Buying IVF meds as Kaiser Fed

[Anonymous]

Hi all. I just got my Kaiser coverage started and am beginning my protocol soon. What is the best (i.e. cheapest) pharmacy that you've used with Kaiser? As far as I can tell they should cover meds -- should I just do my nearest Kaiser pharmacy?

[Anonymous]

All Kaiser pharmacies have the same price. I've never been able to use another pharmacy with Kaiser. When I was in another state that didn't have Kaiser (emergency) I had to pay out of pocket at CVS.

[Anonymous]

Op here - do I have to use a Kaiser pharmacy, or could I use Freedom Fertility and still have Kaiser cover the costs?

[Anonymous]

Anonymous wrote:Op here - do I have to use a Kaiser pharmacy, or could I use Freedom Fertility and still have Kaiser cover the costs?

I used Kaiser, but I think FF was a little cheaper. No Kaiser won't cover any costs at FF. Kaiser only pays 50% of "their rate," which is higher than the normal rate.

[Anonymous]

Op how did you get started so quickly? I haven't even received my membership card yet?

[Anonymous]

OP here. I got my membership card around Jan. 1, maybe a few days before? As soon as the insurance switched over (literally as soon as the Kaiser line opened on the 10th) I called to make an appt with ob/gyn, which I had on Tuesday morning. She referred me to SG, but the referral takes up to 7 days to process, so I am getting other things lined up in the meantime.

Even if you haven't gotten your card in the mail the Kaiser people on the phone can give you your member ID #. That's all you need to get started with them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op here - do I have to use a Kaiser pharmacy, or could I use Freedom Fertility and still have Kaiser cover the costs?

I used Kaiser, but I think FF was a little cheaper. No Kaiser won't cover any costs at FF. Kaiser only pays 50% of "their rate," which is higher than the normal rate.

Thank you for this. So overall, was it cheaper to go with expensive Kaiser meds covered at 50%, or cheaper FF meds paid OOP?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op here - do I have to use a Kaiser pharmacy, or could I use Freedom Fertility and still have Kaiser cover the costs?

I used Kaiser, but I think FF was a little cheaper. No Kaiser won't cover any costs at FF. Kaiser only pays 50% of "their rate," which is higher than the normal rate.

Thank you for this. So overall, was it cheaper to go with expensive Kaiser meds covered at 50%, or cheaper FF meds paid OOP?

I would do Kaiser because it does count towards your out of pocket for the year. But get quotes from both, I'm sure the pricing has changed for 2016.

[Anonymous]

Hi - question for OP here - before you got the SG referral, did Kaiser make you redo all your testing? I also just switched, did all my testing in Nov 2015 while covered by BCBS, but Kaiser has asked me (and hubby) to redo all before they can do a SG referral. I'm amazed and impressed you made it happen so quickly.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op here - do I have to use a Kaiser pharmacy, or could I use Freedom Fertility and still have Kaiser cover the costs?

I used Kaiser, but I think FF was a little cheaper. No Kaiser won't cover any costs at FF. Kaiser only pays 50% of "their rate," which is higher than the normal rate.

Thank you for this. So overall, was it cheaper to go with expensive Kaiser meds covered at 50%, or cheaper FF meds paid OOP?

I would do Kaiser because it does count towards your out of pocket for the year. But get quotes from both, I'm sure the pricing has changed for 2016.

Fertility meds are not counted towards out of pocket expense. Fertility treatments as well.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op here - do I have to use a Kaiser pharmacy, or could I use Freedom Fertility and still have Kaiser cover the costs?

I used Kaiser, but I think FF was a little cheaper. No Kaiser won't cover any costs at FF. Kaiser only pays 50% of "their rate," which is higher than the normal rate.

Thank you for this. So overall, was it cheaper to go with expensive Kaiser meds covered at 50%, or cheaper FF meds paid OOP?

I think I recall Kaiser prices generally being a bit cheaper than online (e.g., FF) prices for most drugs . . . there may have been a couple that were cheaper through Prosperity?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op here - do I have to use a Kaiser pharmacy, or could I use Freedom Fertility and still have Kaiser cover the costs?

I used Kaiser, but I think FF was a little cheaper. No Kaiser won't cover any costs at FF. Kaiser only pays 50% of "their rate," which is higher than the normal rate.

Thank you for this. So overall, was it cheaper to go with expensive Kaiser meds covered at 50%, or cheaper FF meds paid OOP?

I would do Kaiser because it does count towards your out of pocket for the year. But get quotes from both, I'm sure the pricing has changed for 2016.

Fertility meds are not counted towards out of pocket expense. Fertility treatments as well.

not true. I did IUI last year and it counted. I only spent 2k on IUI and it definitely showed up towards my out of pocket max. There also was a thread another woman started where she asked Kaiser if IVF and IVF meds counted towards the OOP max and they verified in writing that it did.

[Anonymous]

OP here. I learned that my referral hasn't gone thru yet -- apparently it takes up to 7 days. So I don't want to count my chickens before they hatch. But no one said anything about redoing testing. I redid all my tests with SG in December so if anyone raises it I hope that would suffice. My doc was fine with it. Did you get notice you needed to redo testing from your doc or from Kaiser directly?

[Anonymous]

OP- who is the doc that referred you? My ob/gyn is making me jump through all types of hoops just for a referral. Did you go to the appt with all of your paperwork in hand. Please share success tips.

[Anonymous]

OP here - my referral has gone through. I did go to the doc with my most recent test results. We have been trying for 3 years with 1 chemical and 1 very very early MC. So maybe that is worse than your situation? Also my AMH is .5. I'm 35.