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Old 01-19-2021, 08:42 PM   #1
Bullseye07
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Default IVF Medication Cost Rant/Beware

My wife and I have been trying to have our first child for some time now. After consulting several doctors, we decided to try IVF. Before starting the IVF cycle we talked to them about cost. They gave us some numbers based on typical medications, procedures, etc.

For those of you unfamiliar with IVF, they do bloodwork to check hormones and other numbers and then have her take medicine to get the right if needed. They then have her take multiple injections everyday for around 12 days which cause her ovaries to grow by about 4x the normal size. Then they give her an injection to trigger her and go in and harvest. After that they take and mix it with the boy stuff and after they’ve grown for up to 5 days they put them back in her. Then you wait to see if successful or not.

I will stop here and say that we are blessed in that my wife’s company health insurance will pay up to $50k for family planning. They’ll only pay for $10k of prescription costs which is included in the $50k. I say only $10k because that’s not even going to cover all of the medication cost for 1 cycle. The reason it won’t cover 1 cycle is because they charge the insurance company $4K for a medication that if we pay out of pocket for is “only” about $900. So they eat up all this cost just because of insurance. Then we have to pay more later because they just blew right through it. And they know we’ll find a way to pay because we’re already committed.

It just makes me so angry that these companies run scams like this. And quite frankly, I don’t know what else we can do, but pay it and play their game.

I know there’s gotta be people out there who weren’t as lucky as us and are still paying the financial toll. And they’d probably do it again for the chance because I know the desperation that they felt to have a child, as I feel it.

We’ll make it through this with God’s hand on us.

Rant over.

Look out for some deals in the classifieds in the coming weeks.


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Old 01-19-2021, 08:47 PM   #2
Craw3773
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I know with some insurance companies, you can pay cash. And then be reimbursed. It may be worth taking a look.
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Old 01-19-2021, 09:07 PM   #3
hgiles
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I feel your pain brother. My wife and I did the same and it's definitely not cheap. However, once that child arrives it's priceless and well worth every cent. It's crazy the amount of shots they have to take on a daily basis.
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Old 01-19-2021, 09:20 PM   #4
Bullseye07
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Quote:
Originally Posted by hgiles View Post
I feel your pain brother. My wife and I did the same and it's definitely not cheap. However, once that child arrives it's priceless and well worth every cent. It's crazy the amount of shots they have to take on a daily basis.

I have no doubt it’ll be worth it. The shots suck. I’m not sure who hates it worse- me giving them or her getting them.


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Old 01-19-2021, 09:30 PM   #5
RLUM
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I feel your pain. We spent 39k out of pocket and still did not have a child.
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Old 01-19-2021, 09:36 PM   #6
sierracharlie338
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Yep you are exactly right that there are more people than not based on my experience that don’t get any financial help from insurance companies for IVF.

Prayers for you and your wife on your journey for a positive outcome.


Sierracharlie out....
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Old 01-19-2021, 10:09 PM   #7
MadHatter
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And people killing em fast as they can smh....
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Old 01-19-2021, 10:27 PM   #8
bdubb
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Best of luck in your process! Costs are crazy, but the rewards and knowing the efforts you two went through to get there are beyond compare.

We were fortunate that my wife’s insurance covered most of the medications. All the rest was on us out of pocket basically. I think our final tally is 4 aggressive cycles due to age, 4 retrievals and two transfers and 1 strong minded little boy. We tried our best in 2020 to get a sibling but wasn’t in the cards for us to have a family of 4 from our own bodies. Wife wasn’t comfortable with the donor route and we settled where we are today a few months ago. It’s rough as a family and especially for the ladies who try to conceive with IVF after years of trying all the other methods.

Couldn’t have been any happier with our Dr though. Top notch.

Last edited by bdubb; 01-19-2021 at 10:29 PM.
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Old 01-19-2021, 10:40 PM   #9
Jason Slocum
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Be thankful that you have insurance and they are covering anything. We were 100% out of pocket, and the cowboys had better odds of winning the super bowl than us having a child.

Fortunately we were blessed with our son on 5-9-20, in the middle of a pandemic, after 36 hours of labor. After 8 years it was all worth it and we wouldn’t change anything!

Go into it knowing the odds and, stick with your “plan”.

