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wwyd? is this sketchy? (long)

lovemymonkeylovemymonkey
in Infertility

hi girls-

please be honest, is this shady for us to do?

I'm in the Shared Risk program at my clinic. We paid $23K OOP to join and it gives us 6 fresh IVF cycles. A single fresh cyle at my clinic costs around $12K. We can drop out of Shared Risk at any time and get a 100% refund.

We will be starting IVF #5 within the next couple of months. Although this is my 5th IVF cycle, it is my 4th with Shared Risk b/c my first IVF was paid out by my insurance (which maxed out after that IVF).

Starting in CY2009, however, my insurance benefits have gotten a LOT better. My primary insurance through my work now pays for 3 fresh IVF cycles per live birth up to $100K lifetime and my secondary insurance (through DH's work) bumped up their lifetime cap of $25K to $40K and apparently I now have $36K left of that. So we essentially have enough insurance money to pay for five IVF cycles. (I know, we're super lucky!!)

I had my WTF appointment with my RE yesterday and we're definitely going to do one more fresh cycle, maybe two... then we're going to pursue adoption. (We've already started looking into adoption and it will cost us ~$30K)

ok, so my question is this. We are considering dropping out of Shared Risk and getting our refund and then using our new insurance benefits to pay for our last IVF cycle or two.

It feels a little shady to me b/c I almost feel like I'm ripping off my clinic... but am I? would you do it? We could use the refund money towards adoption.

Basically it would mean that we got 4 IVF cycles for free and we paid out on 2 (IVF #1 was paid through insurance and IVF #5/IVF #6 will be paid through insurance).

wwyd?

After 5 years of TTC, 3 IUIs, 5 IVFs, 2 FETs, multiple losses and an adoption that wasn
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Re: wwyd? is this sketchy? (long)

  • jensnebjensneb
    I don't think it's shady, it makes the most sense.  I'm sure if someone from the clinic were in the same spot they'd do the same thing. GL.
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  • qtpa2tqtpa2t member
    First off, don't feel like you are ripping off the clinic. ?For one, it is their choice to offer the program. ?You paid $23K to join, and you better believe they have likely been earning interest or investing that money. ?You have also paid for IVF cycles through your insurance, and are looking to possibly do more. ?Just do what makes the most financial sense for you.
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  • epphdepphd member

    Well.... it is like getting three IVFs for free from your clinic when, for those three cycles, they won't be receiving any compensation...  I don't know, honestly.

    I would be surprised if they didn't try to ask you for the forfeited funds if you now start paying with insurance. 

    That said, if you continued with them and didn't have success, you would get your money back anyway, so I'm really not sure. 

    Sorry I couldn't be more help - you might want to learn more about the terms of getting your money back.  There may be some strings attached (like no future cycling with the same clinic or something).

    GL!

    Elizabeth

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    I am a runner, knitter, scientist, DE-IVF veteran, and stage III colon cancer survivor.
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  • cjsbdlcjsbdl member
    Honestly I'd be surprised if they'd let you drop under those terms. You probably just need to call the clinic's finance office and ask what your options are. Great news on the insurance, though--always nice to know you have that in your back pocket!
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  • lnlelnle

    I'm with epphd and csj...(sorry I can never keep the initials straight!)

    I think it's probably best to be up front with the financial office - they would appreciate honesty. Maybe if they don't want to refund 100% they'd be willing to refund a portion. They'd figure out what you were doing anyway so you might as well be honest up front.

    At my clinic if you drop out of the program you get almost all of your money back - they basically keep the cost of one IVF cycle and give you the rest back, even if you did more than one cycle.

    Let us know how it turns out!

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  • lovemymonkeylovemymonkey

    thanks, girls. I just left a message with their Shared Risk coordinator so hopefully she will call me back today. I'm just going to be upfront with our situation and see what she says. You're right though, I wouldn't be surprised if they had some sort of rules in place that says you can't jump in and out of the program or something like that.

    I suppose we could always drop out and go to another clinic, but I love my RE. I can't leave him.

    After 5 years of TTC, 3 IUIs, 5 IVFs, 2 FETs, multiple losses and an adoption that wasn
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