Monday, February 27, 2012

Frustration thy name is Insurance Companies

I woke up this morning with a feeling of unease. I wasn't sure if it was staying up late to watch the Oscar's and chowing down on junk food or the strange dreams that prevented me from having a decent nights' sleep.

I contacted our insurance provider to discuss why our IVF medications the second time around were $800 more than the first time. Here is what I found out after 2 hours of phone calls to three different representatives:


  • According to MedImpact (our Pharmacy Benefit Manager through Blue Cross Blue Shield) notified me that we were listed as "Category B Benefit". Category B Benefit entitles me to the max of $2,500 of fertility drug coverage for a lifetime. (You read that right).

  • Our insurance back in October 2011, when we ordered our medications for our first round of IVF paid for partial medication coverage. Meaning, they paid for half of the Menopur and some of the Follisitim (these are both Gonadotropin injection medications & are used to stimulate the ovaries in the middle of the IVF cycle). Our Progesterone was free. 

  • We have reached our max of $2,500 fertility med coverage and will no longer be able to claim anything through our insurance. 
I need to also point out that when we started this process we were told our insurance did NOT cover anything fertility related. My advice would be to always contact your provider before procedures just to make sure because apparently ours did cover some of the original IVF medications. 


So, where does that leave us? All three representatives were very nice and understanding but the best advice they could give me was, and this is my favorite, "Google and see if you can get some coupons through the drug company." Now to be fair there are some companies that do provide coupons and discounts and according to our rep at MDR (mail order pharmacy based out of Encino California) she already gave us a $40 discount on our order. 

It's a hard pill to swallow (pun intended) that our insurance ear marked $2,500 fertility med coverage for a LIFETIME, but at least we had that. Right? 

We will be ordering our medications this week to the grand total of $1,842.00. It's true you can't put a price on happiness, but if you could, I would show you our medical bills. 

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