I am officially an idiot! — The Bump
Trouble TTC

I am officially an idiot!

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. 


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?
S/PAIFW , S/PALW

My Blog

image



Re: I am officially an idiot!

  • Oh....you silly, silly girl!!!!!! How could you!!! J/k It's too late now to stress!!! I'd really hate to beat you up but....if you insist I will!!!!
    Me:25 DH:30

    My DX:PCOS,ENDO and Uterine Fibroids

    DH:SA Normal

    6/08 started Metformin 2000mg.

    2/09 50 mg clomid: BFN

    3/09 Lap & Hysteroscopy to remove polyp, repair left tube, remove endo tissue.

    4/09-8/09 clomid cycles (50mg up to 200mg) w/ trigger All BFFN!!!

    9/09-9/11 mental and physical break (but still TTC on Metformin) to lose weight and get myself back together...AND I got a new dr.

    10/11 HSG: DX Right tube blocked

    11/11 100mg clomid + trigger + TI: follie on right side so it's a no go.

    12/11 100mg clomid + trigger + Progesterone+ TI= BFFN!


    1/12 100mg clomid + trigger + Progesterone + IUI= Cancelled due to cyst
    3/12 Lap = Lasered off endo and turns out my tubes are all clear!!!!!
    4/12 2.5mg Femara + TI + Progesterone = BBFN!!
    5/12 5mg Femara + Trigger + TI + Progesterone = in progress







    <img src=http://i41.tinypic.com/9i8rk3.gif>



    [IMG]http://i39.tinypic.com/5lxg1j.jpg[/IMG]
  • :( 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! 

    ________________________________________________________________________
    imageimageimage
  • Loading the player...
  • image Shayliz:

    :( 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. 


    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?
    S/PAIFW , S/PALW

    My Blog

    image



  • image katib77:
    image Shayliz:

    :( 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. 

    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!  

    ________________________________________________________________________
    imageimageimage
  • Those were some awesome savings! Sux you didn't think about the injects though :(
  • image Shayliz:

    :( 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! 

    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. :

    imageimage. image 

    || 4 years TTC, 2 M/Cs image 4 failed IUIs, 1 failed IVF || 

    || DIA brought us our beautiful daughter || 

    Baby Birthday Ticker Ticker
  • image MsGMChick:
    image Shayliz:

    :( 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! 

    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.  

    ________________________________________________________________________
    imageimageimage
  • image Shayliz:
    image MsGMChick:
    image Shayliz:

    :( 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! 

    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.  

    imageimage. image 

    || 4 years TTC, 2 M/Cs image 4 failed IUIs, 1 failed IVF || 

    || DIA brought us our beautiful daughter || 

    Baby Birthday Ticker Ticker
This discussion has been closed.
Choose Another Board
Search Boards