Community› The Bump Message Boards› Secondary IF
Secondary IF
New Discussion

Insurance & IF

SassFrassSassFrass member
in Secondary IF
So, I just went through DH's insurance plan through his employment... and my heart sunk a bit... I found the section that discusses infertility, and in the state of NM, in his policy paperwork, it clearly states that IF testing dx and treatments are not covered. I feel like that just put a dead end to all of this. We are currently paying out of pocket for my labs and Clomid, but anything beyond that, I just don't see how we can afford it... not on our salary, I am pushing it considering we have been paying for blood work, which I have done 3 times this month alone and each time is about $150 for the lab not including the office visit... I mean to me it is worth it to see if everything is going right, but in the long run, how can we do this month after month... and with no help from insurance... :( I feel so lost.

Does your insurance cover your IF?

imageimage
image
image


BabyFruit Ticker 

Report Reply to Post

Re: Insurance & IF

  • [Deleted User][Deleted User] member
    The user and all related content has been deleted.
    Report Reply
  • Loading the player...
  • SassFrassSassFrass member
    JimBobCooter said:
    Our IF is 100% out of pocket.  It's why we skipped all other treatments and went right to donor eggs. We can only afford to do this once.  Have you looking into medical financing?  It's not preferable but it you can afford the monthly payment it's an option.  It sucks that so many people's hands are tied by the financial piece.

    Where in NM are you?  I'm originally from Albuquerque and DH moved here from Santa Fe when we got engaged. I miss it so much.
    THIS! and we are in Melrose, 30 mins from Clovis... We have shitty doctors and shitty insurance :( I am not very happy right now


    imageimage
    image
    image


    BabyFruit Ticker 

    Report Reply
  • pettycrockerpettycrocker member
    Yes. I live in one of I believe three(? maybe two) states that have mandatory IF coverage. Sometimes, it's cheaper to relocate than it is to pay for it all OOP. 

    Last year my IF coverage paid out 20k, that was with 1 IUI and 1 IVF. This year will be much more. I have a crazy deductible now though, last year my total OOP was $500, this year is $4k, plus all the copays for meds and visits, so it adds up quickly even with the coverage. 


    Spontaneous pregnancy #1
    DD1 July 31, 2011

    Trying for #2 since Oct 11
    732973 Clomid Cycles
    2 IUIs 
    3 Fresh IVFs= 1 Ectopic treated with MTX
    Spontaneous pregnancy #2= Ectopic #2= lost left tube
    Spontaneous pregnancy #3= DD2 January 29, 2016
    Spontaneous pregnancy #4= Ectopic #3
    Spontaneous pregnancy #5= Baby #3 is a BOY!!! 



    BabyFruit Ticker
    Report Reply
  • freakyfastfreakyfast member
    100% Out of Pocket 



      


    Report Reply
  • SassFrassSassFrass member
    I think it is just CRAZY! I mean this is a REAL issue that millions of women deal with and then to be like "Screw you, don't care about your IF probs" is a real dick move for Insurances I think

    imageimage
    image
    image


    BabyFruit Ticker 

    Report Reply
  • Momarazzi007Momarazzi007 member
    100% OOP...
    Did your husband finally get tested? This could mean the world of 5k for a cycle or up to 25k+! Just hadn't seen if you posted results yet- or maybe if he was still dragging his feet this might motivate him?
    January 2007- Stop BCP! Let's DO this!
    June 2010- MFI. BS. IVF! Ectopic. BS. image

    November 2010- FAILED FET! BS!
    January 2011- BFP FET! TWINS!     February 2011- lost twin. BS. image

    SEPTEMBER 2011- DD Born! Most awesome girl in the world!
    November 2013- FAILED FET! BS! (screw you November FETs)
    April Fresh Cycle, FAILED. Frozen embryos frozen for future FETs.
    FROZEN CYCLE JUNE! BFP
    BABY BOY VINCENT!
    image

    We can't wait to meet you!
    Conception:image    imageimage Potato Love!

