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Why am I going through hell with this new IVF cycle... Insurance related

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Lillies
Grateful for my babies!

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Why am I going through hell with this new IVF cycle... Insurance related

New RE places my meds order with cvs Caremark.
Back and forth with them and finally someone gets on the phone and says that they don't handle the IF meds and that PICA does and everything needs to be done through freedom. That's what I told the RE to begin with.
So now the new RE is saying I have no IF meds coverage bc CVS said so not really understanding what PICA is.
So I made them process it through freedom to see what is up and called freedom and they are waiting for it.

So what's the verdict... Is GHI city of NY no longer covering meds bc Caremark said PICA is covering for it.
Why all the issues with this new RE?
RSoNY was so quick and efficient with this part.

Posted 1/31/14 5:32 PM
 
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JDubs
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Member since 7/09

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Re: Why am I going through hell with this new IVF cycle... Insurance related

It's been a while but yes everything having to do with PICA I had ordered through freedom (injection wise). The only thing Caremark covered for me except for a small copay was crinone which I also got through freedom. I would just tell them to order everything via freedom. The people at freedom should know between PICA and Caremark what's covered when they process it. Good luck!

Posted 1/31/14 8:54 PM
 

2BirdsofaFeather
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Why am I going through hell with this new IVF cycle... Insurance related

I also had to use Freedom. Occasionally we used Krapnauer's!

Posted 1/31/14 9:19 PM
 

ktay2014
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Member since 1/14

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Re: Why am I going through hell with this new IVF cycle... Insurance related

I recently went through this confusion.. I used freedom pharmacy and gave them all the info from the GHI card and my ovidrel was covered. When I went to cvs to get the clomid that was not covered so I'm guessing that went through Caremark. I have GHI through the nypd. Idk if that helps you at all but good luck :)

Posted 2/1/14 1:45 AM
 

babyfever24
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Re: Why am I going through hell with this new IVF cycle... Insurance related

I don't have GHI but Sirm also had to order all my Meds through freedom to have it covered. GL!

Posted 2/1/14 7:07 AM
 

Michelle1110
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Why am I going through hell with this new IVF cycle... Insurance related

It's not your new RE - Remember I told you that they changed things with PICA as of January 1. Apparently the coverage is still there, but getting the meds is dif.

Posted 2/1/14 7:41 AM
 

babydreams21
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Member since 12/12

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Re: Why am I going through hell with this new IVF cycle... Insurance related

Posted by Michelle1110

It's not your new RE - Remember I told you that they changed things with PICA as of January 1. Apparently the coverage is still there, but getting the meds is dif.



Whats the difference now? I'm wondering if we should still be ordering the max or if thats gonna get denied.

Did they end up covering your PIO? When I ordered PIO the most they would give me for a fill was 3 with 2 refills.

Posted 2/1/14 2:46 PM
 

Michelle1110
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Why am I going through hell with this new IVF cycle... Insurance related

I could only get 3. It was covered through the refill.

Posted 2/1/14 4:31 PM
 

babydreams21
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Re: Why am I going through hell with this new IVF cycle... Insurance related

Posted by Michelle1110

I could only get 3. It was covered through the refill.



Yeah its funny bc my RE ordered 5 and when it came there was a sticker on it saying your insurance max is 3. I was surprised they didn't call. I wonder if I switch REs if I can still use my refills from my other RE. I have another refill of menopur and my RE placed it for the max. Who knows. Glad to have any insurance even though its almost gone.


Lillies it seems like you will get the meds covered but it might take some more time. Did you ask them to order the max since we only get 3 fills?

Posted 2/1/14 5:19 PM
 

Lillies
Grateful for my babies!

Member since 2/12

4571 total posts

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Re: Why am I going through hell with this new IVF cycle... Insurance related

She's ordering the max but I still haven't heard from Freedom so I'm calling them tonight to see what's happening. Luckily I still have enough meds for another cycle but rather get another batch in case we have ins problems.

Posted 2/1/14 5:30 PM
 

babydreams21
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Re: Why am I going through hell with this new IVF cycle... Insurance related

Posted by Lillies

She's ordering the max but I still haven't heard from Freedom so I'm calling them tonight to see what's happening. Luckily I still have enough meds for another cycle but rather get another batch in case we have ins problems.



Good shes ordering the max. I hope it gets resolved soon. When do you start meds?

Posted 2/1/14 6:01 PM
 

Lillies
Grateful for my babies!

Member since 2/12

4571 total posts

Name:
<3

Re: Why am I going through hell with this new IVF cycle... Insurance related

No idea! I don't even know if I got authorization. No calls or anything. I left them a message to clarify.

Posted 2/1/14 6:52 PM
 
 

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