Healthy Living

Thursday, November 26, 2009

Infertility Diaries: Uninsured? Bend over.

Today I came home from vacation (Vegas, it was amazing) and found an explanation of benefits from IVF #1 back in February.

I know it's a larger issue than just within the realm of infertility, but hot damn! Insurance companies sure do get a bargain on fertility treatments!!

People don't generally talk about money. Yes, we all gripe about how expensive it is, but does anyone post the cost of each procedure? Each drug? Each lab fee for the entire Internet to see? No. When I first found out I needed IVF, I scoured the Internet for price information and found virtually nothing. Most places that talked about cost said it could cost anywhere from $5,000 to $20,000.

Everyone's protocol is different, and cost varies by location and doctor, but still. Finding out that you need stone cold science to make babies is scary enough, without having any idea about the financial ruin you are about to encounter.

Basically: Bend Over. It's Fricken Expensive.

One clinic I called wouldn't even give me information about any of their prices until I met with a doctor. Which was a fee of $300 for the uninsured. Another clinic sent me a list of prices from 2000 and said it was not accurate but they haven't updated their materials.

I am one of the lucky ones with insurance coverage for IVF. But I didn't know that at first, and I was looking into financing about $10,000 for my first IVF. The IVF that failed. There are lots of people out there who will be paying on their mortgages a lot longer thanks to IVF and other fertility treatments.

It sounds like 2 IVFs aren't bad - especially if you're someone who has been through 3 or 4 failures. But it's expensive no matter how you cut it, and excuse me if I'm wrong, but I don't think most of us have 20, 30 grand just laying around!

So imagine my surprise when I get my explanation of benefits...

Total Charges for IVF #1: $14,650

Total Paid by Insurance: $4,750

Total Patient Responsibility: $350

Now let's take a closer look, so that I may properly illustrate why I told you to bend over a few paragraphs ago...

Total Charges: $14,650 - this is the total amount of charges submitted to my insurance company from my doctor for all ultrasounds, lab work, IVF lab fees, and medications.

Subtract the $350 due from me for copays, which leaves you with charges of $14,300.

Take the $14,300 and subtract the contracted rate that my insurance company has agreed to pay my doctor, which is $4,750.

The remainder is $9,550.

Bend Over.

So, people who pay out of pocket must pay close to ten thousand dollars more than an insurance company. And this is in Ohio, where I am assuming that the cost is lower than other areas.

Does that make you mad? I mean, it makes me mad. Not just about infertility but about any medical condition that needs treatment.

Do you have insurance coverage for infertility? Does your clinic have discounted rates for self-pay patients? How do you finance your treatments if you don't have coverage?


Posted by Jen


Redbook
* Makeup Magic: Bigger Eyes, Plumper Lips & a Firmer Fanny
* Goodbye to Fad Diets
* 5 Things Super-Happy Couples Do Every Day
* Sexy Fiction Blog: The Diary of E
* Get More on Love, Family & Fashion - Subscribe to Redbook & Save up to 82%!


Reprinted with Permission of Hearst Communications, Inc.
Syndication:

From the Community…

Comments 1-10 of 43
  • Mysterious Gryphon's Avatar
    Posted by Mysterious Gryphon Mon Aug 11, 2008 12:53pm PDT

    Ummmmmm .... you don't need IVF. No one does.

    There are lots of beautiful babies and children out there in the world who desperately need mommies and daddies to take them home and love them. Why not invest that $9,550 in a child that already exists instead of whining about the state of your uterus?

    Report Abuse
  • Nicole F's Avatar
    Posted by Nicole F Mon Aug 11, 2008 1:21pm PDT

    Ok. Well, Mysterious Gryphon, while I agree that adoption is a great alternative, you are being incredibly insensitive to what must be an incredbily painful and emotional issue. And if she wants to have IVF, it's her right. I do feel that since it is essentially elective, the patient should have to pay out of pocket for some portion of it. But I think anyone would "whine" about paying 10 grand for somthing that might not even work, in order to make a dream come true.

    Report Abuse
  • Elissa's Avatar
    Posted by Elissa Mon Aug 11, 2008 1:29pm PDT

    we have a biological urge to carry on our genes. Some couples don't want to adopt. Plus most people want babies and it's hard to adopt a newborn. They're in demand.

