What would TTCAL do - OOP FET costs?

Km380 · January 2015

Morning lovelies! I know no one can make this decision but I need some what would you do thoughts. I have had serious insurance issues during my IVF and it seems I am out of insurance and they will not honor the coverage I was told previously. I'm still fighting but I refuse to put my FET on hold for this. So here is my dilemma. The RE has a shared risk program, if you do not have a live birth you get your money back. Mc means I'm still in the program. I have 5 healthy embryos available. I'm in a mathematical hole.

1 FET =$4,600
Shared risk = $11,500 (which we don't exactly have)

So if we pay per FET and have to do 3 we've paid too much. If we do shared risk and are successful after 2, we've paid too much. I have a headache lol...what would you do?

Km380 · January 2015

furrypaws said:
That sucks...IDK. It's really a crap shoot too put it bluntly. Does the doctor offer any type of financing programs?

It is a crap shoot. Completely. Either way we face the potential of a huge financial misstep. I have to ask about financing programs, but if I recall correctly combined we earn "too much" to be eligible.

MrsPhD83 · January 2015

I have no personal experience with this, but wanted to offer ((hugs)). I'm sorry your insurance is being so difficult. I would maybe consider weighing the odds of success in this mix too (i.e., your RE's live birth rate per embryo transfer). And also his thought about your odds of success given your specific clinical presentation. Again, I know they can't guarantee anything but maybe something to just think about.

MrsOscarFelix · January 2015

no advice really but sending ((hugs)) to you for the insurance shit your dealing with. Hope you figure out what is best for you!

Km380 · January 2015

.

heartbot said:
Has your doctor given you any sort of estimate on what he thinks your chance of success might be? Also, I'd look into medical loans or a low-interest medical care credit card (I used something like this to pay off medical bills in the past) to see if you can find some way to stretch out the cost. I'm sorry your insurance is being shitty.

He put my success rate (live baby in my arms) in the 40% range. I sort of intentionally ignored the exact number bc I don't want to get my or mh's hopes up.

dandb925 · January 2015

Hi, just wanted to send you ((hugs)). That's a really tough decision.

If it were me, I don't think I'd do the shared risk program for the 1st FET. My RE said that their miscarriage rate for IVF with PGD patients was 8%. Since most miscarriages during the first trimester occur due to chromosomal abnormalities, that's a big relief to know you have 5 healthy embryos and should theoretically have a better chance of a healthy pregnancy.

Still, I'm sorry your insurance is acting shitty!

rmpar29 · January 2015

Huge ((((HUGS)))). Given my lack of optimism, I'd probably go with the Shared Risk plan if I could possibly afford it.

I agree to look at all options for financing this plan would be a good thing to do before you make a decision.

Ann612 · January 2015

dandb925 said:

Hi, just wanted to send you ((hugs)). That's a really tough decision.
If it were me, I don't think I'd do the shared risk program for the 1st FET. My RE said that their miscarriage rate for IVF with PGD patients was 8%. Since most miscarriages during the first trimester occur due to chromosomal abnormalities, that's a big relief to know you have 5 healthy embryos and should theoretically have a better chance of a healthy pregnancy.
Still, I'm sorry your insurance is acting shitty!

Everything I have read indicates there is no increase or decrease to the miscarriage rate for IVF versus traditional methods. Have you seen something else to indicate that's not the case?

OP: I would also lean towards the shared risk option. I think of it this way: With this choice, either you get your money back or you lose money. But if you lose money, that means you have a live baby in your arms - and at that point how much are you really going to care about a few thousand lost dollars? You'll probably be thinking every step of your journey had been worth it at that point.

I hate that you are faced with this choice It's so unfair that insurance can be so shitty to women TTC.

LizBlue · January 2015

I am definitely not objective about this (See sig), but after one unsuccessful fresh transfer and two unsuccessful FETs, I wish I had gone with the shared risk option. For exactly the reason @Ann612 said. If you "lose", it's because you had a baby. I wish I had the comfort of getting some money back after all of this.

