Infertility

Medco question

Does anyone else on here have Medco for their Rx coverage? I was looking on their website for med prices on some of my IVF meds and a lot of them said "requires review." I'm just wondering what all this consists of and how long it takes.

We are supposed to be starting our 1st IVF cycle as soon as AF shows up any day now and I'm worried this is going to delay things. 

Married 8/14/10 * TTC since Aug 2010 * Met with RE in Feb 2012 * DH: low motility, low sperm count, elevated FSH * Me: Stage 4 Endometriosis * Laparotomy to remove endo in May 2012 * June 2012 - DH on Rx to hopefully increase count/quality * Re-tested sperm 10/22/12, count/quality have both dropped * IVF #1 w/ICSI * Transferred 2 beautiful embryos on 2/18/13 * Beta #1 3/1/13 - 636!!! Beta #2 3/3/13 - 1796!!! First ultrasound scheduled for 3/18/13 Image and video hosting by TinyPic birthday2012_small Anniversary

Re: Medco question

  • It really depends on your insurance. For some, a lot is covered. For us, injects were not covered. You should talk with your RE or the nurse about processing your Meds now. With the holidays, it could delay it a bit. 
    Brandon Le born 9/9/13 as a result of IVF#1


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  • My re's office ordered everything for us and we just paid the bill.  Nothing was covered so they tried to give us some free samples whenever possible.  You should talk to them about it.
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  • In my experience everything processed pretty quickly but that was bc DH company was fast to respond to requests for approval from Medco. Our nurse called it in and within a couple days most things were ordered. I did have a hard time with a couple things here and there but overall it wasn't too bad. Good luck
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  • I was told that any meds over $200 needed to be reviewed.  Fertility meds are not covered in my plan but some questionable meds like Lupron which could be used for things other then ART, needs a Dr's statement and go through a review process.
    TTC #1 since 9/07
    Dx MFI, AMA, Endo, AMH .16
    Lap 10/09 Removed endometrioma, stage IV endo and adhesions
    Lap 2/10 Endometrioma cysts & adhesions returned.
    Ivf #1 4/10 Antagonist, ET Cancelled.
    IVF #2 2/11 A/ACP+E2V C/P
    IVF #3 6/11 Letrozole/Antagonist BFN
    IVF #4 11/11 Low stim Antagonist BFN
    Lap 3/12 Lap & Selective HSG
    Many cycles of Letrozole and LP HCG w/TI and LDN
    IVF #5 8/12 Low stim BFN
    IUI #1 10/12 BFN br> S&PAIFW
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