Good luck OP!

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Old 01-19-2021, 11:22 PM   #10
Rcole1310
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Man I really pray it works out for you guys. I know it’s an emotional ride. Is the doctors office charging the insurance for that medication? Or is it a pharmacy? Wondering if the docs buy the medication and then directly bill your insurance.


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Old 01-19-2021, 11:48 PM   #11
Swampa
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My twin boys were well worth every penny, everyday of my life. We went through every procedure possible before IVF. Don’t give up!


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Old 01-20-2021, 12:33 AM   #12
Kevin
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We had almost zero chance of having a baby without IVF. Now we have an awesome 3 y/o boy and a 9mon daughter. We had no insurance coverage unfortunately but it seems like mine was cheaper without the insurance after reading the above. PM me if you want to talk or anything. I’m not a extrovert but too many men live through this stuff with no support. It was a beating. Those shots suck for everyone.
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Old 01-20-2021, 12:57 AM   #13
LFD2037
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Quote:
Originally Posted by MadHatter View Post
And people killing em fast as they can smh....
Insane, isn’t it?

My buddy went thru the adoption process (adopted 3 siblings). That was an absolute racket as well.
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Old 01-20-2021, 01:07 AM   #14
RLB
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Insane, isn’t it?

My buddy went thru the adoption process (adopted 3 siblings). That was an absolute racket as well.
Child trafficking is big business and, unfortunately, will only get bigger after today.
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Old 01-20-2021, 01:23 AM   #15
175gr7.62
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Man I hope ya’ll are successful in having kids. I love mine but why do you think insurance should be covering any of it?

Kids are like a car wreck money-wise and if I ran an insurance company I wouldn’t be encouraging people to have a car wreck.


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Old 01-20-2021, 05:27 AM   #16
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Originally Posted by Craw3773 View Post
I know with some insurance companies, you can pay cash. And then be reimbursed. It may be worth taking a look.

This - Talk to your insurance company and see if this is an option.
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Old 01-20-2021, 07:13 AM   #17
wellingtontx
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Quote:
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And people killing em fast as they can smh....
Beijing Biden to reverse the Trump "Mexico Policy" today by Executive Order which prohibited US taxpayer dollars from funding abortions in foreign countries. SMH

----

Good Luck and be thankful you have insurance. I would suggest following up with insurance to see about cash pay as mentioned above - great idea.
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Old 01-20-2021, 07:25 AM   #18
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We’ll send prayer your way. We had to do a couple rounds of iui and were getting ready for ivf if the second round didn’t work. We were blessed with a little girl who will be 3 in April. It was cheaper for me to pay out of pocket than it was through insurance. It’s an absolute beat down mentally but you have to stay as positive as you can. I felt terrible watch my wife give herself shots nightly but it was worth it. If i remember right the trigger shot alone was over $1k but they would have billed insurance over $3k

I’ve spent money on dumber ways, it’s worth every penny and all the frustration in the long run
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Old 01-20-2021, 07:26 AM   #19
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Sorry to hear man. We had much difficulty getting pregnant as well. We started with 3 rounds of IUI, all of which cost well more than we were quoted. After none of those worked we were given the option of exploratory surgery on the wife, or IVF. We decided to roll the dice on the surgery, since it was much cheaper. Lucky for us, they discovered some endometriosis, lasered it off, and we were pregnant with our first 2 months later.

The whole healthcare system is a racket. As many know, that first child of ours came 4 months early with some serious health issues. We still receive new bills to this day for this which was 2.5 years ago now. They continue to "resubmit" bills that we knew nothing about. I lost it about 6 months ago and very frankly told them they would not be receiving another dime from me.

Hope it all works out sir. As others have said, try to focus on the outcome of it all and not the finances.
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Old 01-20-2021, 09:39 AM   #20
Bullseye07
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Thanks for the support y’all. I know that it will be worth it in the end, but right now it is a mental *** whooping.


Quote:
Originally Posted by 175gr7.62 View Post
Man I hope ya’ll are successful in having kids. I love mine but why do you think insurance should be covering any of it?

Kids are like a car wreck money-wise and if I ran an insurance company I wouldn’t be encouraging people to have a car wreck.


