Cost of fertility treatments

DCHokiemom · January 2016

So I have a question for those of you that have undergone fertility treatments. My insurance doesn't cover anything for fertility. I am currently on Clomid which I am paying for out of pocket, but it's like $10. So far, my doctor has been working with me to bill blood tests, ultrasounds, etc as treatment for PCOS which is covered. DH and I got to talking last night about next steps if this ends up not working and finances came up. I don't really know what our next step would be should I not get pregnant w/in 6 months on Clomid since that is the max my doctor will prescribe. Can anyone give me an idea of the cost of IUI, Fermera, etc? This is more for curiosity than anything at this point. I haven't talked to the doctor about anything more than what we are doing. Dr. Google isn't super helpful and I would like to know some real numbers.

CoonMom · January 2016

I don't have personal experience but my friend just did 3 rounds of IUI and said she paid $600 out of pocket with drugs and IUI.

DCHokiemom · January 2016

dogmomwantinghuman said:

I don't have personal experience but my friend just did 3 rounds of IUI and said she paid $600 out of pocket with drugs and IUI.

Do you happen to know if that is for all 3 rounds or per round?

CoonMom · January 2016

That was per round, sorry I should have clarified.

LadyMillil · January 2016

From what I've read prices can vary a lot even between clinics in the same region
IUI with drugs is around $1000 at my clinic
IVF is $6200 plus drugs. Drug price varies based on your individual situation

hunnybunny17 · January 2016

The pharmacy I get my Femara and Ovidrel from have the cost with and without my insurance on the prescription. If I'm remembering correctly, it said Femara is ~$20 and Ovidrel is ~$200. No IUI for me, just TI.

missteacherlady16 · January 2016

Originally, my insurance didn't cover fertility treatment (and only a measly $2400 pp for testing...which is barely anything). Our clinic gave us a work up of what was covered and what wasn't. We we're looking at about $1000 OOP per iui with clomid. It was about $500 more with injections.

my husband just happened to have open enrollment shortly after we first saw the RE and have since switched and now have much better coverage for testing AND treatment.

im sorry your insurance doesn't cover anything

that's really shitty and very frustrating. Im surprised it doesn't even cover testing.

ReesaAnne16 · January 2016

We were just shown the numbers, it's about $725 for IUI plus meds which are about $150 for Femara + Ovidrel. We were quoted $12,000 for IVF.
Our insurance pays for 50% of testing but no treatment, so we'll still be paying $600 oop for my hysteroscopy.

Also, my doctor said there was no limited on the number of cycles Femara could be used.

BostonBaby1 · January 2016

*lurking*

the prices vary tremendously based upon the area you live, the RE you choose and how well you respond. The thing that may vary the most will be the cost of injectibles (if you go that route) based upon the type of responder you are and the cost of monitoring.

DCHokiemom · January 2016

Thanks for all the responses, this was really informative. Fingers crossed we don't have to go that route...ugh.

NordyMN89 · January 2016

I highly suggest asking your clinic. When talking to the billing department she said if insurance doesn't cover anything that she would only bill me $250 for the iui. I also only pay $10 for the Clomid. My Ovidrel was $70 from Freedom Fertility. Good luck and hopefully you don't have to go that route!

MrsDho11 · January 2016

One thing to point out, and I'm not sure of your finances. If you can save up and pay for it up front, they may offer you a discount for paying cash vs a payment plan. I believe my sister was able to work that out with her clinic. She paid the entire cost when she went in for the appointment and they cut the price by something like 10%. They're also sometimes willing to negotiate.

onefootinthebayou · January 2016

I went to an RE last week just for an eval and the cost of any treatments are not covered by my insurance. I'm not planning on any treatments (even if needed for pregnancy) but the cost of IUI is $1000 and IVF is $7700-$9000 at this particular clinic. Location NYC.

missteacherlady16 · January 2016

Also wanted to mention about using different pharmacies. I had always gone to cvs for medicine prior to the RE. DH's urologist prescribed him anastrozole, which was like $150 at cvs. The tech gave us a coupon that knocked it down to $45 but I couldn't imagine paying that monthly. as much as I hate Walmart, the prescription was $18 at their pharmacy. I didn't even bother going back to cvs with my prescription for clomid. I think it was around $15.

the other big meds (like injections, triggers, etc) will likely come from freedom fertility or something similar. My insurance didn't cover them so those were more pricey out of pocket.

