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CindySN23
Stop, Think & Breathe...
Member since 8/11 3550 total posts
Name:
Cindy
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I know this may be early to ask...
but I thought I could get some advice from you wonderful ladies...so with my job I have a health transfer period which started earlier this month and I have the option of changing until next yr...I currently have HIP HMO which covers my IUI's completely and I have no co-pays...I have a couple of questions...so we just had our first IUI which I get the feeling will result in a BFN (I am at 13DPO and still a BFN)...so I wanted to know should I consider switching to GHI which covers 75% of IVF but I will need to have 6 rounds of IUI's plus copays??? I know am really being a pessimist but I am trying to think of the worst case scenario and if we wanted to go to IVF sometime next yr we wouldnt be able to until January.
Maybe someone could provide some insight into the steps that you usually take if a clomid + IUI cycle fails...I respond well to clomid so if the clomid + IUI fails what would out options be?
TIA
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Posted 11/13/11 11:28 AM  |
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Long Island Weddings
Long Island's Largest Bridal Resource |
LIRascal
drama. daily.
Member since 3/11 7287 total posts
Name:
Michelle
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Re: I know this may be early to ask...
 Keep positive- I've heard people convinced that they're gonna have a BFN and all of a sudden, they get pg!
For us, I have no insurance limits or specific numbers because I have 120,000 lifetime IF coverage. However, my RE and I make the decisions based on my dx. Which is, unexplained IF.
I do back-to-back IUI's with Clomid. The next one will be my fourth. We decided to go with 5 before moving on to IVF.
I know the success rate is pretty low percentage-wise, but I know 3 people where it took on the first try! I always kept this positive hope alive, till this last BFN. I have to brace myself for IVF. But again, every person is different. 
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| Posted 11/13/11 11:44 AM |
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FlowerWife
Positive Vibrations...
Member since 1/08 8423 total posts
Name:
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Re: I know this may be early to ask...
how much is the copay? IMO better to be prepared. i would take the IVF coverage and pay the copays. hopefully you'll never need it, but if you do, 75% is a HUGE amount of money for IVF (think in the ballpark of $8-$10k covered). so if it came down to that unless your copay is astronomical, your total copays shouldnt even come close to what you would save if you had to do IVF. so i think its worth it to have to spend the money on copays just to know that your IVF would be mostly covered. but obviously this also depends on your personal financial situation. also make sure meds coverage is adequate since its generally a separate package.
Message edited 11/13/2011 11:48:45 AM.
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| Posted 11/13/11 11:48 AM |
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CindySN23
Stop, Think & Breathe...
Member since 8/11 3550 total posts
Name:
Cindy
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Re: I know this may be early to ask...
I know I have to keep positive but I am a realist and a planner...I really hope that we get a BFP soon but you never know and I like to be prepared...I think I will discuss with my doctor but I have the feeling they are going to tell me that we are both young and we have time and other than my PCOS we have no other issues.
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| Posted 11/13/11 11:49 AM |
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CindySN23
Stop, Think & Breathe...
Member since 8/11 3550 total posts
Name:
Cindy
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Re: I know this may be early to ask...
Posted by FlowerWife
how much is the copay? IMO better to be prepared. i would take the IVF coverage and pay the copays. hopefully you'll never need it, but if you do, 75% is a HUGE amount of money for IVF (think in the ballpark of $8-$10k covered). so if it came down to that unless your copay is astronomical, your total copays shouldnt even come close to what you would save if you had to do IVF. so i think its worth it to have to spend the money on copays just to know that your IVF would be mostly covered. but obviously this also depends on your personal financial situation. also make sure meds coverage is adequate since its generally a separate package.
The copays are like $20 each visit which is a drop in the bucket considering...I actually have to see what the prescription coverage is and how much that will be.
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| Posted 11/13/11 11:51 AM |
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gina409
TWINS!
Member since 12/09 27635 total posts
Name:
g
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Re: I know this may be early to ask...
i have ghi and we were supposed to do 12 iui before ivf..we ended up doing 8..my copay for ivf will be abut 4k without meds
i also have unlimited iui with it..
there is no ivf coverage in what u have now? if not i would switch..better to be prepared
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| Posted 11/14/11 12:27 AM |
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CindySN23
Stop, Think & Breathe...
Member since 8/11 3550 total posts
Name:
Cindy
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Re: I know this may be early to ask...
yea there is no ivf coverage at all so I would hate to be in a situation where we would need to go to ivf and not be able to. I checked and the GHI plan I would opt into states only 6 cycles of IUI with at least 2-4 of them being with ovulation induction.
Does anyone have GHI? I also can opt into the prescription plan...it would be $50 bi-weekly but I have to check to see if the drugs I would potentially need would be covered...how much are meds for ivf?
Message edited 11/14/2011 6:39:14 AM.
