Getting Pregnant
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Any advice you can give

This month is the 11th month and 11th cycle of TTC.  While we do not have anything that we know of that is preventing us from getting pregnant, I'm starting to get a little worried.  We are also starting open enrollment at work, so I started looking at IF treatments that are covers.  Apparently nothing is cover through our OAP or HMO.  Ugh...so annoying.  The part that really bothers me is that abortions are covered but nothing that has to do with IF.  I'm trying to figure out where to go from here.  I know that some of it is just me worrying about it, but I'm a planner and I can't help it.  Should this be something that I'm prepping for already?  How many of you pay out of pocket for your treatments?  Also, how did you plan to pay for treatments?  We have quite a bit of money saved but were hoping to keep it for a down payment on a house (in 2-3 years) and rainy day funds. 
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Cinnabun and Junebug say, "Go Wildcats!"

Re: Any advice you can give

  • I'd start with your obgyn. The ultrasounds should still be covered under your regular plan. Then maybe think about the next step. Have you had a visit recently?

    imageimageimage
           Me: All Normal DH: .5% Morph
    Cycles 1-14 (Natural) all BFN
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  • ILoveRedVinoILoveRedVino member
    2500 Comments Fifth Anniversary 500 Love Its First Answer
    edited October 2013
    Dup
    IUI - BFP! Baby boy born still - August 2012
    IVF - BFP - miscarriage June 2013
    FET - BFN
    FET - BFN
    Switched clinics
    IVF with PGD - three embryos created, all healthy - July 2014
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    Baby Boy born July 2015

  • I'd also start with your OB. My insurance paid for the blood tests that the OB ordered.

    When I moved from the OB to the RE, that's when insurance cut out. IUIs ran me about $1000/cycle, which included the sperm cleaning, ultrasounds, meds and the IUI procedure.

    IVF was $13,000 plus the cost of meds, which was another few thousand. It's a lot.

    There are some loopholes. For example, I did several cycles with Femara, a drug that made me ovulate. Femara is actually a breast cancer drug, so insurance covered it.

    Good luck to you!
    IUI - BFP! Baby boy born still - August 2012
    IVF - BFP - miscarriage June 2013
    FET - BFN
    FET - BFN
    Switched clinics
    IVF with PGD - three embryos created, all healthy - July 2014
    FET - transferred two embryos (boy and girl) - Nov 2014 - BFP!
    Baby Boy born July 2015

  • I went in May. She told me that if I wasn't pregnant after 1 year then to come back. I made a compromise with DH that I would wait until January (he wanted to wait for 1 1/2 years off bc which would be march).
    image


    Cinnabun and Junebug say, "Go Wildcats!"

  • I dont understand the anger of abortions being covered?
  • As the PPs said, start with your OB. That's what I am doing and I've found that most things are covered so far other than the copays for lab work. My insurance covers testing 100% after I meet my deductible. Treatments that require assisted fertilization (from what I see that includes IVF but I am not sure about IUI) are not covered and would be completely OOP.

    Keep in mind something that my OB told me (although I don't know where he got his statistics but they seem legit). 85% of women get pregnant within the first year of trying. Out of the 15% of those that don't get pregnant, 50% of them will go on to get pregnant naturally in the second year of trying. It won't hurt to talk to your OB though and see what he/she would recommend. Good luck!

    Daisypath Anniversary tickers

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    Cycle 10: Surprise BFP on 10/17/2013!
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  • I know for most girls the testing to diagnose any IF issues has been covered. Luckily that was all covered for us as well. Our treatment was completely OOP.

    The best bet is to start with testing and find out if there really is anything preventing you from getting pregnant, instead of just guessing that there isn't, and then go from there.
    image

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    Cycle 11, 100 mg Clomid & IUI#1- BFP 2/23/13 - m/c 4/2/13 @ 9w2d
    Cycle 13, 100 mg Clomid & IUI#2 - BFP 6/27/13 - CP
    Met with an awesome new RE in September 2013 new plan: 5mg Femera & IUI #3
    Surprise Natural BFP 9/9/13 - Welcomed our baby boy 5/25/14

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  • Mine doesn't pay for abortions and I think that is totally stupid on their part.
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  • I have no advice on the insurance issues, sorry.

