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Insurance wont cover Follistim

NJshore40NJshore40 member
in Secondary IF
Hi all, I posted only once before back after my 3 MC this yr in august. Quick update: after a failed D&C this past MC and a hysteroscopy 2 weeks ago, they finally removed pregnancy tissue that wasn't coming out on it's own. This has been the MC that refused to end. I am on estrogen and progesterone to get my body ready for a cycle using Follistim. My question is this: anyone have any luck shopping around pharmacies for prices or getting donations of these drugs? Or any luck negotiating with insurance to cover the meds? Is use of medical drug donations really shady? The denied the claim because i havent had 3 failed rounds with clomid yet. I forget why, but my DR Said that follistim was a better fit for me. I qualify for 50% off through first steps program, but it is still so expensive! I just couldnt bear another miscarriage that might have been prevented with use of the better drug. Thank you for reading!
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Re: Insurance wont cover Follistim

  • jen4nyjen4ny member
    My insurance covers just a part of follistim. I am still waiting for the final bill to see exactly what I owe for it. Unfortunately a lot of insurances don't cover fertility drugs. Mine won't cover clomid or femara at all. I haven't shopped around because my insurance says I have to use a particular pharmacy for them to cover anything. Good luck. 
    "From the moment I first saw you, the second that you were born, I knew that you were the love of my life" Baby Birthday Ticker Ticker
    Me: 35, DH: 40
    TTC # 2 since 8/13, Dx: unexplained secondary infertility
    Clomid cycles 7/14 & 8/14= BFN
    IUI # 1 (clomid) 8/27/14= BFN
    IUI # 2 (clomid and follistim) 9/25/14= BFN
    IUI # 3 (femara and follistim) 10/23/14= BFN
    IUI # 4 (femara and follistim) 11/20/14= BFN
    12/12/14- saline sono shows two polyps
    2/15- two uterine polyps and "schmutz" (RE's words) removed
    8/15- surprise BFP! Beta #1 70 Beta #2 150 
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  • Jodee37Jodee37 member
    Alllll my meds are out of pocket. Freedom fertility pharmacy often had rebates. I'd check them out
    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

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  • Bananappeal145Bananappeal145 member
    I just got a free vial of Follistim from Barron's pharmacy. They have a coupon for one free. My RE hooked me up with it so I'm not sure if you could just call but it's worth a shot.


    Baby Birthday Ticker Ticker


    TTC #2 since 1/1/13

    image    imageimage
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  • cwuredhotcwuredhot member
    Mine has been hit or miss. My insurance cover parts of Clomid, Femara and Ovidrel but not Bravelle. My RE calls my injectables into a pharamacy that ships overnight to you called Roxsan out of California. They have been easy to work with and seem to be cheaper than local pharamacies. Good Luck!


    Me: 32 DH: 34 Married 7/08 DD Born 8/09 
    TTC#2 Since 2/13 (Secondary IF)
    2/13 thru 2/14 - Year of charting, OPK and TI
    3/14 thru 7/14 - Clomid cycles, DH SA came back good
    8/14 - HSG and more blood work
    9/14 - Letrozole + trigger + IUI#1 = BFN
    10/14 - Letrozole + Bravelle + trigger + IUI#2 = BFP!! EDD 7/27/15
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  • NJshore40NJshore40 member
    Thanks so much ladies!
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  • lawmom747lawmom747 member
    @NJshore40 - also try Mandell's which is local to us in NJ.
    Me: 35 DH: 35 - Married 10 years
    PCOS and MF
    Two failed rounds IUI in 2010
    IVF #1 in 2011 - BFP 8/5/11 - Our IVF miracle was born 4/8/12
    FET 9/23/13; BFP -Twins-10/3/13; EDD 6/10/14; MC 11/1/13; D&C 11/4/13
    FET 3/28/14; BFN - 4/7/14
    IVF #2 - Transfer 2 embryos 11/14/14; BFP 11/24/14 - Beta 265;
    11/26/14 - Beta 612; 11/28/14 - Beta 1263; 12/1/14 - Beta 3571;
    12/3/14 - first u/s - two gestational sacs; 12/17/14 - two healthy heartbeats (132 and 134)
    Our IVF miracles were born 7/16/15

    image
    image
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  • NJshore40NJshore40 member
    @hoppin747‌ yes Madells gave me a quote, but it is still so high, thankfully they do work with the first steps program.
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  • NJshore40NJshore40 member
    Update: i finally nagged insurance enough that they agreed to cover it BUT what they cover costs $300 more than the first steps discount. This whole insurance system is a failure
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  • sailorgalsailorgal member
    Coupons for meds?!!? Ha crazy, we don't get that type of thing here in Canada (at least that I've ever heard of!)

    Sorry to hear your insurance is causing you grief - I guess that's the bonus of no coverage is I don't have to deal with them? I'm not looking forward to my tax return this year, I'm definitely going to be audited with all the out of pocket med expenses.
    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
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