So while we are totally OOP for infertility after testing, our insurance company is a little iffy on the drugs. ie - when I called and asked they said absolutely nothing is covered. Yet when I've gone to pick up Rx for clomid, trigger & progesterone, it's somewhat covered. And I say "somewhat" because we have an odd plan anyways for non-IF coverage. It covers a certain percent until we've paid $4,000 OOP for coverable charges (ie not including our OOP IF costs). Then it covers over 90% once we've met that deductible.
Since we've had medical issues this year beyond IF, we've met that $4,000 OOP for thinks like my sprained ankle & DH's stays in hospital...so we decided this week to stock up on our meds because instead of like $30 (partial coverage that I mentioned is "somewhat") it's like $1.38. **Don't get me started on how this is 10% of $30 but we'll take it!** So DH and I got our Metformin for $3.74, sweet!
Why am I an idiot then? Because then it hit me...I should get my progesterone refilled now. Instead of the $127 for 30 pills....it cost me $11!!! Woohoo. But did I think to call my RE last week to get Rx for the injects to see if they would be in this mythical not covered yet covered area? NO!! We've been on a break for 8 frickin months so we can use our HSA to help cover the injects cycle - which will include about $1,000 of drugs. I am still hoping to be able to get some donated through the meds program here, but I can't believe I didn't even THINK that maybe I could have gotten them for like $100 instead of a grand. I pray that I'm able to get them donated, because otherwise that $1,000 is really really gonna hurt even more now.
Someone please, beat me senseless. Because apparently I have no sense.
Re: I am officially an idiot!
I did a big prescription order too! Are you sure it would have been $100 as opposed to $1000? I just haven't seen any insurance knock injects down THAT much!
I don't even know if it would be knocked down at all - but since we're at the point where they cover at least 90% and on our metformin & progesterone it mathmatically is more than that, I don't know. I just don't know. But it kills me missing out on even the chance to have saved any money since we are living almost paycheck to paycheck paying down debt and OOP IF.
IUI#4 1/23/13 on 75iu x9 Follistim = BFP then chem preg m/c (Feb 2013)
IUI#5 BFN (April 2013)
S/PAIFW , S/PALW
My Blog
I was just trying to help you maybe feel a little better that there's a chance it wouldn't have been covered at all! *hugs* I know my Metformin is 73 cents once I hit my deductible, but insurance still laughs at me if I try to get any fertility meds. I hope you are able to get some donated!
My ins. knocks my follistim from $1300 ish to $115.
Sorry, hun! That def sucks. Too late to stress now though- use your FSA. Que sera sera I suppose. :
I'm totally jealous.
Sorry! I realize I'm very fortunate for that.