I called to see what my lame insurance covers for IF...

Llamamama · May 2012

It looks like I will have to pay for 50% of everything. Which is better than 100% but still sounds expensive. I have no idea what any of the procedures actually cost though.. I have Kaiser. Does anyone else have 50% coverage that has also paid for some of the traditional IF services? I would love to know what amount you were financially responsible for.

And yes I know I can call and find out for SURE, but since dh is not on board yet I don't want to do that and get any deeper in this than I already am--in case I have to back out all together.

Thanks in advance.

Geekywife · May 2012

I have kaiser as well in Southern California. I also have 50% coverage. I was quoted 700 for the appointment to talk to the RE and from 500-700 for the tests. That was just for me. My husband is on a different plan so I am not sure what his tests would be. Everything had to be paid ahead of time and all the tests and the appointment had to be paid the first time I went in.

I am on hold with that visit until after we move in June and hopefully have a better handle on the money thing with the new place.

Good luck!

Country Girl in the City · May 2012

I have a 50% plan. I don't have Kaiser but I go to the same RE as our local Kaiser uses. My IVF was around $3000 for everything including meds. On my plan, the meds go through insurance differently than other IF stuff. I paid less than 50% for the meds.

You should be able to go to the RE for an initial consult (just a chat no exam) with DH. You can then sit down with the financial person and they should be able to lay out for you what your costs would be based on your insurance at your clinic. We were able to go in and have the woman give us a preprinted hand-out.

Maybe that would help your DH have a more full understanding of everything.

Llamamama · May 2012

So if I understand correctly you were quoted approx. $1200-$1400 for the first visit plus all your (not including dh) diagnostic tests? And then I assume if you went on to need actual treatment, there would be additional charges as well which is the scary unknown part. I would like to go thru the tests to see WHY I am not getting pg but if I have to spend that kind of money and they never can determine a cause or a way to fix it..well that would be awful. I have a lot of thinking to do I guess. THANK YOU for the information!

Geekywife · May 2012

Llama,

This is where I am at as well. I want to know what is keeping my husband and I from having the children we already love, but to spend a month's worth of wages to find out and have it maybe nothing makes me worry.

solarflare · May 2012

I have the Kaiser 50% plan. Nothing IVF is covered so that would be completely 100% and separate.

But, everything diagnostic including HSG, and Cystic Fibrosis testing, and ALL the bloodwork was completely covered. So this was pretty great.

IUI's and meds were 50% covered. I ended up paying $1000 - $2000 for each IUI because I used injectables.

You can call your local Kaiser RE and get their 50% price list which will show you everything detailed out.

Good luck!

annalisel · May 2012

Kaiser at 50% is very affordable for diagnostic and IUIs.

Kaiser at 50% is $38/office visit. Each blood test (FSH, E2, Prog, etch) is in the $20 range, though many can be billed under pregnancy rather than infertility. An HSG is ~$250 (or was it $350?). Each vaginal ultrasound is $127. The IUI is ~$200 for the actual procedure. Saline ultrasound is $243. I never used injectible drugs for IUI so I don't know the cost, but clomid and femara were next to nothing. OOP a SA is $110, so presumable $55 at 50%.

I have no coverage for IVF. It is specifically excluded. 50% of an IVF cycle would be ~$5000 plus another ~$1250 for assisted hatching and ICSI if needed. Drugs are extra.

Good luck!

Llamamama · May 2012

Country Girl in the City:
I have a 50% plan. I don't have Kaiser but I go to the same RE as our local Kaiser uses. My IVF was around $3000 for everything including meds. On my plan, the meds go through insurance differently than other IF stuff. I paid less than 50% for the meds.

You should be able to go to the RE for an initial consult (just a chat no exam) with DH. You can then sit down with the financial person and they should be able to lay out for you what your costs would be based on your insurance at your clinic. We were able to go in and have the woman give us a preprinted hand-out.

Maybe that would help your DH have a more full understanding of everything.

Thanks for the info.. and I agree it would be a good idea for him to get a full understanding. That way if we agree to move forward he can't say I didn't tell him about something.

