{ "media_type": "text", "post_content": "My wife and I are starting a first cycle of IVF. Given how expensive IVF is/can be, wondering if anyone has lessons learned on the insurance front—understanding it varies by plan, of course. We’re currently enrolled in HDHP w/ HSA, and have nurse consult tomorrow discuss financials among other things. Still in open enrollment, which is great timing. Thanks all. Staying hopeful.", "post_id": "5fb2b909fbd9c5002b1448e2", "reply_count": 19, "vote_count": 2, "bowl_id": "5adbdacf814eb200185465b5", "bowl_name": "Fertility Bowl" }

My wife and I are starting a first cycle of IVF. Given how expensive IVF is/can be, wondering if anyone has lessons learned on the insurance front—understanding it varies by plan, of course. We’re currently enrolled in HDHP w/ HSA, and have nurse consult tomorrow discuss financials among other things. Still in open enrollment, which is great timing. Thanks all. Staying hopeful.

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Yes, the medication will eat up your limits very quickly. We actually decided to pay out of pocket since it would be cheaper (actually ended up doing a trip to a Mexican Speciality Pharmacy, saved thousands of dollars). If we do additional rounds in the future this will be the route we go again. Max out your HSA. Could just be our experinece, but insurance was a back and forth game for us, make sure you just keep on top of things, they would deny claims for some reason and we'd just needed to push back, eventually all worked out, but a lot of calls that I just didn't mentally prepare for beforehand.

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Thank you!

If you max out your limits with your insurance co, just change to a different insurance company during open enrollment next year, and the limits start over in Jan next year with the new insurance co. I did this with Aetna & bcbs - and it worked

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I think kpmg only offers aetna plans, shoot me a message if you were asking something else

God bless anyone and everyone who’s been though this process. Getting the medications alone has been a nightmare—menopur national shortage, delayed fulfillment of all of our medications through AllianceRx, lost package through FedEx (containing medication requiring refrigeration), and discovering an empty medication carton once the package was finally received. Deep breath and now the real work starts 💪

likeuplifting

The 2 most stressful (and unnecessarily so) parts of ivf for me was coordinating meds delivery and insurance coverage. Hopefully the rest will be a breeze!

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Lots of the medications require prior authorization and while our clinic was proactive about submitting a prior auth for the IVF treatment itself, they did not do that for the medications which was really stressful to do in a tight timeline. Also, the prices for the medications are sometimes very different from one pharmacy to another. You don't have to go with the pharmacy your clinic recommends. If you have the time and start looking into it early enough, it might make sense for you to use multiple pharmacies to save money

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This is great advice. I’m in the middle of an IVF cycle with my wife, as well, our first, and can’t recommend enough doing the prior authorization work early. We confirmed and reconfirmed our coverage with our prior authorization department, then called our insurance and went through medication by medication to ensure 100% coverage. We ended up using a pharmacy delivery service recommended by our insurance which made things very easy. Good luck!!! 🤞🏾🤞🏾🤞🏾

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Price out what med costs will be if you pay out of pocket vs. If you pay through insurance, especially if you have a limit on fertility coverage.

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Thanks!

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There are a bunch of FB groups with other women going through IVF that have leftover meds - worth a try if you get a crazy high quote. Also check your state’s insurance mandates. I live in MA and health insurance is required to include infertility and associated treatments by mandate. Also some plans have restrictions on cycle frequency and age so check with your carrier to be on the safe side.

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