Infertility meds

Question for those that had to use infertility treatments and meds.   Does insurance pay for any of the infertility medications??? I know that some insurances will cover some diagnostic testing, and it doesn't pay for IVF or other procedures, that I am aware of. Thanks!

Lucy 

You are going to love my answer.  It all depends.

Some pay for everything (with deductables), some pay for nothing, some pay for JUST meds, some pay for everything BUT meds....and then every variation in between.  Most that do pay have a lifetime max or a number max (i.e., 3 IVFs or 6 IUIs).

The only way you can know is to look at your coverage booklet or call.

You will have to check with your insurance.  My company covered no fertility treatments at all, nor medications.  They did however, pay for testing to show you have fertility issues- odd.   Additionally, my insurance would not even cover my progesterone that I needed to sustain my pregnancy- they considered it a "life style medication".  No sure what fun life style those crazies live- I sure could think of more fun things to do then have 3 inch need in my buttocks everyday for 12 weeks.  Insurance is so variable.  Good luck--- but I can say I have never had a health plan that covered any of it. 

The others are right. It really depends on the insurance...but it also depends on the state you live in. In CT (where I live) there are laws about what insurance companies have to pay for and how they have to pay for them until you're 40 years old. Check the laws and if your insurance doesn't match up, tell them about it. My insurance would cover regular prescriptions (like clomid) but not injectables. And they would cover a portion of the IVF etc. There's usually a section in the summary plan descrition of your policy that will talk all about this in particular. So ask your HR person for a copy of the SPD.

Tina 

Hello-

I am from CT as well. I did see in my insurance plan that I have coverage but my concern is me being in a same sex marriage. I want to know if those same laws would help me? Would you happen to have come across any info about lesbian moms in CT?

Thanks for any info that you can give to me

I'm sorry. I don't know anything about that. I did this research several years ago (before my RNY) before same sex marriage would have been a consideration.

Tina

What is the average cost of Clomid??? What about the injectables? 

There is a generic of Clomid available and when I was on it I could get a prescription filled for about $60...it varied by a few dollars per pharmacy, that was full price, because my insurance did not cover the cost of any fertility meds. Now when i was on the Metformin/Glucophage and also the Femara those were covered subject to my copay but only because those are typically medications for Diabetics adn Breast cancer patients so insurance does not "know" the are being used to treat infertility. Not sure on the injectables.

My insurance paid for diagostic but no treatment. So, we paid for IUI and meds out of pocket.

Global fee for IUI $895 (include all ultrasound monitor during cycle, insemination, and first blood test to see if pregnant)
Clomid - $33-$41 (it went up in price one month). I did two pills per day
Trigger $249 (orvidel trigger shot to time ovulation)
Injectibles $680 & $1200 (it depended on how much needed. one time it was $680 and the next was $1200 and covered 1 1/2 cyles)
Progesterone pills inserted vaginally - $10 (my insurance covered)

I will say personally, you may not needed fertility drugs. You got pregnant on your own. You may want to look into progesterone if you do get pregnant.

Thank you!!  My gyn is giving me til december 2nd  (when I see her again) to get preggos on my own, after this she is sending me to a fertiility specialist.  With my increasing age and my fertility history, I may need a little help.  Why I got pregnant on my own??  God only knows!! It was a miracle I did!  The pregnancy was very abnormal and progesterone wouldnt have helped it. BUT, it may be an issue as well.  They have never done a full workup on my hormone levels etc.  I will be asking about this too.  Thanks for giving me the prices, it gives us an idea of what we are dealing with. I am going to share this with my husband.

Thank you!!
Lucy