EML2011 · January 2016

**lurker**
I couldn't help but notice that no one mentioned the cost of monitoring. I would expect at least 3 ultrasounds + blood draws per cycle. At my clinic each ultrasound was around $200 and blood draws were $25. Total cost of our IUI is around $3k when you add up the actual procedure (1k) ultrasounds + blood draws (1k) and injectables (1k). Of course it would be cheaper if you didn't need injectables. IVF is around $10k. My clinic gave us a cost sheet when we started treatment so I'm sure if you ask your clinic they would give you something similar. Good luck and hopefully you won't need further treatment!

edit: format

ReesaAnne16 · February 2016

Monitoring with ultrasounds was included in the package price we were given

LadyMillil · February 2016

ReesaAnne16 said:

Monitoring with ultrasounds was included in the package price we were given

Same, ultrasounds are included in the price and blood draws are only extra at my clinic if you're getting genetic testing done.

juliehollz13 · February 2016

@DCHokiemom i'm in the same boat as far as my insurance not covering fertility treatments "per se" but I do have PCOS, and they've covered all ultrasounds for that, and any time I think I have a cysts I have to come in immediately. my gyno prescribed me clomid but wont monitor me (so im not taking it), he said he'll refer me to an RE if I want all that. How did you go about with the billing for ultrasounds and such? I'm getting on Dh's insurance in July which will cover fertility treatments but my insurance has much lower copay's for specialists and I would like to at least utilize it for consultations or whatnot since I upgraded my plan specifically for this reason.

PugsandKisses · February 2016

My fertility center (Atlanta, GA), has a pre-done sheet on the price of everything. Femera is listed as being about $100 per month, plus I needed a Beta shot $100, plus my steriod.

The IUI with SA pre is listed as $456. This does not include lab work and at least the two U/S (day 3 and mid point). They estimate for a total IUI round to be around $1723, w/o insurance. But if your insurance can pay for some of it (labs and U/S), that cuts down on a large amount of the cost.

DCHokiemom · February 2016

juliehollz13 said:

@DCHokiemom i'm in the same boat as far as my insurance not covering fertility treatments "per se" but I do have PCOS, and they've covered all ultrasounds for that, and any time I think I have a cysts I have to come in immediately. my gyno prescribed me clomid but wont monitor me (so im not taking it), he said he'll refer me to an RE if I want all that. How did you go about with the billing for ultrasounds and such? I'm getting on Dh's insurance in July which will cover fertility treatments but my insurance has much lower copay's for specialists and I would like to at least utilize it for consultations or whatnot since I upgraded my plan specifically for this reason.

Since I have PCOS, but doctor bills my ultrasounds and blood draws as treatment for that. I told them right off the bat I didn't have insurance coverage for fertility treatments and they have been trying to work with me on how things are coded and stuff. Granted, I have only done two months so I doubt my insurance will allow this for an extended period.

ShallowSeas · February 2016

I've called around and Femara is more expensive than Clomid, however the Goodrx website has coupons for it that brings the cost down significantly. It's like $6 with these coupons.

missteacherlady16 · February 2016

EML2011 said:

**lurker**
I couldn't help but notice that no one mentioned the cost of monitoring. I would expect at least 3 ultrasounds + blood draws per cycle. At my clinic each ultrasound was around $200 and blood draws were $25. Total cost of our IUI is around $3k when you add up the actual procedure (1k) ultrasounds + blood draws (1k) and injectables (1k). Of course it would be cheaper if you didn't need injectables. IVF is around $10k. My clinic gave us a cost sheet when we started treatment so I'm sure if you ask your clinic they would give you something similar. Good luck and hopefully you won't need further treatment!

edit: format

The prices I gave included u/s and bloodwork

Kaessi · February 2016

This is a great thread - thanks for posting!

Since I'm 35 and we have been TTC for over a year, my OB decided it was time to start testing, and that the first course of action would be an SA of DH. The results came back as low (count & motility) and my OB immediately referred us to an RE. We do not have many RE options where we live, but made an appt. with one that came recommended. However, I then read horrible online reviews & now can't get the clinic to return calls to even find out what the initial consultation will be. DH was able to get his PCP to refer him to a UR, so we are going to try that route & cancel the RE appt. for now. I called my OB back & asked if we could go ahead and proceed with any testing for me, but I was informed that they can't do any testing on me until the issue with DH is resolved. I'm assuming maybe this has to do with insurance? But doesn't really make sense?

My insurance also does not cover any kind of fertility treatment but I think hormone tests & things of that sort through my OB are covered slightly. Just confused & don't quite know what course to take! Considering changing OBs but not sure if I will face the same scenario elsewhere.

