Question about costs...

tops-2 · September 2017

Hey guys,
So some of you will know I'm from Australia. I know most of you are from the US, and I know you have to pay for your healthcare over there. I'm genuinely interested in finding out how much you have to pay for things there (100% not political, just genuinely curious).
Not everything is covered by Medicare here - e.g. I see my specialist privately, so we pay about $265 per appointment and I pay $360 per cycle for my monitored letrozole cycles. I have health insurance but it doesn't cover any of that, so that's full cost.
So, how much do your cycles cost, and your RE, and if you've had one (TW), a d&c?

Thanks guys - just wanting to learn more about how it is for you

MooFish2364 · September 2017

I have insurance through my employer. I only get $2,500 lifetime for fertility treatments. I have to pay out of pocket for my RE unless they are able to code some things as women's health (like my fibroid surgery and u/s to determine painful periods, etc. ). My D&C was mostly covered by my insurance but I did still have to pay $1,500 out of pocket. Which just added insult to injury.

When i I had my most recent surgery (possible fibroids) they could get my insurance to cover that part, but my RE also wanted to look at my tubes and that is not covered. His office works out a deal with the hospital so if I paid $600 cash, that's all I would be charged. I did see the final bill that my insurance was charged for my laparoscopy and it was over $34,000 just for my endo removal!

Bababatty · September 2017

I have insurance through work, which covers a seemingly endless number of IUIs (New York State requires insurers to pay for at least up to IUI, although my insurance is particularly generous in this regard). They also covered all of my and DH's testing, drugs, etc. I did have $50 copays for every visit, copays for drugs, and apparently I pay 10% of IF treatments but I can't remember how much that was. I am totally OOP for IVF, but they are able to bill my insurance for all the monitoring appointments. IVF (drugs, ER, fresh transfer) would have been ~$14,000, but we paid less through a state pilot program my clinic participates in (wherein the state picks up a portion). Our FET will be about $3,000 OOP, with insurance picking up monitoring and drugs.

@tops-2 Now I'm just curious--in Australia you have Medicare and you need to carry your own insurance?

@MooFish2364 You insurance made you pay that much for a D&C? WTF?

MooFish2364 · September 2017

@Bababatty yep. It was ridiculous. Nothing like paying money for a pregnancy loss. I had to make payments and it was so gut wrenching.

soehlerk · September 2017

I've got insurance through my employer, and it's relatively good. I have $10k lifetime max for all infertility treatments, and they cover 80% of IVF (included in the $10k). My medications (Clomid, Femara) have cost $10/mo and $3/mo respectively. My appointments w/ my RE are $35 each. The IUI was originally billed at $300+, but insurance covered most of that--I think I paid around $70. However, I spoke to my RE about IVF (we're not there yet, but I just wanted to know numbers), and she said that it would be $7000/cycle after insurance. She said that next year she expects our insurance provider (United Healthcare) to increase their infertility coverage, so that price may go down.

tops-2 · September 2017

@Bababatty - So our system is a little complicated I suppose. Basically medicare covers most things (eg my d&c cost nothing - just go to the hospital, have it done and leave), and it covers emergencies and anything needed as such. So my hubby had to have a whole heaps of tests (MRI, brain scans, etc) when he was diagnosed with epilepsy and that all cost nothing. And a lot of medications are very cheap because they are mostly covered - about 3 months worth of metformin costs about $15, birth control can vary a lot but the basic pill is about $7 for 4 months worth.
Not everyone has private health cover and it's definitely not needed, but it just helps make elective things cheaper, plus it'll cover you for using private hospitals rather than public. So with health insurance if you need glasses you'll usually be able to get a couple of pairs per year (plus the tests) for free, and if you don't you'll have to pay around $100 per pair.

So through my clinic I use, IVF is around $7,500 per cycle if you pay outright. If you have private health cover I'm sure it would be less.

I hope that makes sense

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