Fertility meds assistance - Long and lots of info

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I have spent most of this week fighting with insurance companies and speaking with pharmacies in some attempt to save any money that I can. Especially since my insurance is not the best at covering these meds with a $2500 lifetime max!

Here are a few things I found out.

1. Fertility Life Lines 1-866-538-7879 through Freedom Fertility Pharmacy has two assistance programs. One is Fertility Assist and one is Fertility Assist 2 (creative, huh?). In order to begin to qualify and get an application for either of these programs you cannot have ANY insurance coverage. Even though I have hit my cap, my insurance pays 50% of meds. That sounds great, but sometimes it ends up being more expensive than the cash paying price anyways, because pharmacies charge insurance companies more.

2. Once you "qualify" to move forward with these programs, you will receive an application, and I was told you would have to send in your last 1040 you filed, two recent paystubs for you and your partner as well as a list of all fertility out of pocket expenses you have incurred over the past year. The last part is huge because that goes against your salaries and helps establish the need for assistance. The qualification is based on poverty level in your area. That sounds sad that you have to go that low, but that's what I was told.

3. Fertility Assist Program will help pay for Gonal- F, Cetrotide and HCG for one cycle. If you do not use one of these, that's okay, it's not an all or none deal. I think the gonal-f is the biggie for most people.

4. Fertility Assist Program 2 will pay for part of Gonal-F if you have used it in a prior cycle. I believe you had to use at least 900Ius the first cycle and at least 900 ius the second cycle to qualify. They will pay either $250 or $500 towards the next cycle if you qualify for the program. And the only qualification from what I understand is no insurance coverage and it is your second cycle with the appropriate dosage. Your RE signs you up for this program when they call your meds in.

5. I found out that Lupron is not considered a fertility drug. So, if you have insurance, but it does not pay for fertility drugs, make sure that your pharmacy is still running Lupron through the insurance. I know some pharmacies don't run any of it if you tell them that you have no fertility coverage, but Lupron could be covered and mine saved me $115!!

6. There is a program called Heart Rx Initiative that can be used for Menopur or Bravelle. I got the brochure from my RE and it looks like it can be used with a lot of different pharmacies. Ferring Fertility You cannot use it in combination with insurance, so again, cash paying patient. There is a 1 year membership fee of $10, but it still is worth it I think. You would receive $18 off on every vial of Bravelle prescribed by your doctor up to 100 vials. And you would receive $3 off every vial of Menopur prescribed by your doctor up to 100 vials.

7. This last program I am not familiar with, but it is listed on the back of a pricing card my RE gave me. It's called the Design Rx Managed Cash Program through Village Fertility Pharmacy. Village Fertility Pharmacy - The Infertility Specialty Pharmacy or 1-877-334-1610. It says it is a program for those who do not have insurance benefits for Follistim, Ganirelix and Pregnyl or for individuals who have exhausted their insurance benefit for these medications.

I wish I had a lot of this info back when I was starting my injectible cycles. I really hope this information can help some of you ladies out. And please, fight the insurance companies if you ever feel something is not right. I just found out that I overpaid for my first IVF cycle by $570 and unless I brought it up, I probably would not be getting that money back!

Good Luck!