Medication & Ins nightmare.

How's a girl supposed to get pregnant around here with all the stress ins puts us through???? It's not like I'm asking for Demerol or Morphine; and it's not like I'm trying to get a boob job covered through my ins. I'm trying to have a baby for goodness sakes. It's not supposed to be this hard

I went to RE Saturday and they prescribed Follistim 100 units and told me to come back on Tues for sono/BW/and dosage adjustment. The nurse said she would call it in to a pharm they use bc they have quick delivery. I told her with my ins I could only go through freedom pharm, and I was worried bc I needed to start that night and freedom fedexs, no same day delivery. She said, "don't worry, we use them all the time." Ok, so the pharm calls to get my ins info, I give it to her, she says,"Oh no, you need to go through freedom with your ins." UGH! So then they transfer it to freedom and they tell me the can go through a concierge service and deliver it to me by 11pm. But I freaked out bc RE said start it 5pm and it was already 1pm. So I call RE back and the nurse says they have a cartridge there, come back to the office (30 mins away and I was already there TWICE) I just have to replace it when I get mine. So I go pick it up. By this time I have a raging migraine. An hour or two later freedom calls me...I need preauth for this medication. Are you kidding me? Preauth? Its fertility medication for goodness sakes and it is time sensitive! Who has time for authorizations???? Then she says, "Well, you can pay out of pocket and then just get reimbursed." So I ask how much...$1400 per cartridge and they ordered 2!!! Thank goodness they gave me one at RE. So they tell me they will call first thing Monday to get auth.

So here it is Monday. I call oxf/uhc and they tell me I have to call optimum health. I call optimum and they say nope, I have to call medco. So I call medco. They say nope, oxf/uhc has to do it. So I call oxf/uhc again and they say nope, not us. Well now I'm furious and upset! The rep gets optimum back on phone and she says it takes 48 hours just to get the case assigned. So I ask for a supervisor. FINALLY she helps me, she is going to call RE and pharm and get back to me. SO STRESSFUL!

Rant over, thank you for listening

***If anyone has or knows someone who has follistim AQ cartridges left over pleeeeeeease keep me in mind just in case this is not covered. I do have a friend thats been on the boards for a long time who can vouch for me if needed. ***

Anyone else with medication or insurance stresses?

And NOW....freedom says with my ins, i have to have 3 failed cycles with Gonal-F, but I've already taken the Follistim twice. WTH???? Its the SAME medication!!

Message edited 2/4/2013 11:31:24 AM.

Re: Medication & Ins nightmare.

im sorry you are going thru this
We use Krupners Pharmacy in brooklyn, they deliver the same day.

I say this alll the time, we are not suppose to be stressed and we are the MOST, if its not the waiting period, waiting for our blood results its insurnace. You are not alone, there is always something.

The 1st time i am sure its the most stressful, hang in there :)

Re: Medication & Ins nightmare.

Wow...this sounds so stressful! I can't even imagine what you are feeling. Follistim and Gonal F is the same thing so they(ins) want you to do a round of gonal before they give you follistim?? Is that right?

Medication & Ins nightmare.

Yea. They won't authorize follistim until 3 failed GonalF cycles. But I don't get why it's such an issue bc it's the same stupid medication UGH Unfortunately my ins won't let me use Krupners I have to use freedom :(

Message edited 2/4/2013 11:54:01 AM.

Re: Medication & Ins nightmare.

Oye...i'm so sorry for all of the running around...the good thing is that you have insurance coverage. We paid oop for everything so as much as it stinks to make 1,000 phone calls, in the end if it's covered it's well worth it. I hear ya on the stress! This is not normal for an every day gal and just knowing that adds to it. I feel your frustration and i hope this ends quickly and you get this resolved asap.
Best of luck!

Re: Medication & Ins nightmare.

Ughh sorry you're going through this - insurance companies are the worst!!!

I love when people say 'Oh just relax and everything will work out.' Yeaaaa OK!!!! Between running back and forth to doctors, taking meds - not too mention the side effects! - and dealing with the finances, it's enough to drive anyone crazy!!!!

We have no infertility coverage so we just took out a $25,000 loan that we'll be paying off for 6 years, how the heck do you RELAX with that hanging over your head!!!!

All I can say is, hopefully everything works out because once you look into your child's eyes I'm sure all the work and stress with melt away!!

Re: Medication & Ins nightmare.

i hate to say it but welcome to infertility meds!

ordering the meds and delivery and paying for it were some of the biggest headaches ever!

i am glad it is working out!

and i see they raised prices lol..we paid oop for meds and then the gonal was only 1k

Medication & Ins nightmare.

Thank you everyone, I know I am fortunate that I have some coverage as far as the meds and IUI, as some women do not. So I really shouldn't complain. It was just a merry go round of phone calls and I just needed to let it all out lol. It really gets me angry because I feel like infertility should be covered 100% by insurance for all women!!!

Luckily I was able to get it all straightened out and I did receive my meds today. RE office said it was ok to replace the follistim they gave me with Gonal F so all is well...PHEW! Hopefully this does the trick

Re: Medication & Ins nightmare.

yay!!!!!!!!!!! glad it all worked out!

best of luck!