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Insurance Medication Navigating Your Insurer

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3 replies to this topic

#1 Rae272

Rae272
  • Member
  • 11 posts
  • Gender:Female
  • Location:Saskatchewan, Canada
  • Dx:Tubal
  • My Clinic:Aurora Saskatoon

Posted 04 April 2016 - 10:59 AM

Good Morning Everyone,

 

I have filled out the website and have waited for someone to contact me for over 3 weeks... has anyone else had this trouble? Has anyone used this program??

 

We are starting our IVF Journey this month at Aurora in Saskatoon and have ZERO coverage with our Great West Life plan and was told to try the navigatingyourinsurer.com but have had no luck. We also tried the compassionate care program but was denied because I am a Registered Nurse and "make to much money"... 

I guess all in all I am frustrated... Plans don't cover your medications because Infertility Medications are a "choice" ... I can tell you one thing I didn't "Choose" to have Infertility r/t bilaterally blocked tubes... and to be told you make to much money to receive any type of compensation is appalling... 

 

End of Rant :) haha... 



#2 quandry

quandry

    Basket Case

  • Cyclebase
  • 6250 posts
  • Gender:Female
  • Dx:DOR

Posted 04 April 2016 - 11:44 AM

Many ivf drugs have alternate uses. I've seen quite a few people here be able to claim them anyways... If your insurance has an online claim portal you can try to check the din's of what your re is looking to use? Good luck... My dh is just a teacher and I don't work so I understand very well the burden ivf places on a couple.

See about me page.

 

 


#3 Rae272

Rae272
  • Member
  • 11 posts
  • Gender:Female
  • Location:Saskatchewan, Canada
  • Dx:Tubal
  • My Clinic:Aurora Saskatoon

Posted 04 April 2016 - 11:46 AM

Thanks for the reply Quandry :)

 

I have looked into our DINS all my meds will not be covered as per my insurer unfortunately (Gonal-F, Menopur, Cetrocide)



#4 Hopingfor1

Hopingfor1
  • Global 100+
  • 312 posts
  • Gender:Female
  • Location:Toronto
  • Dx:DOR
  • My Clinic:Mt Sinai

Posted 04 April 2016 - 12:15 PM

I haven't heard of that website, but the unfortunate thing is that once you have an infertility diagnosis or are starting the investigation process it won't be possible to find another insurer to cover your meds as it will now be considered a pre-existing condition and excluded.

Although I had coverage (with lifetime dollar limits), I fully understand the difficulty of the cost of the meds as I was a poor responder who quickly used all our drug coverage (at one point injecting over $600/day).

Some of the (relatively) cheaper meds like estrace or prometrium have other uses and are often covered, but unfortunately not the actual stimulation drugs that are really pricey.
  • CdnHockeyGal and Rae272 like this

Me: 40  = High FSH (ranges from 8 - 15), Low AMH (2.7), Low AFC = DOR

DH: 43 = borderline sperm analysis

Started TTC#1 January 2010

 

2011 - 2012 - First fertility clinic, lots of testing, operative hysteroscopy to remove polyps, multiple unsuccessful IUIs, 1 IVF (150 Menopur/150 Gonal F) converted to IUI due to poor response

 

2012 - got second opinion and after AMH results came back, advised at 36 I had a less than 5% chance of conceiving via IVF.  Donor eggs strongly recommended but not yet ready for that (I should say - hubby not ready for that.  I was ready for donor eggs - I just wanted to be a Mom).  Decided clinic wasn't for us and back to clinic #1

 

2013 - IVF #1 (after 1st converted to IUI).  Estrogen Priming protocol - start Climara patch 7 days post ovulation and change every other day.  3 orgalutran injections beginning day after first Climara patch applied.  Start stims day 2 triggered on night 15 of stims = 3 eggs retrieved, 0 fertilized via ICSI = no transfer  (300 Gonal F/150 Menopur & Orgalutran)

 

2013 - Switch clinics

 

Office hysteroscopy = all clear

 

IVF #2 (37 years old) June 2013 - Estrace priming protocol.  4 mg estrace started 7 days post ovulation.  Start stims Day 3 (300 Gonal F/150 Menopur & Orgalutran)

Slow response as usual

Triggered on night 12 of stims (given the option to cancel as it looked like we'd get 3 eggs - knew we wouldn't do any better so continued).

ER:  6 eggs, but advised some were small and would be immature

Fert report:  5 of 6 eggs immature.  2 fertilized via ICSI (including one of the immature eggs)

ET:  Transferred our only 2 embryos - a 5 cell and an 8 cell

11dp3dt = BFP - HCG = 65

16dp3dt = HCG 1,305 (cautiously pregnant)

7 week ultrasound = 1 baby HB = 141

12 weeks ultrasound NT scan = NT = 1.7mm all looks good.  Combined with blood work risk is 1/1,400

Got Harmony blood test results back (done for peace of mind) - all clear and we're having a GIRL!

EDD = March 2014 (cautiously looking forward to that date)

However - baby had plans to arrive early. After PPROM and managing to cook the little one a bit longer, our bundle of joy arrived at 33 weeks.  After a 3 week NICU stay, she is finally home.  We are totally in love and forever thankful for our little miracle baby - Ashley Nicole.

 

 






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