Well a lot has been going on recently. My 4
th attempt at and
IUI didn't work out and was cancelled. Dr.
Slackman then suggested we move onto injects so my body will respond better. He suggested
Follistim, I called our pharmacy and it is not covered. I then called Freedom Pharmacy and was told it would cost around $1200.00 OUCH she then suggested
Gonal-F it's a little cheaper as they have a good relationship with the manufacture. It is only $707.00 for the same amount of medicine. That sounds better, so we're thinking about that and maybe
IVF next year.
In the mean time our employer decided they are revamping our health insurance next year and it's going to be much worse than what we have now which is really really good insurance! I was so scared to hear about the infertility coverage b/c we have had it so good this year. We've been trying for two years and I want to continue trying with the help of our health insurance. I called and got the specifics last week and
NOTHING is covered after
diagnosis which we did last year.
AHHHH seriously oh my gosh?? So that kicked
IVF into high gear for us.
Dr.
Slackman suggested another Dr in Richmond about 3 hours away for us to visit to at least get a second opinion. We figured we might as well schedule that appointment so we did for October 14
th. We took the day off from work and traveled to Richmond. We met with Dr.
Edelstein and the nurses and insurance specialist and just loved the facility and how comfortable they made us feel. We got all the info and tons of
pamphlet's to look over he suggested I have Poly
Cystic Ovaries b/c of all the symptoms I have. He wrote us 3
prescriptions one for the pill to take before the procedure, one for an antibiotic for both of us to take and the third for
Metformin to help reduce insulin amounts. He said for me to call him when I got my period and he would let me know when to start the pill and antibiotic. We then went off to give blood and get a baseline work up for me and of course I got to visit the
stirrups for an exam. He said I had one large
follie at 23mm looked like I was going to ovulate I just didn't. He said everything else looked great. We we thrilled thinking this could really be
happening and that we were going to be doing
IVF in the end of November and how exciting it was going to be. He gave us a 50% success rate given our age and health. The center averages 60% success. Great News!!! Next was the meeting with the insurance specialist she told us our coverages which we already knew and then said the Center that the procedure would be done at is out of network and that we would need to pay the procedure amount up front which comes out to be
$7420.00. Our mouths dropped we had no idea and there is
absolutely no way we can come up with anything close to that. She suggested financing until we got reimbursement from our insurance and I decided at that moment I was going to do everything I could to get this covered. This morning I called the
IVF Center in Richmond and was told that we would have to have Dr.
Edelsteins permission and approval to not pay upfront and she would speak to him about it and also suggested I look into insurance
deeper. I went back and forth with the
IVF Center and my insurance all morning. I received a call from the insurance specialist with Dr.
Edelstein who suggested sometimes insurance companies will to a waiver if another center is not within a certain mileage. She told me to call my insurance and explain there is not another
Andrology center within 100 miles and to see about a waiver. I called and we do qualify for a waiver when the center is over 30 miles away and gave me another 800 number to call to request approval. I called that number requested approval and we should know something in 5-10 days.
We have Dr.
Edelsteins approval for the center to bill the insurance directly and all we need is our insurance approval to use an out of network center since there is not another one in net work for 100 miles. It's going to be a long 5-10 days. I pray so hard we get the approval and that we can go forth with a November
IVF! I pray and pray and pray so hard!!!!