    BabyFruit Ticker


    Report Reply
  • SassFrassSassFrass member
    Momarazzi007 said:
    100% OOP... Did your husband finally get tested? This could mean the world of 5k for a cycle or up to 25k+! Just hadn't seen if you posted results yet- or maybe if he was still dragging his feet this might motivate him?
    this, but I also haven't been able to get in touch with my dr... She has been out of office and the nurse taking messages has been pretty snooty... I should get a call about my 7DPO labs today or tomorrow, and if it is my regular nurse, I will ask her if we can schedule one.. and  just make him go.

    imageimage
    image
    image


    BabyFruit Ticker 

    Report Reply
  • Momarazzi007Momarazzi007 member
    I hope it is your regular nurse then!!! Good luck w results!!!
    January 2007- Stop BCP! Let's DO this!
    June 2010- MFI. BS. IVF! Ectopic. BS. image

    November 2010- FAILED FET! BS!
    January 2011- BFP FET! TWINS!     February 2011- lost twin. BS. image

    SEPTEMBER 2011- DD Born! Most awesome girl in the world!
    November 2013- FAILED FET! BS! (screw you November FETs)
    April Fresh Cycle, FAILED. Frozen embryos frozen for future FETs.
    FROZEN CYCLE JUNE! BFP
    BABY BOY VINCENT!
    image

    We can't wait to meet you!
    Conception:image    imageimage Potato Love!

    BabyFruit Ticker


    Report Reply
  • MrsLaurenandDanMrsLaurenandDan member
    I'm in NM too. We are lucky that lab insurance covers testing, but not treatment. FYI I looked up your town, and your closest RE (in Nm you look pretty close to TX though) will be in Albuquerque. There are only 2 in the state, there and las cruses. The RE in ABQ does do payment plans, FYI. That's what we will probably have to do.
    TTC #1 June 2010
    1/3/11 S/A - Count 45; Motility 32; Morph 4.3 - 2/10/11 - S/A Count 17mil; Motility 39; Morph 7.9
    1/5/11 Femara Cycle #1 = BFN  2/4/11 Femara Cycle #2 = BFP: 3/4/11 - Starting Progesterone suppositories 
    Beta#1 15DPO = 108; Beta#2 17DPO = 179; Beta#3 18DPO = 259; Beta 4# 20DPO =659!!
    Lilypie Premature Baby tickers
    TTC#2 Pulled goalie 5/12, PPAF 3/13, BFP 6/27 Beta 15DPO=248! 
    Dx Severe Hydrocephalus and severe Dandy Walker Cyst.   Stillborn 10/19/13
    Lilypie - Personal pictureLilypie Angel and Memorial tickers 
    TTC#3 - (No preventing, TTC+progesterone starting 12/13)
    4/7/14 CD3 BW - FSH 5.6; AMH 0.469 - 4/11/14 S/A Count 35, Motility 47, Morph 1.5
    4/16/14 - Cycle 6 - Natural IUI - Beta 12DPIUI = 3; Beta 13DPIUI=4.  15DPIUI=6. 17DPIU=4. Chemical Pregnancy  
    TTC #4
    5/5/14 Dx MTHFR homozygous A1298C, Benched 1 cycle HSG 5/14 both tubes open w/scarring on the left   
    5/28/14 Starting clomid 6/8/14 IUI #2 1 dominant follicle 31mm Beta 11DPIUI =4, 15DPIUI = 74, 17DPIUI = 165 
    Lilypie - Personal pictureLilypie Maternity tickers
    Report Reply
  • SassFrassSassFrass member
    Where in NM!!!??


    imageimage
    image
    image


    BabyFruit Ticker 

    Report Reply
  • MrsLaurenandDanMrsLaurenandDan member
    edited April 2014
    I'm in LA. So we just did the 2 hr drive to the RE for my HSG and HYst. We're hoping to have a plan today. So wish me luck!
    TTC #1 June 2010
    1/3/11 S/A - Count 45; Motility 32; Morph 4.3 - 2/10/11 - S/A Count 17mil; Motility 39; Morph 7.9
    1/5/11 Femara Cycle #1 = BFN  2/4/11 Femara Cycle #2 = BFP: 3/4/11 - Starting Progesterone suppositories 
    Beta#1 15DPO = 108; Beta#2 17DPO = 179; Beta#3 18DPO = 259; Beta 4# 20DPO =659!!
    Lilypie Premature Baby tickers
    TTC#2 Pulled goalie 5/12, PPAF 3/13, BFP 6/27 Beta 15DPO=248! 
    Dx Severe Hydrocephalus and severe Dandy Walker Cyst.   Stillborn 10/19/13
    Lilypie - Personal pictureLilypie Angel and Memorial tickers 
    TTC#3 - (No preventing, TTC+progesterone starting 12/13)
    4/7/14 CD3 BW - FSH 5.6; AMH 0.469 - 4/11/14 S/A Count 35, Motility 47, Morph 1.5
    4/16/14 - Cycle 6 - Natural IUI - Beta 12DPIUI = 3; Beta 13DPIUI=4.  15DPIUI=6. 17DPIU=4. Chemical Pregnancy  
    TTC #4
    5/5/14 Dx MTHFR homozygous A1298C, Benched 1 cycle HSG 5/14 both tubes open w/scarring on the left   
    5/28/14 Starting clomid 6/8/14 IUI #2 1 dominant follicle 31mm Beta 11DPIUI =4, 15DPIUI = 74, 17DPIUI = 165 
    Lilypie - Personal pictureLilypie Maternity tickers
    Report Reply
  • SassFrassSassFrass member
    YES GL!!! FX!!!!!

