Question about insurance and prescriptions

kelbel · 10-13-2009, 06:22 PM

I'm sure I could ask my insurance company, but I don't want to draw attention from them.

I'm starting Femora/Follistim soon. My insurance (Anthem) will not pay for infertility treatments, but I do have prescription coverage. Does anyone know if I will need to pay more than the co-pay? I've heard from several that Femora was covered because it's actually a breast cancer drug. What has your experience been? TIA

**BC-MomZ** · 10-13-2009, 06:34 PM

Does your RX coverage cover the infertility drugs? Not sure if you will have to pay more, depends on how much they cover and if there is a deductable or co insurance.
GOOD LUCK
Julie

iMama · 10-15-2009, 11:34 AM

From my experience with this, it will depend on how much your Anthem Dr wants to help you. My obgyn was willing to write prescriptions for everything I needed, (even though my RE is at a completely different clinic) but insurance only covered my steroids and antibiotics through my regular co-pay. However, the cost for a few of the other drugs was still cheaper through my HMO, even though only 50% was covered.

I do reccomend shopping around for your IF drugs. I wasn't precribed Femora, but I was able to save $1425 on Follistim alone by getting it from a different place. I am saving $1600 total by getting my IF drugs from 5 different pharmacies. I wrote about this on my blog at Lowering IVF Medication Costs Vintagemother’s Blog If anyone wants me to email them a spreadsheet with the prices I found, let me know. I compared prices at Freedom, Schraffts, Walgreens, Target, Kaiser, IVFMeds.com, and some other places.

So, if your Dr wants to help you, I think he can prescribe it, if he doesn't, he might not even be willing to prescribe it.

Good luck!

kelbel · 10-17-2009, 09:23 AM

Thanks imama! I got the email. I am in need of a few drugs not on there, so I did some research. I think I'm going with Walgreens specialty pharmacy. I didn't even know they had those. They have free next day or 2 day shipping (depending on what you spend). Here is the link if anyone's interested:

Walgreens Specialty Pharmacy fertility support

iMama · 10-17-2009, 02:19 PM

Thanks for the link. Were you able to find prices on for Walgreen's or did you have to call?

10-13-2009, 06:22 PM	#1 (permalink)
kelbel 0-99 post 2 of hearts Join Date: Oct 2009 Location: Indiana Posts: 7	Question about insurance and prescriptions I'm sure I could ask my insurance company, but I don't want to draw attention from them. I'm starting Femora/Follistim soon. My insurance (Anthem) will not pay for infertility treatments, but I do have prescription coverage. Does anyone know if I will need to pay more than the co-pay? I've heard from several that Femora was covered because it's actually a breast cancer drug. What has your experience been? TIA

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10-13-2009, 06:34 PM	#2 (permalink)
BC-MomZ Board Coordinator Join Date: Jan 2002 Location: New England Posts: 7,583 Blog Entries: 385	Does your RX coverage cover the infertility drugs? Not sure if you will have to pay more, depends on how much they cover and if there is a deductable or co insurance. GOOD LUCK Julie

10-15-2009, 11:34 AM	#3 (permalink)
iMama 0-99 post 2 of hearts Join Date: Mar 2009 Location: Northern CA Posts: 58	From my experience with this, it will depend on how much your Anthem Dr wants to help you. My obgyn was willing to write prescriptions for everything I needed, (even though my RE is at a completely different clinic) but insurance only covered my steroids and antibiotics through my regular co-pay. However, the cost for a few of the other drugs was still cheaper through my HMO, even though only 50% was covered. I do reccomend shopping around for your IF drugs. I wasn't precribed Femora, but I was able to save $1425 on Follistim alone by getting it from a different place. I am saving $1600 total by getting my IF drugs from 5 different pharmacies. I wrote about this on my blog at Lowering IVF Medication Costs Vintagemother’s Blog If anyone wants me to email them a spreadsheet with the prices I found, let me know. I compared prices at Freedom, Schraffts, Walgreens, Target, Kaiser, IVFMeds.com, and some other places. So, if your Dr wants to help you, I think he can prescribe it, if he doesn't, he might not even be willing to prescribe it. Good luck!

10-17-2009, 09:23 AM	#4 (permalink)
kelbel 0-99 post 2 of hearts Join Date: Oct 2009 Location: Indiana Posts: 7	Thanks imama! I got the email. I am in need of a few drugs not on there, so I did some research. I think I'm going with Walgreens specialty pharmacy. I didn't even know they had those. They have free next day or 2 day shipping (depending on what you spend). Here is the link if anyone's interested: Walgreens Specialty Pharmacy fertility support

10-17-2009, 02:19 PM	#5 (permalink)
iMama 0-99 post 2 of hearts Join Date: Mar 2009 Location: Northern CA Posts: 58	Thanks for the link. Were you able to find prices on for Walgreen's or did you have to call?