGAL/PAL welcome
    Image and video hosting by TinyPic

    Trying to start our family since 2010
    BFP #1 11.4.10, EDD 7.12.11, HB 12/9/10, MMC 12/27/10; 11w6d
    BFP #2 9.12.12, EDD 5.24.13, Baby Boy Born 5.15.13!!
    My Ovulation Chart
    3 Clomid (100mg) cycles + TI + Trigger = BFN's, Femara + Trigger + IUI#1 = BFN
    Femara + Trigger + IUI#2 = BFP!
    "Strength does not come from physical capacity. It comes from an indomitable will." ~Gandhi
  • imageAllie-Jo:
    BTW did I miss an update from you?  How did your follie check go?

    Not yet!  I'm going to post one right now though :)  Thanks for asking!

    PGAL/PAL welcome
    Image and video hosting by TinyPic

    Trying to start our family since 2010
    BFP #1 11.4.10, EDD 7.12.11, HB 12/9/10, MMC 12/27/10; 11w6d
    BFP #2 9.12.12, EDD 5.24.13, Baby Boy Born 5.15.13!!
    My Ovulation Chart
    3 Clomid (100mg) cycles + TI + Trigger = BFN's, Femara + Trigger + IUI#1 = BFN
    Femara + Trigger + IUI#2 = BFP!
    "Strength does not come from physical capacity. It comes from an indomitable will." ~Gandhi
  • imagelavril:

    Thanks ladies!!  After crunching all the numbers, I think we're going to go with the 2nd option.  A couple IUI's and we'll recover the increase in cost. 

    We do have a flex spending account option and we'll use that as well (great suggestion Allie!).  I had one this year and it worked out really well!

    Thanks again!

    I'm glad you got it figured out. I hate insurance plans. When i'm full time at my job, they only have one option to get. But we're on DHs plan and he had many options, he sat down with an expert at his work and she choose one for us after hearing what we would need. Unfortunately none of his plans cover IF meds or procedures.  


    BFP#1 {Cashew} - 9.19.09 EDD 5.26.10
    The day you first lay in my arms, you made my life complete.
    Aurora Rose born sleeping at 35w on 4-21-10
    BFP#2 {Almond} - 2.1.11 EDD 10.12.11 C/P 2.11.11

  • I would go with the second option-if you end up not needing the IUI then you really won't care about the extra expense b/c you'll be pregnant!  If you do need IUI's then having the monetary stress removed would be wonderful!  The OOP expense of IUI's and IVF is one of the biggests sources of stress to me and my DH.  If that wasn't a consideration I think our stress level about IF would be much lower!

    TTC since 5/2010
    DX with Diminished Ovarian Reserve - AMH of 1.1 - 7/2011; AMH of .42 8/2012
    BFP 9/1/10-M/C confirmed 9/8/10-Methotrexate 10/6/10
    IUI #1 (w/clomid)-9/5/11-BFN ; IUI #2 (w/clomid)-10/5/11 - BFP - 11/1/12-No sac seen; 11/2/11 and 11/9/11-Methotrexate 
    IVF #1- ER 2/2; ET 2/5;-Two 8 cell embryos transfered = BFFN
    Surprise BFP - 5/7/12
    U/S on 6/8/12 - H/B at 128 BPM; U/S on 6/14/12 @ 9wks-No H/B-D&C on 6/17/12
    IVF 2.0- ER 10/17; ET 10/20-One 12 cell, one 10 cell and one 8 cell embryo transfered
    BFP!   11/16/12 U/S- Two nuggets with perfect heartbeats! EDD 7/10/13

     

    5/31/2013- My miracles arrived at 34w2d!  Welcome to the world Harper and Nolan!Lilypie First Birthday tickers

    My Blog- http://waitingonaangel.wordpress.com/

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  • imageCashewsMommy:
    imagelavril:

    Thanks ladies!!  After crunching all the numbers, I think we're going to go with the 2nd option.  A couple IUI's and we'll recover the increase in cost. 

    We do have a flex spending account option and we'll use that as well (great suggestion Allie!).  I had one this year and it worked out really well!

    Thanks again!

    I'm glad you got it figured out. I hate insurance plans. When i'm full time at my job, they only have one option to get. But we're on DHs plan and he had many options, he sat down with an expert at his work and she choose one for us after hearing what we would need. Unfortunately none of his plans cover IF meds or procedures.  

    I do too!  They're so complicated.  I have so many options that it was hard to even narrow it down to two plans.  I still am in shock that his plan covers IF!  None of my options do, and I didn't think any would!  I'm sorry that your DH's doesn't.  This stuff adds up quickly.  Sad

    PGAL/PAL welcome
    Image and video hosting by TinyPic

    Trying to start our family since 2010
    BFP #1 11.4.10, EDD 7.12.11, HB 12/9/10, MMC 12/27/10; 11w6d
    BFP #2 9.12.12, EDD 5.24.13, Baby Boy Born 5.15.13!!
    My Ovulation Chart
    3 Clomid (100mg) cycles + TI + Trigger = BFN's, Femara + Trigger + IUI#1 = BFN
    Femara + Trigger + IUI#2 = BFP!
    "Strength does not come from physical capacity. It comes from an indomitable will." ~Gandhi
  • imageMandaS08:
    I would go with the second option-if you end up not needing the IUI then you really won't care about the extra expense b/c you'll be pregnant!  If you do need IUI's then having the monetary stress removed would be wonderful!  The OOP expense of IUI's and IVF is one of the biggests sources of stress to me and my DH.  If that wasn't a consideration I think our stress level about IF would be much lower!

    You're so right!!  I will feel much better with the better plan, even if it costs a  bit more.  FX I'll only need the maternity coverage!

    PGAL/PAL welcome
    Image and video hosting by TinyPic

    Trying to start our family since 2010
    BFP #1 11.4.10, EDD 7.12.11, HB 12/9/10, MMC 12/27/10; 11w6d
    BFP #2 9.12.12, EDD 5.24.13, Baby Boy Born 5.15.13!!
    My Ovulation Chart
    3 Clomid (100mg) cycles + TI + Trigger = BFN's, Femara + Trigger + IUI#1 = BFN
    Femara + Trigger + IUI#2 = BFP!
    "Strength does not come from physical capacity. It comes from an indomitable will." ~Gandhi
  • Having the dizzying array of plans really sucks sometimes. It's always so hard to pick!
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