My insurance is BCBS of NC and it does not cover IVF. I went to 3 IVFs clinics talking about IVF and all of them told me my insurance probably would not cover the medicine and that I would have to pay out of pocket around 3000.00. Well Cooper institute sent my medicine in to 2 pharmacies and they both just called me. One of them said my out of pocket would be a little over 2000.00 and that it would be 3 business days to see if my insurance would cover it. The other insurance company said that out of pocket would be $3400 but it put it thru to my insurance and that I only owed $336.00 Which is a good thing but I hope if I pay that that they dont come back and tell me I owe more later.
you should call your insurance company and ask them directly if they are going to cover it like. you dont want to get a bill in the mail at a later date to worry about.
If the pharmacy is willing to give $3000+ worth of meds for $334, it means that your insurance already APPROVED it. No pharmacy is going to dispense $3000 worth of product hoping that the insurance pays, and then have to try to collect that from a patient who may or may not be able to pay.
I’d call the ins co just to be certain, but I can say with confidence that the pharmacy has already gotten the green light to dispense it and your co-payment/co-insurance is $334.
Sounds promising! I was told at first by my insurance company that alot of the procedures would be covered. I didn’t think that was true from what I read…so when I called back I was told that they are not. I was disappointed to say the least. I was told to have your doctor/pharmacy do a “pre-certification” letter to verify everything up front. Sounds like maybe that is what they did. Good luck!
Check out my blog if you like…
Every time I called my company to verify medications, they stated “not covered”…and everytime I ordered them from the in-house mail order service, they were covered…I paid about $275 out of pocket for my IVF cycle and about $75 out of pocket for each IUI cycle. I have decided to accept this discrepency as a gift from God that something is covered and live with the fact that coverage will always be verbally denied, but always shows up on the order form.
The other comments are right…they would not give you the meds without some sort of pre-approval…just accept this as the gift it is!