    imageimage
    image
    image


    BabyFruit Ticker 

    Report Reply
  • Jodee37Jodee37 member
    My insurance pays 100% of everything leading up to the dx of IF but anything beyond that is 100% OOP. i have to get pre-auth for everything under the sun though, and they have kicked back a bunch of RPL labs saying they are "experimental." i call bullshit. i wish i lived in the 2 states that pay for IF treatments. maybe i'll move to israel. either way this country sucks as far as providing coverage to IF couples. It's a medical problem just like everything else, what in the fuck. sorry. it pisses me off.
    Me: 36, DH: 36
    DH's SA = normal
    1 tube only wonder
    AFC 3-5, AMH 0.30

    BFP #1 3/29/11.  EDD 12/4/11... Missed m/c 5/9/11. Cytotec fail. D&C 5/17/11.
    BFP #2   7/5/11.  EDD 3/14/12... Our rainbow Kellen born 3/14/12 via c/s.
    BFP #3 5/30/13.  EDD 2/8/14...  6wk u/s HB 126. 8wk u/s lost HB. D&C 7/12/13.
    BFP #4 2/18/14.  EDD 10/30/14... Ruptured ectopic with L tube removed & D&C 3/7/14.
    BFP #5 7/27/14.  EDD 4/9/15...  m/c @ 5w4d.

    IVF #1    Oct 2014 - antagonist protocol: 9R, 7M, 5F. 3dt of 3 Grade 2 embies. BFN. 
    IVF #2    Jan 2015 cancelled due to dominant follicle.  Converted to IUI #1. BFFN
    IVF #2.1 March 2015 cancelled due to dominant follicle.

    BFP #6  (SUPRISE!) 3/19/15.  EDD 11/30/15...  CP at 4w2d.
    IUI #2:    Clomid + Follistim = 3 follies. BFN.
    IVF #2.2 May 2015 - horrible response to micro lupron flare protocol: 3R, 3M, 3F. 3dt of 2 Grade 3 embies. BFFN. 

    BFP #7 (beyond surprised again!) 4/26/16. EDD 1/5/17. beautiful betas!!!! and then near-fatal hemorrhagic corpus luteum. turns out baby was ectopic after all; another lap 5/6 (@24dpo).

    the universe can fuck off.


     "You are overly paranoid and delusional that every one is out to get you." -lastsliverofhope

    Baby Birthday Ticker Ticker
    all AL welcome. TTC #2 for 43 44 months.
    follow my infertility journey here at timestandsstillblog.com

    Report Reply
  • ConstanceGoodspeedConstanceGoodspeed member
    Yes. DH took a pay cut for a job in a coverage mandated state. He hates his job and it is a long commute, but IF coverage is like a $30k+ "bonus."
    IVF/ICSI #1 - BFP, DS born Jan 2013
    IVF/ICSI #2 - BFP, DD born Feb 2015
    IVF FET - BFP, due April 2017


    Report Reply
  • GraceyandTroyGraceyandTroy member
    Which states are IF mandatory coverage?  

    My insurance covers testing, but not treatments.  We were able to get one round of clomid monitoring covered because the RE's office submitted it under testing codes, but they wouldn't approve it the second time, so I paid OOP the second time.  I ended up doing weekly acupuncture for 9 months that we paid for ourselves before getting pregnant with DS.  It ended up costing well over $2k, which could have paid for two IUI's at my old RE's office.  Now that I'm a SAHM, we don't have the extra income.

    This is part of the reason why I really like working with a midwife and learning and practicing traditional Chinese medicine.  It's much more subtle and takes longer to get in balance, but it's a lot cheaper! 
    Happily Mrs. C 
    image  image

    image Image and video hosting by TinyPicimage image
    Baby Birthday Ticker Ticker 
    start ttc #1 in Jan 2009
    dx PCOS in May 2010, begin metformin
    Two failed clomid cycles (made lining too thin)
    Started acupuncture while saving for IVF in Sept 2011
    Add herbal infusions to the mix in Dec 2011
    Hoping holistic approach works!!!

    BFP on April 2012 at 11dpo
    Meepy Man born on Jan 2013 - Hip Hip Hurray!

