What I Learned From Trying to Order IVF Meds

Published August 30, 2014 by Jennie

August was supposed to be our IVF month.  It has come and (almost) gone and I have yet to even start injections.  Our first hold up came when LabCorp botched my genetic testing  which put us back a few weeks (you can read about that here).  Well those tests FINALLY came back this Thursday and everything was fine.  My RE then called in my IVF drugs to the pharmacy.  The plan was to get those on Friday.  Apparently, the pharmacy my RE used does not take my insurance.  I have Blue Cross Blue Shield and they are very picky about which pharmacy they will use for infertility medication.  My RE then called everything in to another pharmacy which we later found out is also not approved my insurance.

I called my insurance and they told me that the only place I can go to is called Freedom Fertility.  I hope no one ever has to use them because they are awful.  I called them Thursday evening and they said they had not gotten my prescription even though it had been sent several hours ago.  I try again on Friday morning and they finally had it. They told me if I gave them my credit card they would process everything and get my meds to me by Saturday.  It sounded strange that they wanted my credit card information before they would even tell me the prices with insurance.  I told them I had a right to know the total cost of a purchase before I make it and I wanted a total before my card got charged.  They did not like that.

I told my RE and she said that Freedom Fertility uses very shady business practices.  They are the only pharmacist my RE knows of that will not give insurance prices to doctors over the phone.  Also, they make the cash price of a drug much higher than other places.  In some cases, using insurance with them is more expensive that paying out of pocket at other pharmacists. For example, 3 units of Follistim 600 is $1,655 at the original place my doctor sent my meds to (Success Meds), but at Freedom Fertility, it is $3,237.

Freedom Fertility told me they would not give me copays until my order went to processing.  I do not understand why they could not just look that up.  I told them I needed to get those copays ASAP.  They said they would call me back in an hour with that information.  After an hour came and went, I called them back and got the same story.  I continued to call them every hour with the same story.

At about 5:30, they called me with the copays.  They also told me that one drug, Lupron, needs prior-authorization. When I last spoke to my insurance company, I SPECIFICALLY asked if any of the drugs needed prior-authorization and they said no.  At this point, my RE is closed so I am out of luck.

Due to the holiday weekend, the earliest these drugs can be shipped is Tuesday with Wednesday arrival (this is assuming no other problems).  This might not be so bad but I recently learned our insurance may be ending soon (this is a long story I may get into later) so our time is limited.  I really want to run genetic testing on our eggs but that would turn my cycle into a FET and we simply may not have that much time.  In fact, we may not even have time for one fresh cycle, especially if we keep running into problems.  I do not think I have ever been this frustrated in my life.  This whole process has been awful and we haven’t even really started yet.  I just want to hide in my room and cry. – Jennie

 

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39 comments on “What I Learned From Trying to Order IVF Meds

  • Yikes! I’m so sorry. I don’t think Lupron has to be from a fertility pharmacy, because it is often used for women undergoing the “change of life”. If you have a nearby pharmacy you can probably get it there instead with your insurance because it is technically NOT a fertility drug, though you are using it as such. I’d give that a try. I work at a hospital, so I get a greater discount for drugs that I order there, so my non-fertility drugs are filled at my hospital pharmacy instead of the fertility pharmacy and it has worked out great for me. Good luck! If you were close by, I’d give you my extra Lupron to get you started!

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    • Yeah, all I really need to get started is the Lupron. That one needs a prior authorization so I am hoping my RE calls me back even thought they are closed. Then maybe, I could just go to a regular pharmacy.

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  • So sorry to hear this. I had trouble ordering drugs and waiting for insurance approvals too. No one seems to understand that fertility treatment is time sensitive. I will pray that everything works out!!

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  • This process is crazy, I start the priming today and just found out yesterday I’m supposed to be taking meds that no one realized I should be taking until I specifically asked about it! Luckily I had time to pick them up at the pharmacy yesterday and my pharmacy was a lot easier to deal with than yours seems to be (so far!)! I really hope you get everything sorted- the last thing we need is more stress about doing all of this!

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    • I am so glad you got your meds worked out. It makes me sad to see how many people have had problems getting their meds. This is supposed to be the easy part. I hope your cycle works out!

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  • Unfortunately, getting fertility drugs with insurance coverage is more expensive than paying out of pocket, which is the opposite of paying for treatment out of pocket. We had a $5000 coverage for fertility drugs and it was used up even before I could get all the meds for my first cycle. Fertility drug companies charge insurance company more for some reason. If we had paid out of pocket, it would’ve cost less than $3000. That’s the opposite of fertility treatment. Insurance paid so little for the treatment that a $10,000 coverage could last us 2 retrievals, and IUI, and all the bloodwork and ultrasound in between. That’s the world of ART for you. It’s a totally frustrating process. It’s even more frustrating when there is a long weekend. I hope that everything gets sorted out for you early next week.

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  • so frustrating. i’m trying to balance the best of both worlds. i have most costs of IVF covered by insurance, but i basically pay the pharmacy out of pocket, then get reimbursement later. on the other hand, my RE is billing the insurance directly. still have yet to see my reimbursement check though, even though my online account showed they approved it last week. fingers crossed, or paying all the bills next month is going to be very dicey! i hope you get your meds ASAP!! sucks on FF’s part, but it sounds like they aren’t alone. i will say their training videos and app have been very useful.

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  • So sorry you are having so any problems! I on the ther hand had a great experience with them both time I used them. I got my meds much cheaper through them using my insurance, but I also have UHC. Infertility is hard as hell, why can’t the processes involved at least be easy!!!

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    • I am so glad you were able to get your meds with no issues. It is possible that UHC makes things easier than BCBS. I feel like the rest of this is supposed to be the hard part, not simply getting the meds. Hopefully this will be our last roadblock (then again you never know!).

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      • I do know with UHC I asked about copays and they had them to me immediately. So I bet it is a insurance thing. My RE gave me a huge packet of all fertility med places they have worked with successfully along with their non insurance prices on meds. It was a huge time saver!

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  • OMG this is awful. 😦 When the dust settles a bit you should definitely write a formal complaint about this pharmacy to your insurer and show them how they are getting screwed. I hope there is some light at the end of this very frustrating tunnel soon!

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  • I am so sorry you’re having to go through so much crap just to get your meds. Like those of us dealing with infertility don’t have enough on our plates without pharmacies trying to rip us off. Good Luck and I hope you get your meds very soon!!!

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  • I am so very sorry that you are going through all of this! Does your RE have someone on call or an emergency number? If so, I would page or call the on call person or the emergency number to see if they can get you some sort of samples or get the meds. pre-authorized and you could maybe get the one at the pharmacy. I definitely understand why you are so frustrated and not giving prices ahead of time is ludicrous! You are in my thoughts and I am sending lots of positive energy your way!

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    • I didn’t think to do that. Thank you so much for the suggestion. I would be good if I can just get some Lupron. Everything else can wait a bit. Someone recently told me that it can usually be filled at a regular pharmacy. I could always try to get reimbursement later. Thanks again! The suggestions and tips I get from other bloggers are always do helpful.

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