I didn't opt for the shared risk because it seemed like too much money and deep deep down, it was because I really thought it would work. I feel naive now.

That doesn't mean it won't work for you. But 40% is 40%, you know? The odds are statistically not in your favor.

I'm sorry if I sound pessimistic - I fully own that my own experience is biasing my opinion. I can see the other side (I *was* the other side), so I completely understand if you choose that option.

Good luck and I have everything crossed that you will be successful! xo

Km380 · January 2015

Ann612 said:

dandb925 said:

Hi, just wanted to send you ((hugs)). That's a really tough decision.
If it were me, I don't think I'd do the shared risk program for the 1st FET. My RE said that their miscarriage rate for IVF with PGD patients was 8%. Since most miscarriages during the first trimester occur due to chromosomal abnormalities, that's a big relief to know you have 5 healthy embryos and should theoretically have a better chance of a healthy pregnancy.
Still, I'm sorry your insurance is acting shitty!

Everything I have read indicates there is no increase or decrease to the miscarriage rate for IVF versus traditional methods. Have you seen something else to indicate that's not the case?

OP: I would also lean towards the shared risk option. I think of it this way: With this choice, either you get your money back or you lose money. But if you lose money, that means you have a live baby in your arms - and at that point how much are you really going to care about a few thousand lost dollars? You'll probably be thinking every step of your journey had been worth it at that point.

I hate that you are faced with this choice It's so unfair that insurance can be so shitty to women TTC.

Bc we did so genetic testing the chance for mc statistically decreases. My RE said 10% chance of mc after testing. But that is a good way to look at losing money.

Km380 · January 2015

LizBlue said:
I am definitely not objective about this (See sig), but after one unsuccessful fresh transfer and two unsuccessful FETs, I wish I had gone with the shared risk option. For exactly the reason @Ann612 said. If you "lose", it's because you had a baby. I wish I had the comfort of getting some money back after all of this.

I didn't opt for the shared risk because it seemed like too much money and deep deep down, it was because I really thought it would work. I feel naive now.

That doesn't mean it won't work for you. But 40% is 40%, you know? The odds are statistically not in your favor.

I'm sorry if I sound pessimistic - I fully own that my own experience is biasing my opinion. I can see the other side (I *was* the other side), so I completely understand if you choose that option.

Good luck and I have everything crossed that you will be successful! xo

First off ((((hugs)))) sweetie. I really appreciate you chiming in.
Yeah 40% not exactly in my favor and I haven't landed on the right side of a statistic yet. I'm just worried about driving us into debt but it seems no matter what I do, that will happen

Nikolie93 · January 2015

I really don't have much experience in all of what you listed so I am not much help, I just wanted to offer *hugs*

One thing to add about the financial piece. I know people that, for different reasons, put a big purchase on a new, zero percent interest card. If it wasn't paid down by the time the promotion expired, they would apply for another zero interest promotional card. I know it's a pain in the ass but it's worked for some.

Sorry you have such a hard decision

eliida · January 2015

F; what a decision... ((Hugs)) I hate that you are facing this.

Rachaeleigh · January 2015

I didnt read everyone's responses but I'm all for shared risk.
Dh and I just decided on this option last night.
GL making your decision!

Frenchteachermama · January 2015

I vote shared risk too. We had to borrow money from my parents for our IVF cycle so I know exactly how expensive this shit is. HOPEFULLY If you do the shared risk you won't need it and you and your DH can be mad that you paid the extra money for no reason!

Km380 · January 2015

Rachaeleigh said:
I didnt read everyone's responses but I'm all for shared risk.
Dh and I just decided on this option last night.
GL making your decision!

Good luck to you!!

Km380 · January 2015

Frenchteachermama said:
I vote shared risk too. We had to borrow money from my parents for our IVF cycle so I know exactly how expensive this shit is. HOPEFULLY If you do the shared risk you won't need it and you and your DH can be mad that you paid the extra money for no reason!