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| Posted 11/14/11 6:35 AM |
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JDubs
different, not less
Member since 7/09 13160 total posts
Name:
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Re: I know this may be early to ask...
I have GHI but a separate prescription plan through DH's union, its not great because even the generic version of clomid is not covered. GHI however does pay for my HCG trigger that I order through Freedom Pharmacy (I had to meet a deductible though first, it was around $125ish)...
Right now I basically pay $30 each time I go into the RE for routine sonos & bloodwork.. but IMO I would switch to GHI just to be safe if you need to go the IVF route. I know I feel better knowing if it comes down to it, at least we are only responsible for 25% of the IVF costs... no idea what the med costs are though, would like to hear a ballpark estimate on this as well.
Anyway good luck! Hoping we get our BFP's soon..
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| Posted 11/14/11 7:34 AM |
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CindySN23
Stop, Think & Breathe...
Member since 8/11 3550 total posts
Name:
Cindy
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Re: I know this may be early to ask...
we talked it over and we are going to switch to GHI just to be safe...you never know and I dont want to have to wait until January 2013 if we had to for IVF...I dont think we will do the prescription drugs since its going to cost me $100 per month plus $150 deductible and then a 20% co-insurance...to me it seems like if the we have to do ivf then we would just pay for the meds OOP.
Thanks girls!!!
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| Posted 11/15/11 8:52 AM |
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classc1
LIF Adolescent
Member since 6/10 805 total posts
Name:
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Re: I know this may be early to ask...
Posted by mama2b
we talked it over and we are going to switch to GHI just to be safe...you never know and I dont want to have to wait until January 2013 if we had to for IVF...I dont think we will do the prescription drugs since its going to cost me $100 per month plus $150 deductible and then a 20% co-insurance...to me it seems like if the we have to do ivf then we would just pay for the meds OOP.
Thanks girls!!!
Hi,
I have GHI but another plan for meds. I just wanted to say that you might want to re-think through not getting insurance for your meds. Meds can run you several thousands of dollars and $100 a month and $150 deductible is a drop in the bucket with a 20% co-pay. Things like Clomid are cheap but once you start to get into injectibles, it can run you into the thousands and GHI requires a few medicated cycles of IUI. I take mostly high stims/medium stims and if I had to pay OOP for my meds it would have cost me nearly $8,000 for my first cycle which was very high stims. Even with lower stims...my meds would have cost me nearly $6,000 out of pocket. Of course, your may not need stims as high as I did, but even so, you are still talking several thousand dollars. Just something to consider.
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| Posted 11/15/11 10:21 AM |
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CindySN23
Stop, Think & Breathe...
Member since 8/11 3550 total posts
Name:
Cindy
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Re: I know this may be early to ask...
Posted by classc1
Posted by mama2b
we talked it over and we are going to switch to GHI just to be safe...you never know and I dont want to have to wait until January 2013 if we had to for IVF...I dont think we will do the prescription drugs since its going to cost me $100 per month plus $150 deductible and then a 20% co-insurance...to me it seems like if the we have to do ivf then we would just pay for the meds OOP.
Thanks girls!!!
Hi,
I have GHI but another plan for meds. I just wanted to say that you might want to re-think through not getting insurance for your meds. Meds can run you several thousands of dollars and $100 a month and $150 deductible is a drop in the bucket with a 20% co-pay. Things like Clomid are cheap but once you start to get into injectibles, it can run you into the thousands and GHI requires a few medicated cycles of IUI. I take mostly high stims/medium stims and if I had to pay OOP for my meds it would have cost me nearly $8,000 for my first cycle which was very high stims. Even with lower stims...my meds would have cost me nearly $6,000 out of pocket. Of course, your may not need stims as high as I did, but even so, you are still talking several thousand dollars. Just something to consider.
When you say medicated cycles does that mean something more than clomid???...I respond well to clomid so would I need to do injectables with IUI before I could go onto IVF? I thought it would be a couple thousand only...if its going to be that much then def I would get the prescription benefits.
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| Posted 11/15/11 11:25 AM |
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cateyemm
Twins!
Member since 7/10 8027 total posts
Name:
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Re: I know this may be early to ask...
Posted by mama2b
Posted by classc1
Posted by mama2b
we talked it over and we are going to switch to GHI just to be safe...you never know and I dont want to have to wait until January 2013 if we had to for IVF...I dont think we will do the prescription drugs since its going to cost me $100 per month plus $150 deductible and then a 20% co-insurance...to me it seems like if the we have to do ivf then we would just pay for the meds OOP.
Thanks girls!!!
