HSG and Clomid coverage info

[LesleyL]

I am scheduled for and HSG this Tuesday...when I called to make it the secretary was questioning me on whether or not my insurance would cover it. I told her I wasn't sure and asked them to fine out. I have very good Blue Cross insurance....did you ladies pay out of pocket for it or was it covered? Then that got me wondering about the Clomid that I'm starting next month too????????????? Thanks!

 

[ssh0923]

idk about the hsg, but i got bcbs as well...its not the greatest but i only pay anywhere between $9-$10.50 for clomid after the insurance covers whatever on it. its not that expensive.

 

[LesleyL]

Thank you! I looked it up on my insurance and it says that if there is an underlying problem then they will pay for it. I have anovulation and amennorhea and told them to use that diagnosis. The secretary told me the insurance usually will only use infertility as a diagnosis for an HSG. My hubby has a SA on April 1st and I'm also wondering if that will be covered.....

 

[iprayforbump]

Both were covered for me!

 

[sportymom]

Hey, i have Anthem Blue Cross and the clomid was about $50...but i think it depends on your insurance some is better than others, mine isnt that great...lol

 

[ssh0923]

i just went to get whatever done n let them send the stuff to the insurance company. i have to meet a yearly deductible so either way i have to pay something out of pockty...when they ran my blood test i only had to pay $20 which was really good cause typically they charge me $100 just for shits n giggle. so i was shocked. thats when i found out i had pcos. so i guess because of that the insurance covered most of it?! same thing with medications i get a prescription and they give me a discount.

let me know if they covered most of your hsg i would like to know as well. hoping i dont have to get that far before i get pregnant. and the SA!

 

[LesleyL]

Yes. The hubby is fighting me on the SA...but let me make the appt. I did not even think about asking about if insurance would cover it when I called to make it. He's terrified of it! I never thought I would have any of these problems or have to get this many tests done! Everyone around me is pregnant

 

[ssh0923]

Hey, i have Anthem Blue Cross and the clomid was about $50...but i think it depends on your insurance some is better than others, mine isnt that great...lol

damn $50?! for clomid?! i know i had to pay $50 for the prometrium but i paid $9 for clomid at walmart and one month i paid $10.50 for clomid at walgreens and i have bcbs. suprisingly not many people know this but u can shop around and see how much it will cost with your insurance. never go to cvs...they will jack up the price to an extremely amount. i'd call other pharmacies first and see if they carry it and if they do how much it would cost w insurance. sometimes they make you submit your prescription first and if you dont like it have them transfer it to another pharmacy for you.

 

[LesleyL]

i just got my second round of provera from cvs and i paid nothing for the generic. my insurance is supposed to be 0 for the generic and $5 for the brand name drugs...just not sure about the 'fertility' meds.

 

[ssh0923]

i guess ur bcbs is amazing! lol wish i had that coverage!

 

[sportymom]

ssh0923...thanks 4 the advice on the insurance had no idea! I went to Walgreens last but i will shop around..thanks!

 

[keyahopes]

You will have to talk to your insurance company about this. It also depends on which state you live in. For eg, I live in Illinois, where they mandate that IF diagnosis and treatment should be covered just like any other disease. In some states, it is not a mandate, so the insurance company can decide.
Some times insurance companies will cover the diagnosis, but not treatment. In our case, we were also told to call and inform (pre notify) the insurance company before starting any treatment.
My HSG cost me close to 2000 I think, but the insurance covered it. I still had to pay the 250 $ deductible.
Here's a link about the insurance mandates:


https://www.fertilitylifelines.com/payingfortreatment/state-mandatedinsurancelist.jsp

 

[Trishg21]

I just got off the phone with my insurance company (BCBS) and they won't cover it. They said they won't cover any infertility. So now I have to tell my husband and I know he is not going to want to do it. So I'm screwed.

 

[LesleyL]

trish...that sucks the secretary that was scheduling my hsg called me to set up an appt for it...its this tues morning. I asked her if she found out if it was covered or not, and she did not yet. she said she will find out and if it is not she will call me back and discuss the pricing of the procedure. i don't think its going to be covered by mine either. i pulled up my husband's coverage on the internet. an hsg is not listed. if they would use anovulation diagnosis instead, mine would be covered. the secretary said they will see an hsg scheduled and assume its for infertility purposes! can't get around it at all!!!

 

[katertots]

I have bcbs of alabama, my insurance covered it. I had to pay $10 thats it I also just had mine last month.

 

[katertots]

Oh by the way, my insurance did not say online or in the booklet that it covered this procedure, and it did.

 

[Nikki Leigh]

My insurance only covers 50% of fertility related treatments (and does not appear to cover IVF at all) so I had to pay for half of the cost of the HSG. Haven't gotten any Clomid or the like yet, but I'm thinking that it might be just the co-pay for that. We'll see.

 

[ssh0923]

So the doctor called in another prescription of clomid for me yesterday. They said it was $40 before the insurance...since they didn't have my insurance info from before (damn idiots) i have to go back and give them the info...it shouldn't be no more $15 since its a double dosage of clomid (100mg this month! woooohooo)

 

[LesleyL]

ssh...that a good start! i can't wait to start mine in april. i have to wait til monday not to find out if i'm even having my hsg tuesday. its so dumb to me...they are going to give me the clomid anyways whether i'm blocked up or not so they should've just gave it to me in march! haha i'm so impatient with the whole thing.and katertots...that's promising to hear! my bcbs is out of illinois so we will see.

 

[ssh0923]

i picked up my prescription today. it was $20 for 100mg the insurance covered $20....so not too bad. i'm in va but my insurance card says bcbs of illinois - lol maybe because our main office is up there in elmhurst?