Costs for Femara+ hcg shot and monitoring

[wantanerd]

Dh and recently separated from the military and now our insurance doesn't cover anything infertility related. Would anyone be willing to share how much out of pocket it cost them in office visits for the treatment using Femara and the hcg shot. I am most interested in how much you had to pay for the routine ultrasounds. Ovulation strips and BBT don't work so I had to rely on 3-6 ultrasounds a cycle to know when to trigger.
any help would be appreciated =)

 

[Pirate]

I got out the price sheet from my clinic and it looks like $2300-2800 (depending on number of ultrasounds needed) for a monitored cycle, not including meds or a trigger. This was technically the cost for an injectable cycle, but I gave you this price since it included 3-4 ultrasounds and you said that you would likely need that many. This number also included a "monitoring fee," bloodwork (FSH, LH, and I can't remember the rest without digging the sheet out again), and the ultrasounds. Each ultrasound was $518. Hope this helps!

 

[messica]

Our IUI's were under $500. Less than $20 for the Femara, $89.00 from Walgreens specialty for the trigger, and I never needed more than one follicle study (I was lucky that I ovulated regularly, so could pretty well bank on day 12 or 13 giving us a good picture of when to trigger and when I'd ovulate with it). I want to say that one follicle study each time was $214.00, and then the collection, wash and insem was about $100.

Since we had no coverage and paid cash our clinic offered us a discount.
If we'd have had insurance I know they would have charged more for those services. I'd check with whom ever you go to, to see if they not only offer those discounted prices for paying cash up front and/or some sort of payment plan. Since prices can vary greatly I'd just call them up and ask to get you your specific projected expense to nail it down, especially if you do indeed end up needing 3-6 follicle studies to time well.

 

[wantanerd]

thank you.

 

[europa59]

Have your clinic check with your insurance company. My insurance covers nothing infertility related, but it has to cover the u/s, and bloodwork because they are considered diagnostic. It also covers most of the fertility medications. All we had to pay for were the copays for the meds, the IUIs themselves ($250 each) and donor sperm (I don't even want to think about how much we spent on that!).

 

[wantanerd]

I was told nothing would be covered after a diagnosis (which I have already had) by my insurance company.

 

[Pirate]

Have your clinic check with your insurance company. My insurance covers nothing infertility related, but it has to cover the u/s, and bloodwork because they are considered diagnostic. It also covers most of the fertility medications. All we had to pay for were the copays for the meds, the IUIs themselves ($250 each) and donor sperm (I don't even want to think about how much we spent on that!).

It's all in how the charges are coded. If the bloodwork and ultrasounds are coded as diagnostic they will be covered but if they are coded as treatment they will not be covered. If you can find a doc willing to code things as different than what they actually are while risking an investigation for insurance fraud, great, but a lot of doctors are more interested in making a buck and covering their own ass as opposed to committing insurance fraud. Luckily most RE's are up front about costs for their services and will provide billing codes for the procedures enabling you to call your insurance and check coverage. Even if you think it's not going to be covered, it's worth the time to call and check.

 

[europa59]

It's all in how the charges are coded. If the bloodwork and ultrasounds are coded as diagnostic they will be covered but if they are coded as treatment they will not be covered. If you can find a doc willing to code things as different than what they actually are while risking an investigation for insurance fraud, great, but a lot of doctors are more interested in making a buck and covering their own ass as opposed to committing insurance fraud.

My RE isn't committing insurance fraud. My state has laws that list out categories considered diagnostic and require insurance companies to cover everything on the list. Bloodwork, u/s, and even hsgs are all on it.