    But, I do know that insurance companies are in business to make money, and, in the long run, abortions are much cheaper than paying for IF tx. It's not a moral decision, it's a business decision.
    imageimageimageAnniversary
  • ILoveRedVinoILoveRedVino member
    2500 Comments Fifth Anniversary 500 Love Its First Answer
    edited October 2013
    Yep @lilliesandvino
    It's financial.

    It sucks that IF isn't covered though, I agree.
    IUI - BFP! Baby boy born still - August 2012
    IVF - BFP - miscarriage June 2013
    FET - BFN
    FET - BFN
    Switched clinics
    IVF with PGD - three embryos created, all healthy - July 2014
    FET - transferred two embryos (boy and girl) - Nov 2014 - BFP!
    Baby Boy born July 2015

  • Additionally, abortions can be and often are medically necessary procedures. IF isn't. 
  • Completely sorry about writing the abortions thing. I am pro choice, but got caught up in the frustration of nothing IF being covered. I definitely agree with all of you in the fact that financially abortions both medically necessary and otherwise are a good decision for insurance companies to cover. I apologize for my "word vomit." Thanks ladies for your input. It means a lot to me!
    image


    Cinnabun and Junebug say, "Go Wildcats!"

  • I'm so sorry you're having to go through this.  (((hugs)))

    All of the testing was covered by our insurance company until we were labeled "infertile".  Once that happened and we started treatments, then it became OOP.  We probably spent around $1k in co-pays and covering the percentage our insurance company wouldn't cover prior to OOP.  The only things we really had to pay for OOP were our IUIs which ran us around $2,600 each.
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    * After 22 months and 2 failed IUIs, we finally got our BFP *
    DS delivered naturally at 41w6d on 4/18/14
    * TTC #2  March 2015 *

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  • Panderp said:

    Additionally, abortions can be and often are medically necessary procedures. IF isn't. 

    This seems like a weird thing to "love". It's more like a "thanks for adding additional insight" button in this case.

    Hope you all know what I meant!
    imageimageimageAnniversary
  • abt8113 said:

    Completely sorry about writing the abortions thing. I am pro choice, but got caught up in the frustration of nothing IF being covered. I definitely agree with all of you in the fact that financially abortions both medically necessary and otherwise are a good decision for insurance companies to cover. I apologize for my "word vomit." Thanks ladies for your input. It means a lot to me!

    Thanks for taking it well and not running away!

    imageimageimageAnniversary
  • Like everyone else has said, talk to your obgyn about where to start. Mine ordered an HSG for me and SA for DH. Both were covered by insurance (DH's was considered "lab work," which is 100% covered, and I just had to pay the $75 physician's fee for the HSG to be performed at their affiliated hospital, the rest was covered).

    I'm expecting a call today or tomorrow from an insurance rep to give me the low-down on further testing. Like, if some other tests get billed from an RE's office, are we SOL on insurance coverage, or is blood work from one office covered just like blood work from another office? There are a lot of variables and questions, so I would just start exploring and gathering what information you can so you're prepared if/when the time comes to move forward with help.
    imageimage
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    BFP #2: 12/31/13. B/w 12/31: betas >1000, progesterone 13.6; B/w 1/2: betas 3065, progesterone 10.2
    B/w 1/8: betas 17,345, progesterone 25.6
    Progesterone suppositories started 1/2. Please stick, baby!!
    Fiona Elise born 9/9/14 - welcome beautiful girl!
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  • My insurance covered all the IF testing, but no treatments.  The HSG and u/s ended up going to my deductible.  I agree with what everyone said and try talking to your OB first and see what the first steps would be.
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  • amccul20amccul20 mod
    Moderator Eighth Anniversary 5000 Comments 500 Love Its
    edited October 2013

    start with your OBGYN and go from there, hopefully they can do some of the basic testing for you.

    I was completely OOP for testing and treatments and it was difficult, but I paid because I had the money and I wanted a baby...but it was tough and frustrating.

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