Everycol0r · February 2016

I'm in Houston and my BCBS contract price was $100 for each appointment, $45 for each scan and $20ish for each lab. My insurance at the time didn't pay anything towards treatment but they still had a contract with the doctor that they couldn't charge more than a certain amount for different procedures. Without insurance coverage at all I'd imagine it was much much higher. Clomid for me without copays around $20 but I know the pharmacist gave me coupons both times. I think it was originally $50.

So, when you ask your doctor/billing dept about pricing, and they haven't run it through your insurance yet, ask them what their "contract price with BCBS/Aetna/Humana" is for certain things. It -will- be different than if you showed up without insurance at all assuming your RE is in-network with your insurance carrier.

DCHokiemom · February 2016

@Everycol0r , that is really interesting. We have BCBS as well so maybe that would apply to us as well. Great advice!! Thanks!

Everycol0r · February 2016

DCHokiemom said:

@Everycol0r , that is really interesting. We have BCBS as well so maybe that would apply to us as well. Great advice!! Thanks!

It's called a "negotiated price", if that helps.

juliehollz13 · February 2016

I'm about to get on Dh's BCBS plan too....thanks @Everycol0r !

Kaessi · February 2016

I have United Health Care & while they don't cover anything fertility related, they are part of a program called ParentSteps that "offers the ability to purchase treatment cycles and infertility medications at group discount prices" if you go to a clinic in their network. Has anyone heard of or tried this? I am in East Texas, and the nearest clinic in network is in Dallas, which is about 2 hours away, so am unsure if it's worth it?

juliehollz13 · February 2016

@Kaessi i saw your comment and called my UHC to check on the program. I didnt even notice it on there. I'll have more info tomorrow when they call me about it, but I think I may still get on DH's BCBS policy if I dont like what I hear.

I also called the fertility clinic where I would be referred (there's only 1 in the area that works with my current healthcare network). So they said that the intitial consultation should be covered by your insurance. I called my insurance and they said until there's an infertility diagnosis on your claim, all specialists and most testing should be covered. (regular blood work and such, not SA). The clinic said that if you make an appt they will have a financial advisor go over everything with you, but a self-pay IUI procedure will cost $900, including sperm washing and ultrasounds but not including medication. I live in NC though, so I know things in our state aren't as high as others. It seems to really depend on your region, so I would call and find out.

Kaessi · February 2016

Thanks for the info @juliehollz13! Would love to hear what you find out from UHC when they call you back.
I haven't gone as far as to check with them since we are first going to pursue a UR before RE and I'm not sure what we're facing just yet.

Good luck on your journey!!

britters314 · February 2016

@Kaessi I'm thinking they can't do the testing on you until issues are solved with your husband because fixing his issue might allow you to get pregnant and there is no point in using the resources for testing you if they think they already found the problem.

KLake42 · February 2016

At my clinic in Atlanta, IUIs with drugs and ultrasounds run about $1400 each. Bare bones IVF package is just under $10k, but most people go for the $13k package since it includes ICSI and frozen transfers, if needed. Drugs for IVF came up to $5500 for me.

Edited to delete a line where I mentioned how much I spent in 2015, because it includes stuff like acupuncture, and other things (I got it together for my taxes). And it's a stupid number. And I'm still not pregnant.

ShallowSeas · February 2016

At my clinic, the IUI is between $800-1200 depending on the package...and that includes all blood work and u/s but no meds. I just filled my Letrozole (Femara) last night at Target and got 10 pills for $12.99 without insurance.

juliehollz13 · February 2016

Kaessi said:

Thanks for the info @juliehollz13! Would love to hear what you find out from UHC when they call you back.
I haven't gone as far as to check with them since we are first going to pursue a UR before RE and I'm not sure what we're facing just yet.

Good luck on your journey!!

@@Kaessi I got the call from the Parent Steps nurse with UHC. Basically they assign you an RN that works with RE's to be your consultant and you can call her anytime with questions about anything fertility related. Like your personal case worker. She will also be able to answer any insurance questions. She told me that even though UHC doesnt offer infertility treatment, all diagnostic testing leading up to an infertility diagnosis should be covered. She confirmed that while normal TSH range is up to 4.5, to get pregnant and stay pregnant it absolutely has to be under 2.5. She will send a packet with discount packages and such, basically the parent step program IS discount fertility service program.

She also suggested "fertility lifeline" website that has alot of discount programs, some on a sliding scale based on your income and some depending on other factors.

Parent Steps also offers counseling services for depression and anxiety for TTC couples.

Kaessi · February 2016

Thank for you sharing @juliehollz13! Sounds like it might be worth a shot. Do you think you're going to try it? And is there a clinic in network that's in your area?

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