[QUOTE=houston]It must just be offered to your employer, but your employer may have declined the coverage. Even if it is offered, there are so many loopholes to jump through, for me, even though I am really infertile, I did not qualify (when my employer had this).
If you have BCBS of Texas (I think it must be “of Texas”) then you can call the speciality pharmacy (Triessent) and they will file the meds under your major medical and they will be covered. This saved me tons of money. I thought it was a mistake, I even called BCBS and they said my meds weren’t covered b/c they were specifically excluded under my policy. Then, I called BCBS and someone else told me they were. However, Triessent handles all of this for you and you don’t even have to worry about it. They took care of everything once I found out about them (I paid for a few cycles of meds before I figured this out). You may not have BCBS of Texas, but just in case anyone does and reads this, I would like to pass this on…
Also, if none of this works for you, I did not have the money to pay for my cycles, I ended up getting a loan through the bank at a low interest rate. I also initially got a medical loan through I think Capital One or something like that. I figured I only have a certain amount of time to have children, but all the time in the world to pay the money back. I was able to pay off the two cycles it took to have my daughter right before she was born (I put absolutely all my money towards this until I had her).[/QUOTE]
Still not sure if this still works or not. Triessent is now Prime. They wouldn’t tell me anything as far as prices without a script. So I had my RE office send over a script but it had micro Lupron on it so Prime sent it to Walgreens since it needs to be compounded. Walgreens called and for 55 vials of Bravelle it was $3089 - about $56 a vial, which is more expensive than Freedom. Anyways I called Prime back and asked if they could just give me a price for the Bravelle and I was told $3,000 and the lady specifically said “because it’s going under your major medical”. She couldn’t tell me though if it is $3,000 because that is the actual cost or if it is because that happens to be the exact amount of my yearly deductible/out of pocket max. So I guess when I am ready to order meds in a few weeks I will have to have my RE office send Prime a script for just the Bravelle and Menopur and see what they say … I hate not knowing and being able to plan!