Llamamama · May 2012

Geekywife:
Llama,
This is where I am at as well. I want to know what is keeping my husband and I from having the children we already love, but to spend a month's worth of wages to find out and have it maybe nothing makes me worry.

Exactly! I have already spent over 3 yrs TTC and have gotten NO where. I am not sure if I can take any more disappointment--especially with a hefty bill to go with it.

Llamamama · May 2012

solarflare:
I have the Kaiser 50% plan. Nothing IVF is covered so that would be completely 100% and separate.
But, everything diagnostic including HSG, and Cystic Fibrosis testing, and ALL the bloodwork was completely covered. So this was pretty great.
IUI's and meds were 50% covered. I ended up paying $1000 - $2000 for each IUI because I used injectables.
You can call your local Kaiser RE and get their 50% price list which will show you everything detailed out.
Good luck!

Do you think they would send me an actual list of prices? THAT would be great!

Country Girl in the City · May 2012

I sent DH to talk to the financial person without me. I don't do money. I am a 1950's housewife with the exeption that I make over twice the salary of DH.

solarflare · May 2012

Llamamama:
solarflare:
I have the Kaiser 50% plan. Nothing IVF is covered so that would be completely 100% and separate.
But, everything diagnostic including HSG, and Cystic Fibrosis testing, and ALL the bloodwork was completely covered. So this was pretty great.
IUI's and meds were 50% covered. I ended up paying $1000 - $2000 for each IUI because I used injectables.
You can call your local Kaiser RE and get their 50% price list which will show you everything detailed out.
Good luck!
Do you think they would send me an actual list of prices? THAT would be great!

Definitely. Just give them the RE in your network a call! You may have to get a referral from your OBGYN.

Llamamama · May 2012

annalisel:
Kaiser at 50% is very affordable for diagnostic and IUIs.
Kaiser at 50% is $38/office visit. Each blood test (FSH, E2, Prog, etch) is in the $20 range, though many can be billed under pregnancy rather than infertility. An HSG is ~$250 (or was it $350?). Each vaginal ultrasound is $127. The IUI is ~$200 for the actual procedure. Saline ultrasound is $243. I never used injectible drugs for IUI so I don't know the cost, but clomid and femara were next to nothing. OOP a SA is $110, so presumable $55 at 50%.
I have no coverage for IVF. It is specifically excluded. 50% of an IVF cycle would be ~$5000 plus another ~$1250 for assisted hatching and ICSI if needed. Drugs are extra.
Good luck!

Thanks for all the great info!

MelleTX · May 2012

Llama,

Can you just ask your regular OB/GYN or primary care physician to run standard Day 3 Bloodwork? I paid for that OOP and it was about $375.

That would be the first step with an RE anyway and would give you a good picture of your starting point before you step into any more invasive tests or drag your husband to give a sperm sample.

Llamamama · May 2012

MelleTX:
Llama,
Can you just ask your regular OB/GYN or primary care physician to run standard Day 3 Bloodwork? I paid for that OOP and it was about $375.
That would be the first step with an RE anyway and would give you a good picture of your starting point before you step into any more invasive tests or drag your husband to give a sperm sample.

Yes I can do that. She has ordered the FSH test twice already (my results were 6.5 in 2010 and 7.5 in 2011) and it has been 10 months since the last one. I will put that on my list of stuff to ask for IF I decide to go forward.. I keep talking myself out of it and then I start to think about what it REALLY means to give up and I just can't do it..

MelleTX · May 2012

Llamamama:
MelleTX:
Llama,
Can you just ask your regular OB/GYN or primary care physician to run standard Day 3 Bloodwork? I paid for that OOP and it was about $375.
That would be the first step with an RE anyway and would give you a good picture of your starting point before you step into any more invasive tests or drag your husband to give a sperm sample.
Yes I can do that. She has ordered the FSH test twice already (my results were 6.5 in 2010 and 7.5 in 2011) and it has been 10 months since the last one. I will put that on my list of stuff to ask for IF I decide to go forward.. I keep talking myself out of it and then I start to think about what it REALLY means to give up and I just can't do it..

I am sure you know this, but make sure to get your AMH, LH, TSH, P4 and E2 as well. It's not just the FSH, but how they all compare to each other.

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