Cha-Ching

The word “payor” is in our file, with a big ✔️ mark next to it. It sounds so exciting, doesn’t it? Almost like when your elementary teacher handed back your worksheet and there were stickers on the top of it with a big red check. A check mark is usually a good thing: check minus- not good, check- good, check plus- great! So a check, therefore means we are good!! Except when it does NOT mean that. There are no star stickers on the top of our papers, not even one of those cute puppy stickers. Or the silly smiley faces that my teachers always had for our spelling tests. Stay with me here…

Infertility isn’t a fun experience, but thank goodness for health insurance! We told the doctor what our insurance was, and he said, “ok, we will figure it out. (We meaning the ladies that work in the office.) Why don’t you just call to see what they cover?” Of course, once we were back at home, I logged into my account online and started looking for the breakdown of coverage. There was nothing. Not a single mention of fertility or infertility. Zip. Zilch. Nada. The website of course had a disclaimer saying that not all services were listed, and to call for further inquiries. So I call. 

I explained why I was calling, and that I was trying to determine what my insurance would cover. I was then informed “there’s no coverage on this plan.”

Nothing. 

Zip. 

Zilch. 

Nada. 

….whatttttttttt?!? Then I had to know if the other plan that was offered through my employer had the coverage. Again, no. “Ok, if the appointments aren’t covered, my prescription benefits will cover the medicine and injections and anything else. Correct?” After being transferred to the “prescription benefits” person, I was told “unfortunately, there’s no coverage for prescriptions for fertility treatments” …WHATTTTTTTTT?!? 

Here’s a fun fact though, and please make sure you’re sitting for this. Should I ever decide to have my boobs done (yes, boob job…breast augmentation sounds so clinical!) a tummy tuck, or a face lift, drum roll please…my insurance covers it!! So they’ll cover pumping me full of chemicals and insert implants, but not cover or assist us in trying to have a child. Insert perplexed face, some expletives, and a BIG glass of wine. Not tonight, when this all happened I had a large glass of wine. Maybe 2. 


Mind you, prior to making this call, our doctor had already given us a “rough breakdown” of costs, should we not have any coverage. He was sure we would have some, but was quick to remind us that should we not, this process gets expensive. Fast. Very expensive, and at an accelerated speed. I had done research and knew costs, but I was just reading them. I didn’t think we would have to deal with the cost, between $1,000-$10,000, depending on what option we wanted to try. Let me clarify, that is $1,000-$10,000 PER treatment. 


Disregard the chicken scratch. Those are the rough prices. We went with the top line. Less sticker shock if you will, and a pretty significant increase in the chance of getting pregnant. So we went with Clomid – HCG – IUI. 

Grand total: $1,996.45           Eeeeeeeep 😳

Back to that ✔️…we are the payors. Which in the infertility world is not a good thing. The costs are on us. There are no shiny sparkly stickers.Our Doctor only takes credit cards or…CASH! The check mark is the scarlet letter in our file. (Hawthorne anyone?)

We’ve now started round 2…same things, Clomid – HCG – and IUI. Here’s to another $2,000, no, $3.55 less than an even $2,000. 

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7 thoughts on “Cha-Ching

  1. I have discovered through a year of this BS that the only things covered by insurance that are relevant to infertility treatments are: 1) birth control pills (no comment), 2) Femara (because it’s used primarily for breast cancer patients, which is why I did that last year instead of Clomid which isn’t covered at all), and 3) Estradiol pills (because they’re used for menopausal women primarily). Otherwise, we’re SOL. But yeah, my husband’s employer DOES cover the cost of sex changes !

    Liked by 1 person

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