    Ready to start ttc #2 April 2013, but plan to be an extended BF'er
    Back on metformin Aug 2013
    Restart herbal infusions Sept 2013 - currently drinking nettle, oatstraw, and red raspberry leaf
    DS weaned in April 2014
    Taking a break from herbs and just riding the healthy train.  
    Planning medicated cycle end of summer.  FX I get KU before then!!!
    Report Reply
  • CeCe8579CeCe8579 member
    edited April 2014
    100% OOP here....it's not uncommon. Did you not ask or wonder why your Clomid wasn't covered?
    Carly
    (Former UN: iloveshanej)

    Birdie born 05/01/2007
    Rainbow Surprise Baby due 05/26/2017                                          


    Potato Launcher


    Report Reply
  • pettycrockerpettycrocker member
    GraceyandTroy said:
    Which states are IF mandatory coverage?  

    My insurance covers testing, but not treatments.  We were able to get one round of clomid monitoring covered because the RE's office submitted it under testing codes, but they wouldn't approve it the second time, so I paid OOP the second time.  I ended up doing weekly acupuncture for 9 months that we paid for ourselves before getting pregnant with DS.  It ended up costing well over $2k, which could have paid for two IUI's at my old RE's office.  Now that I'm a SAHM, we don't have the extra income.

    This is part of the reason why I really like working with a midwife and learning and practicing traditional Chinese medicine.  It's much more subtle and takes longer to get in balance, but it's a lot cheaper! 
    I just googled, it says CT, MA, RI, NJ so basically only NE. It does say CA, and TX offer it but it's not mandated yet. 


    Spontaneous pregnancy #1
    DD1 July 31, 2011

    Trying for #2 since Oct 11
    732973 Clomid Cycles
    2 IUIs 
    3 Fresh IVFs= 1 Ectopic treated with MTX
    Spontaneous pregnancy #2= Ectopic #2= lost left tube
    Spontaneous pregnancy #3= DD2 January 29, 2016
    Spontaneous pregnancy #4= Ectopic #3
    Spontaneous pregnancy #5= Baby #3 is a BOY!!! 



    BabyFruit Ticker
    Report Reply
  • GraceyandTroyGraceyandTroy member
    Thanks for the legwork, @MrsCastillo (how do I tag you?)  I'm in CA but I have non :((  Annoying!
    Happily Mrs. C 
    image  image

    image Image and video hosting by TinyPicimage image
    Baby Birthday Ticker Ticker 
    start ttc #1 in Jan 2009
    dx PCOS in May 2010, begin metformin
    Two failed clomid cycles (made lining too thin)
    Started acupuncture while saving for IVF in Sept 2011
    Add herbal infusions to the mix in Dec 2011
    Hoping holistic approach works!!!

    BFP on April 2012 at 11dpo
    Meepy Man born on Jan 2013 - Hip Hip Hurray!

    Ready to start ttc #2 April 2013, but plan to be an extended BF'er
    Back on metformin Aug 2013
    Restart herbal infusions Sept 2013 - currently drinking nettle, oatstraw, and red raspberry leaf
    DS weaned in April 2014
    Taking a break from herbs and just riding the healthy train.  
    Planning medicated cycle end of summer.  FX I get KU before then!!!
    Report Reply
  • HawaiianSunset09HawaiianSunset09 member
    Our insurance is through Illinois, and we have IF coverage(this JUST happened in January). We actually downsized and sold our first home to try and save money for fertility treatments. We went through IF for almost 3yrs with our son, and ended up about 20k in debt because of it. 
    .Became a mama to my sweet little boy after 3 years of waiting and praying in October '12. Baby Birthday Ticker Ticker

    Miscarried twins from our first IUI cycle. D&C on August 14th, 2014
    Second IUI cycle: BFP
    Beta #1 (13dpiui): 74 Beta #2 (16dpiui): 505 Beta #3 (18dpiui): 1205
    First Ultrasound- 6w2d 110BPM! Our baby has a heartbeat!!
    BabyFruit Ticker
    imageimage
    image
    Report Reply
  • sailorgalsailorgal member
    We're 100% out of pocket. What bites is that DH had a contract position previously with a kick ass insurance plan. He got a full time job recently and the insurance benefits exclude fertility treatments entirely, meds and all. Being in Canada, thankfully some blood tests, ultrasounds etc. are covered. 

    Recently government announced that in 2015 they plan to cover one IVF cycle for a single embryo transfer in an effort to reduce health costs long term from multiples etc. But who knows if that will go through or when. Would be nice if it did. Currently IVF is completely off the table for us. 
    Me: 32, DH: 33
    DS #1: April 2010
    DS #2: July 2015 (preemie born at 31 weeks) - our little miracle conceived through ART - unexplained secondary infertility/adenomyosis
    Report Reply
This discussion has been closed.
Choose Another Board
Search Boards
"
"