We already borrowed some money from my parents and his parents for the ER and the testing. I can't bring myself to ask for more. So I have to research how to come up with more. The financial coordinator told me to look at Fertility Finance. I'll be doing interest rate research tonight

TheAerialist · January 2015

If you have good credit, check out bankrate.com to compare credit cards and to specifically look for cards with 0% introductory rates. I just got one in the mail for 0% for 21 months from Bank of America.

Another route is something like care credit, which is specifically for health costs, but I don't know the details or how it differs from a regular credit card, where at least you can get miles or cash back or something like that.

I don't have any magic words of advice, but if I was in your shoes, I THINK I would want try one cycle and then move to shared risk if that first one didn't work. It's a gamble either way, and that sucks.

[Deleted User] · January 2015

Ann612 said:

dandb925 said:

Hi, just wanted to send you ((hugs)). That's a really tough decision.
If it were me, I don't think I'd do the shared risk program for the 1st FET. My RE said that their miscarriage rate for IVF with PGD patients was 8%. Since most miscarriages during the first trimester occur due to chromosomal abnormalities, that's a big relief to know you have 5 healthy embryos and should theoretically have a better chance of a healthy pregnancy.
Still, I'm sorry your insurance is acting shitty!

Everything I have read indicates there is no increase or decrease to the miscarriage rate for IVF versus traditional methods. Have you seen something else to indicate that's not the case?

OP: I would also lean towards the shared risk option. I think of it this way: With this choice, either you get your money back or you lose money. But if you lose money, that means you have a live baby in your arms - and at that point how much are you really going to care about a few thousand lost dollars? You'll probably be thinking every step of your journey had been worth it at that point.

I hate that you are faced with this choice It's so unfair that insurance can be so shitty to women TTC.

This is exactly how I'd feel. I would probably do shared risk because if it took more then the shared risk price then I'd be grateful I did it and didn't spend a ton more. But if I got pregnant earlier and lost a few thousand...I probably wouldn't care at this point because I would be so happy to have a baby.

I know it's a tough decision and one you really need to think through because it's a lot of money. Good luck!

Km380 · January 2015

Thank you ladies for all your thoughts. I have been thinking about this nonstop all day and think I want to do shared risk. I talked to mh (I didn't want to upset him at work after I talked to the financial coordinator) He automatically said shared risk, we'll see if we can use the 401k and what sort of penalties that is. Now he's gone into male shut down. I know he needs time to process but right now I feel utterly alone and I'm just glad it's not a shot night. Anyway thank you for being here

MyFirstRaspberry · January 2015

((hugs)) I am sorry you are faced with the decision. Medical care for IF should be covered my insurance at 100%!!!

Only one thing to add on top of the great advice you have already received. Have you double checked with your financial coordinator if your health insurance company has pre-negiotated or contract rates for IVF procedures with your RE? I recently found out that the original cost of FET at my RE office is $4600 (same as yours), however, the contract rate is $1850 for patients with a particular insurance company. It's worth asking about.

Km380 · January 2015

MyFirstRaspberry said:
((hugs)) I am sorry you are faced with the decision. Medical care for IF should be covered my insurance at 100%!!!

Only one thing to add on top of the great advice you have already received. Have you double checked with your financial coordinator if your health insurance company has pre-negiotated or contract rates for IVF procedures with your RE? I recently found out that the original cost of FET at my RE office is $4600 (same as yours), however, the contract rate is $1850 for patients with a particular insurance company. It's worth asking about.

I've heard of that, I'll have to double check. I'm pretty sure they don't let you pay the contract rate

nikiswimr · January 2015

As several people have said, if there was a way to financially swing it, I would opt for shared risk. Losing money for unsuccessful cycles would hurt me worse than money lost and a THB. It's a huge chunk of change though. We have no IF coverage and are saving for possible OOP IVF now and the costs are shocking. So sorry insurance totally sucks.

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