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Can’t afford an IVF? Read on to see our insider’s advice

How to pay for an IVF is a worry many couples face once they’ve reached the decision to move forward.  Find some options in our insider’s information.   

The world of ART (Assisted Reproductive Technology) is an expensive one.  An IUI (Intrauterine Insemination) alone can start at around $300.00 per round.  Some couples will require several series of IUI’s before hopefully achieving success.  However, once you move on to an IVF (Invitro fertilization), costs run in the thousands of dollars without even considering the other thousands of dollars the hormone medications will cost.  Because of this, think that IVF isn’t an option for you?  After undergoing several IVF’s myself, I’ve gained some valuable information which might help you think outside the box and finally be able to afford this costly procedure.  Read on…

  1. Did you know that many clinics offer what are called “Clinical Studies” which, if you qualify, can significantly lower the costs associated with IVF?  These studies can encompass a wide range of requirements such as being in a particular age group, whether you are a 1st time IVF patient, if you suffer from DOR (Diminished Ovarian Reserve) which would mean being willing to take a new hormone or supplement, etc.  If you meet these certain criteria to qualify for the study, all costs associated with your IVF can be covered or you might only be responsible for paying for the medications needed.  These studies, their requirements and offerings vary greatly from clinic to clinic.  They are conducted in numerous clinics throughout the U.S. and more than likely, a clinic near you is looking for new participants for a study in process.  For a list of clinics in your area and their clinical data, check out www.sart.org and also our article on choosing the right clinic for you.
  2. Just like RE (Reproductive Endocrinologists’) clinics vary in data and statistics, so to do they vary in price.  It’s always a good idea to inquire about all the costs which would be associated with your treatment, including blood work for both partners, semen analysis, any medical procedures prior to the IVF, the drugs the doctor will recommend (as they too vary in price), and the costs associated with retrieval and transfer.  The better informed you are prior to undergoing the IVF, the better prepared you will be financially and emotionally.
  3. Once your medications have been recommended by your RE, ask your doctor if the generic version of the medication would be a suitable alternative.  One such medication, Follistim, can vary greatly in price when compared to its generic equivalent, Gonal-F.  One caveat- not all drugs perform the same and what works for one person might not in another.  Don’t be convinced by the pharmaceutical companies that their product is equivalent.  It might be in its chemical compound form but, once it’s inserted in a human body, all is a waiting game to see the actual results.  Believe me, after undergoing several IVF’s myself, I can personally tell you that this is just not the case! I’ve gotten great results while only sticking with a name brand while other ladies I’ve known, have gotten the exact opposite effect.  There always are differences in medications (even in the exact generic versions) so talk in detail with your doctor before deciding which course of action to take.
  4. The drugs used in an IVF are meant to stimulate your ovaries so that your follicles/eggs, over the course of the IVF, will mature and continue to grow in order to be “retrieved” and then fertilized within a lab setting.  The drugs used to “mature” these follicles are very expensive and can range into the thousands of dollars for a full IVF cycle.  Since the average time frame of an IVF and the use of these stimulating drugs can vary greatly (between 10-15 days), an average treatment can cost you thousands of dollars.  Yikes! If you’re lucky enough to have your insurance carrier cover these costs, you are definitely in a privileged group.  However, if you will be responsible for these costs on your own, consider purchasing your medications from a pharmacy which works with self-pay individuals and can offer these drugs at a significant price reduction.  One such pharmacy is www.freedomfertility.com.  They offer the same medications your doctor prescribes but at a discounted price for self-pay patients.  Another pharmacy to check out is www.villagefertilitypharmacy.com which can also offer discounts on medications for self-pay patients along with providing helpful information for patients.
  5. Let’s talk about insurance.  Many insurers now offer benefits for infertility treatments.  In fact, a number of states have enacted some form of infertility insurance legislation and many more states are set to follow suit.  Now, if you’re one of the lucky ones with a good plan that offers Infertility or Assisted Reproductive benefits (as they are routinely called) but are unsure as to your coverage, you’ll make that important call to the 1-800 number on the back of your insurance card to inquire further.  Don’t be surprised, however, if the person on the other end of the line knows less about it than you do! There is always room for interpretation and pay attention not only to what’s actually stated, but also to what is not.   Infertility benefits are almost always a separate part of your insurance plan and needs further investigation than the first representative you reach can offer you.  Don’t be deterred and be your own advocate!  Continue “up the chain of command” until you reach the right department and speak with the right representative.  It will make a world of difference as to what your final financial obligations might be.  BTW- Don’t be surprised if you ultimately find out that only the procedures are covered or just the medications (or both hopefully!).  Plans differ greatly as to what they are willing to pay.  It always amazes me when I hear about a plan that will pay for an IVF retrieval but won’t cover the costs of the medications needed to start the process!  With this insight, you can at least be prepared for anything you hear.  One source to consider in enlisting some help navigating the insurance maze by calling Fertility Lifelines at 1-866-LET’S TRY (1-866-538-7879).   They can help verify what coverage you do have if you’re stuck and need some assistance.
  6. Let’s say that you do have insurance coverage but the medications are not covered under your Infertility benefits.  As I always say “let’s try out a different path to get a different result”….ask the representative if the medications might actually be covered if your Gynecologist prescribes them?  Or perhaps your Primary Care Physician (PCP)?  One caveat to keep in mind: fertility medications are almost always through the prescription coverage of your plan and separate from your medical coverage.  Therefore, you might be told (incorrectly) that you have no medication coverage because it doesn’t show up in the medical portion of your plan on their screen.  Don’t stop however!  Continue on your quest and be prepared to talk to several (perhaps confused) benefit representatives until you navigate the complicated waters of infertility coverage.  Remember, always look for an alternative to a problem and you just might find a solution.
  7. An insider option that is much less known…ask your RE’s office if they have samples they are willing to share with you. Some clinics have a very limited supply of medications to give to IVF patients but it doesn’t hurt to inquire.  Even a day or two’s worth of medication of say, Follistim for example, can save you about $700!
  8. Lastly, one that I have seen quite often occur, are IVF patients “donating” medications after they conclude their own IVF cycle.  There could be many reasons for this: a failed IVF cycle, the days it took for their ovaries to be stimulated were less than anticipated, the medications have been stored and will soon expire, etc.  I am happy to say that I have donated medications to others in need and was glad to help out in any way I could.  Other ladies have donated to me so it’s a “pay it forward” philosophy.  Of course, there is a huge caveat attached to this option in that you must wholeheartedly trust the person donating with the proper care and handling of IVF medications (some of which have to be constantly refrigerated).  It is an occurring situation which is generally frowned upon by both the RE’s and the pharmacies as a whole, but a last resort to those who don’t have other means of purchasing these costly medications.

IVF is costly and financially draining but there are options out there to help you cover the costs.  Remember, we are all here to help one another through this tough journey we’re facing.

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