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I never said there was any expectation that insurance covers it. We went into this process without even knowing that was a thing. But since her insurance does provide some coverage, we want to make the most of it. My complaint is that the money would go a lot further if the amount billed to the insurance company were the same as the cash price.


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Old 01-20-2021, 09:58 AM   #21
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We spent roughly $25k out of pocket but have a beautiful little boy to show for it! It was a tough pill to swallow spending that much money but it’s all worth it in the end. We still have 2 embryos frozen. We used Dr Kauffman at ft worth fertility and highly recommend him!
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Old 01-20-2021, 09:58 AM   #22
KDinTX
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Quote:
Originally Posted by Bullseye07 View Post
I know there’s gotta be people out there who weren’t as lucky as us and are still paying the financial toll. And they’d probably do it again for the chance because I know the desperation that they felt to have a child, as I feel it.



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Praying for great news in the coming weeks.

We are in this group, we have one daughter born in 15 from a surgery to clear endo and cysts. We tried in 19 via IVF since the chance was very low for another natural. Cost was way over what they quoted us and insurance only covered 2 doctors visits. Everything else out of pocket, we hope to try again this summer since we have 4 embryos left frozen from the first try in 19, but unsure of continuing after if unsuccessful again.
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Old 01-20-2021, 10:09 AM   #23
Rcole1310
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Quote:
Originally Posted by Bullseye07 View Post
Thanks for the support y’all. I know that it will be worth it in the end, but right now it is a mental *** whooping.




I never said there was any expectation that insurance covers it. We went into this process without even knowing that was a thing. But since her insurance does provide some coverage, we want to make the most of it. My complaint is that the money would go a lot further if the amount billed to the insurance company were the same as the cash price.


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The reason I was asking is I think you guys may be getting hit by the office by what’s called a buy and bill model. You’re paying the markup put on by the docs office. I’d reach out to the drug manufacturer and ask do they have a patient assistance program. Also, ask your insurance company can you pay cash for the medication and not use the insurance benefits for that.


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Old 01-20-2021, 10:13 AM   #24
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I paid for all of it as my company covered zero. I begged borrowed and sold almost every toy I had. That being said my boy just turned 4. Best money I ever spent.
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Old 01-20-2021, 10:17 AM   #25
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Pay cash for meds if you can. Call around to smaller pharmacies. We ended up sourcing from several different places. I think we got a majority of stuff from a pharmacy in Miami. And yeah, those shots suck.
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Old 01-20-2021, 10:19 AM   #26
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Have you tried negotiating directly? I've never done it, but it may be an option.
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Old 01-20-2021, 10:25 AM   #27
hooligan
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Quote:
Originally Posted by josh3 View Post
We spent roughly $25k out of pocket but have a beautiful little boy to show for it! It was a tough pill to swallow spending that much money but it’s all worth it in the end. We still have 2 embryos frozen. We used Dr Kauffman at ft worth fertility and highly recommend him!
We used Kauffman too, he's great. They were the ones that let us know about buying meds direct, I think it was from a company in AZ. They sent over the prescription a we just had them delivered to the house
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Old 01-20-2021, 11:06 AM   #28
bowhuntz
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I feel your pain. We tried it 6 times.
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Old 01-20-2021, 11:15 AM   #29
El General
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Our insurance does not cover anything. We purchased the drugs for IVF direct, and it still cost $5k. We went about $22K out of pocket on the first go round and don't have a single viable embryo to show for it. Now we have to decide whether to borrow the money at poor interest rates to try again.

Last edited by El General; 01-20-2021 at 11:19 AM.
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Old 01-20-2021, 02:05 PM   #30
Kevin
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Leave it to the handful of people to make this a political post. Geez.

El_General, I can't imagine going through all that without an embryo. It has to be devastating. The cash is one thing, the mental toll and the effects of all those hormones / shots / etc... is something else.

Our first round we got 1 viable egg and that one egg worked.

The second round we got 2 viable eggs and one worked. Will try the last one next year.

We are also of the belief that a fertilized egg is a baby, so we will give the last egg a shot even though we are both getting too old for infants lol

If anyone needs a referral for someone in the Southlake or Dallas area, shoot me a PM.
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Old 01-20-2021, 06:12 PM   #31
glen
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Good luck. Pray and have faith that it will be the beat money you have ever invested.
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