    Yes, there are perfect grown children out there, but you gotta be one hell of a good person to opt out of those first few years.

    There's nothing wrong with choosing IVF over adoption.

    Report Abuse
  • Erica's Avatar
    Posted by Erica Mon Aug 11, 2008 1:37pm PDT

    Obviously Mysterious Gryphon has never had to try any of the above...do you really get how LONG it is to wait for a baby to adopt, and how expensive it is? If you're going to fork out that kind of money, it should be that person's decision to spend it how they wish. I suggest keeping your trap quiet unless you've walked in their shoes before. It's not a fun walk.

    Report Abuse
  • Carol's Avatar
    Posted by Carol Mon Aug 11, 2008 1:40pm PDT

    Wow, that is shocking. My husband and I went through a round of IVF along with some other interventions (unsuccesfully, in California). We spent at least $20K out of pocket, as both of our insurance companies categorically deny coverage for fertility treatments (even though our monthly insurance premiums top $1200). So -- if I were an insurance company, I would have spent maybe $5k for same. Nice "system" we have here in America, isn't it?

    Report Abuse
  • Auntie Daisy's Avatar
    Posted by Auntie Daisy Mon Aug 11, 2008 8:55pm PDT

    My insurance was GREAT, as my husband and I went throught three cycles of IVF. We spend, on a total of maybe 700.00 out of pocket for each cycle. We've checked into adoption, but yes it is very expensive, 20k for a newborn, and months or years of waiting. Yes, we could adopt out of the country and save ourselves 2k, maybe. It is quite sad when we hear of babies found in dumpsters, or newborns shaken to death, when their are GREAT people who would just love to love a baby. Our country makes it so hard to adopt, and its a shame.

    Report Abuse
  • Julio L's Avatar
    Posted by Julio L Mon Aug 11, 2008 9:53pm PDT

    Hard working tax-paying adults are denied coverage for Infertility, even though this is a recognized medical problem. Yet illegal alien scumbags enter America and receive tax-payer funded healthcare.

    It sickens me.

    Prisoners, sex offenders in prison receive tax payer funded Viagra.

    What the Hell is wrong with this country?

    IVF should be covered as long as we are paying the healthcare benefits of illiterate peasants and jailbirds

    Report Abuse
  • Maddam's Avatar
    Posted by Maddam Mon Aug 11, 2008 10:06pm PDT

    I'm glad to see that the majority of you who have commented on this blog are not as ignorant and stupid as others. The problem of infertility reaches farther than most people care to hear about. Yes there is many children out there that are in need of homes but the Government and greed of these so called agencies looking for homes for these children make it almost impossible to adopt and even if you are lucky enough to find and adopt that child you face the chance that the parent that gave up their rights will come back for a second chance and the courts have and will always side for the rights of the biological parents, even the unfit ones. So until certain persons know the facts of the system maybe they should keep their, uneducated opinions to themselves. For those out there who suffer from this, I myself am there too and wish you all the best of luck.

    Report Abuse
  • Meghan's Avatar
    Posted by Meghan Mon Aug 11, 2008 10:07pm PDT

    The insurance company's have negotiated with providers to pay certain amounts for certain procedures and care. It is the bulk rate type of idea, if they can guarantee that X number of people will use their center for fertility treatments then they are given a discount rate. It is a supply and demand issue. It is a sad thing when couples cannot get pregnant, but it is an elective choice to go through IVF, and an expensive on at that.

    Report Abuse
  • PaulD's Avatar
    Posted by PaulD Mon Aug 11, 2008 10:08pm PDT

    Mysterious Griffon, you are correct that there are many children out there that are in need of being loved but to tell someone they don't have the right to try and have their own children is unfair. Claiming to "whine" about the situation is a cruel statement with something as incredibly sensitive as this topic! Please try to be more understanding and sympathetic to women who have infertility issues.

    Report Abuse
Comments 1-10 of 43

leave your comment

You must sign in to post a comment

Sign In for personalized information

New User? Sign Up

Health Byte

Who doesn't want to look hot at all those holiday parties? ExerciseTV shares how to get in skinny jeans-shape -- and quickly!