I'm so upset....small update pg. 2

I just got an email from my re's office that of the 20k lifetime max I have already 12k has been used!! I've only had 3 iui's this year so I couldnt figure out how I used so much of my lifetime max. Well it turns out that the meds come out of my lifetime max and it cost over 10k!!!! So it looks like this will be my one and only ivf attempt. Does this sound right? When I agreed to do ivf and we spoke it over with the doctor and I told him what kind of coverage I had we made the decision BASED on the fact that I would probably get 3 attempts out of the 20k max. This is just not what I need right now. I cant stop crying....I feel like I have one shot and then its over

Message edited 8/19/2009 5:09:22 PM.

Re: I'm so upset

I'm so sorry you're upset... Have you looked into the possibility of getting covered by an IVF grant somewhere?

Re: I'm so upset

Lisa,
I was there the day they told you you only used a few hundred dollars! I would def. let Dr. B know his staff made an error and that you made your decision based on that error. I'm sure he'll do something for you, if there's a need. Get in touch with HIM, right away!

Re: I'm so upset

Posted by BaseballWidow

Lisa,
I was there the day they told you you only used a few hundred dollars! I would def. let Dr. B know his staff made an error and that you made your decision based on that error. I'm sure he'll do something for you, if there's a need. Get in touch with HIM, right away!

Re: I'm so upset

Re: I'm so upset

Message edited 8/18/2009 12:36:40 PM.

Re: I'm so upset

oh Lisa.. i am so upset for you.. i hate all this insurance BS.. its good that you spoke to Dr. B.. you did the right thing.. and i am sure he will call you back after he looks into it.. i just hope that its wrong.. it is really so unfair. i can't even imagine how you feel

let us know.. i am thinking of you

Re: I'm so upset

That's terrible! It's my worst fear: I get $5K per calendar year. We def are going to have to pony up $$$ at some point & I'm really careful about what costs what.

I've been paying for many meds out of pocket.
Maybe you can use pocket $$ for the generics (if there are any at this point).

Another option is to put money in flex- accounts at work (this will give you tax-free money: a discount).

Lastly, ask your RE. Mine heard about my financial plans & decided to skip certain small things when he can so that I could get further on my insurance. A friend of mine worked out a discount: Their overall IUI times 3 and IVF came to 15K including meds (totally OOP)... but they forwent buying a house & had kids instead.

Hopefully: this will be a moot point & you will have a beautiful baby at the end of this round!!!!!! And...you're not out of money yet!!!

Re: I'm so upset

Posted by daisy32



I know - all I wanna do is go home and crawl into bed My husband is gonna flip.....we both made the decision to move onto IVF based on the fact that we were informed with a 20k max we'd get a few attempts. It wouldnt be so bad if it were a yearly max but its a LIFETIME max.

Had I known that one ivf attempt would have used my insurance max I would have stuck with the IUIs.

Re: I'm so upset

Lisa, I am so sorry you had to find this out right now. That is 100% not fair that they made a mistake llike that ,what they told youmade a huge impact on your decision. I pray that this is the only one that you need and you wont have to worry about it again.
If God forbid you need it again I hope your dr's office will help you out somehow.

For now try to focus on this cycle, extra prayers that this it for you and you never have to worry about IVF insurance again.

Re: I'm so upset

I'm so sorry!

I know that a FET is a lot less $ than a regular cycle bc they don't have to do the retrieval. As long as they are able to freeze some, it will be a lot less OOP than a regular cycle.

Don't give up hope---the 1st time can def work! There are so many success stories!

Re: I'm so upset

Don't stress over this now. I know Braverman will work it out for you. I know of some stories that I wont repeat here where he's gone above and beyond what he should be doing. Don't stress, this is so stressful enough. You need to just focus on what you are doing now and you'll deal with this later.

Need to be positive!!!!!!

Seriously... take a deep breath and tell yourself everything will work out. Oh and of course "F_ to the insurance company!!".

Re: I'm so upset

I am sorry you have to deal with this on top of everything else. Try and take it one step at a time. Hopefully the Dr. will call you back with some good news.

Re: I'm so upset

Thanks girls...this is in no way Dr. B's fault. Its no ones fault actually....except for the ***** pharmacy who charged my insurance company almost 12k for one cycle of IVF medication!! Even Dr. B was shocked at how much the pharmacy charged the insurance company. He's looking into it though. He was very very nice and very comforting about it.

Re: I'm so upset

Wowzer!! What pharmacy was that from??? That is way too high!! Hopefully Dr. B will talk some sense into them and get the charges reduced!

Re: I'm so upset

Re: I'm so upset

sorry this is happening, but that is way too much money for meds

all of my IVFs were OOP and I think the most one cycle of meds cost was about 3000 (I was on alot of follistim at $500 per pen)

hope you get it all straightened out

Re: I'm so upset

12k for meds?? that's nuts- it should only be @ $5k tops.

Def get to the bottom of that, but try not to think about the max too much- you don't know what you'll need to do until after this cycle so why stress yourself out. Positive thoughts and prayers that this will be the one and only IVF you'll need and you'll have frosties left for you to use in the future!

Re: I'm so upset

aww lisa I am so sorry you are dealing with right now
12k sounds out of control for meds and I hope that they can fix this for you, you don't need the stress right now.
praying that this all works out ok

Re: I'm so upset

This is going to work out I promise

Re: I'm so upset

Thats ridiculous I know the meds are expensive but it sounds like they over charged you. I hope it all works out

Try not to stress about the $$ I know you're worried that you may not be able to do another IVF but hopefully you won't have too! I have to put out $2500 for this IVF cycle but hopefully there will be viable embroys to freeze if this cycle doesn't work. Also, if you have to get more meds in the future you might be able to get them cheaper elsewhere or women on this Board may have extra meds.....

When is your retrieval?

Re: I'm so upset

I'm so sorry that you are going through this. It has to be an error.

You really don't need this stress right now, wait until he calls you back and let's you know exactly what is going on. It will all work out, don't worry.

Re: I'm so upset

Thank you guys so much. I'm waiting for the RE to call me back. In a way I would rather him call back tomorrow b/c I dont want any more bad news today. I feel sick over this.

Re: I'm so upset

I have a feeling that this will work out for you... I know it's easier said than done, but try not to stress too much...

Re: I'm so upset

Just wanted to send some to you...The meds are just ridiculous ( We had no IF coverage so I remember all too well )

I feel in my heart of hearts that this cycle will be all you need !!!!!!!