Hi,
I have GHI but another plan for meds. I just wanted to say that you might want to re-think through not getting insurance for your meds. Meds can run you several thousands of dollars and $100 a month and $150 deductible is a drop in the bucket with a 20% co-pay. Things like Clomid are cheap but once you start to get into injectibles, it can run you into the thousands and GHI requires a few medicated cycles of IUI. I take mostly high stims/medium stims and if I had to pay OOP for my meds it would have cost me nearly $8,000 for my first cycle which was very high stims. Even with lower stims...my meds would have cost me nearly $6,000 out of pocket. Of course, your may not need stims as high as I did, but even so, you are still talking several thousand dollars. Just something to consider.
When you say medicated cycles does that mean something more than clomid???...I respond well to clomid so would I need to do injectables with IUI before I could go onto IVF? I thought it would be a couple thousand only...if its going to be that much then def I would get the prescription benefits.
ITA with Clssc1. One months worth of Follistim alone is like $800. Your doc may consider doing IUIs with injects, and for IVF, you'd definitely need lots of meds. Did you ask your doctor what s/he thinks?
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| Posted 11/15/11 12:29 PM |
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CindySN23
Stop, Think & Breathe...
Member since 8/11 3550 total posts
Name:
Cindy
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Re: I know this may be early to ask...
Posted by cateyemm
Posted by mama2b
Posted by classc1
Posted by mama2b
we talked it over and we are going to switch to GHI just to be safe...you never know and I dont want to have to wait until January 2013 if we had to for IVF...I dont think we will do the prescription drugs since its going to cost me $100 per month plus $150 deductible and then a 20% co-insurance...to me it seems like if the we have to do ivf then we would just pay for the meds OOP.
Thanks girls!!!
Hi,
I have GHI but another plan for meds. I just wanted to say that you might want to re-think through not getting insurance for your meds. Meds can run you several thousands of dollars and $100 a month and $150 deductible is a drop in the bucket with a 20% co-pay. Things like Clomid are cheap but once you start to get into injectibles, it can run you into the thousands and GHI requires a few medicated cycles of IUI. I take mostly high stims/medium stims and if I had to pay OOP for my meds it would have cost me nearly $8,000 for my first cycle which was very high stims. Even with lower stims...my meds would have cost me nearly $6,000 out of pocket. Of course, your may not need stims as high as I did, but even so, you are still talking several thousand dollars. Just something to consider.
When you say medicated cycles does that mean something more than clomid???...I respond well to clomid so would I need to do injectables with IUI before I could go onto IVF? I thought it would be a couple thousand only...if its going to be that much then def I would get the prescription benefits.
ITA with Clssc1. One months worth of Follistim alone is like $800. Your doc may consider doing IUIs with injects, and for IVF, you'd definitely need lots of meds. Did you ask your doctor what s/he thinks?
I am going to meet with my doctor to go over this since I have to decide by the end of the month...I want AF to come quick so I can kill 2 birds and have my CD 3 done as well.
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| Posted 11/15/11 1:28 PM |
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classc1
LIF Adolescent
Member since 6/10 805 total posts
Name:
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Re: I know this may be early to ask...
Posted by mama2b
Posted by classc1
Posted by mama2b
we talked it over and we are going to switch to GHI just to be safe...you never know and I dont want to have to wait until January 2013 if we had to for IVF...I dont think we will do the prescription drugs since its going to cost me $100 per month plus $150 deductible and then a 20% co-insurance...to me it seems like if the we have to do ivf then we would just pay for the meds OOP.
Thanks girls!!!
Hi,
I have GHI but another plan for meds. I just wanted to say that you might want to re-think through not getting insurance for your meds. Meds can run you several thousands of dollars and $100 a month and $150 deductible is a drop in the bucket with a 20% co-pay. Things like Clomid are cheap but once you start to get into injectibles, it can run you into the thousands and GHI requires a few medicated cycles of IUI. I take mostly high stims/medium stims and if I had to pay OOP for my meds it would have cost me nearly $8,000 for my first cycle which was very high stims. Even with lower stims...my meds would have cost me nearly $6,000 out of pocket. Of course, your may not need stims as high as I did, but even so, you are still talking several thousand dollars. Just something to consider.
When you say medicated cycles does that mean something more than clomid???...I respond well to clomid so would I need to do injectables with IUI before I could go onto IVF? I thought it would be a couple thousand only...if its going to be that much then def I would get the prescription benefits.
I don't have my GHI policy in front of me but I do remember it saying that a certain amount of IUI cycles must be medicated before moving onto IVF. It makes sense that Clomid should be included, but I really don't know. You might want to call GHI. Also..if you have male factor or tubal issues...you might be able to skip IUI's all together and go straight into IVF by asking for a waiver. GL.
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| Posted 11/15/11 5:25 PM |
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gina409
TWINS!
Member since 12/09 27635 total posts
Name:
g
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Re: I know this may be early to ask...
i have ghi and express scrips for meds..they suck and do not cover anything and gonal is 1k a pen
my femara was 125 for 10 pills
the list goes on and on..i would def look into another coverage if u can for meds
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| Posted 11/15/11 7:26 PM |
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