IVF Drugs_How to Lower Price When Paying Out of Pocket
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Anonymous
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Hi. I live in Virginia and we are about to do a fresh IVF cycle with SGFC. I have Aetna, but have already reached the lifetime maximum insurance benefit, so I have to pay out of pocket for the treatment and drugs. SGFC is charging me Aetna discounted rate for one single IVF cycle (around $7000). However, my nurse sent the drug prescription to a SMP Fertility Pharmacy, which told me that the médication (Gonal F, Menopur, and Cetrotide) will cost me ~$25000. This is almost three times the price of the cycle and insane! Are they any ways to lower the drugs price? Does anyone know any pharmacies that have a much lower rate? I m open to any suggestions, including ordering medications from abroad or signing up for another insurance if such options exists. Thank you in advance for any advice!
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Anonymous
| I bought mine abroad much much cheaper ; I used SMP for some stuff but everything else came from overseas I used fastivf.com, good luck ! |
Anonymous
This is insane. There must be a mistake unless you are being prescribed a massive dosage. I did IVF two years ago and paid around $4,000 out of pocket. How much are they charging you per vial of Menopur? (I recall the pricing being $80). I wonder if you are being charged the insurance rate. Double check with them and call other pharmacies. |
Anonymous
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That's insane. Gonal F can be swapped with Follistem, which is much cheaper. And Cetrotide can be swapped with Ganirelex. (Of course, check with your doctor on this, but mine told me they are exact swaps.)
If you're shopping around, Hanns Pharmacy in Fairfax has decent prices. When I last price checked, they were on par with SMP. |
Anonymous
| Thanks for the reply. They are charging me $6600 per vial of Menopur and yes they said they are charging me the insurance rate because I reached the maximum lifetime cap. |
Anonymous
| Thanks for the info. I will check fast IVF.com and Hanns pharmacy. |
Anonymous
| 23:31 poster here. Based on what the other poster said re Follistim and Ganirelix being substitutes for the other drugs you need, just so you can compare: I was prescribed 200 IU of follistim and 150 IU of menopur for about 10 days. When you call the pharmacies for a quote, don’t even bother mentioning your insurance and the fact that you’ve reached the lifetime max. Just tell them you are an OOP patient. |
Anonymous
I’ve just posted below but that doesn’t even make sense - they must mean per box (can’t remember how many goals per box). Or you meant $660? I don’t understand how a patient who’s reached their lifetime max can be treated differently, and considerably worse at that, from an uninsured patient or simply someone whose insurance does not cover IVF. |
Anonymous
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Just don't tell them that you have insurance. the cheapest I've found menopur is around 76 per vial at Freedom.
You can routinely get Follistim or Gonal F 300 iU for about 300. Try WinfertilityRx-they make you order multiple medications, but it comes to approximately 280 per 300 Iu. You get more extra medicine (overfill in the vial) in the 300 IU, so I would order them instead of the 900 IU. Ganirelix is also cheaper at WinfertilityRx. You can also get the medicines overseas for much cheaper, but I've always been slightly nervous about that so I haven't tried it. |
Anonymous
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7:51 poster here. I agree with the above-- just call the pharmacy and say you're out of pocket. You don't want this run through your insurance. There is nothing wrong with that. The OOP prices are MUCH cheaper.
Good luck! |
Anonymous
Relatedly, I am looking at another egg retrieval if my upcoming FET fails (again) and I will have maxed out my coverage at that point. Did you have to do anything to get SGF to honor the negotiated insurance rate or was it automatic? |
Anonymous
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A couple of years ago, I used Professional Pharamcy in Baltimore. And Freedom Fertility near Boston. And if you tell them you're out of pocket, they might have coupons for certain drugs. Freedom was very help with the coupon stuff.
i would not buy IVF drugs from abroad, but maybe that's just me. |
Anonymous
| I had good prices from Freedom Fertility. Make sure you tell them you’re paying OOP. |
Anonymous
| I got those exact same medications from SMP last fall and there is no way that’s correct. I think I spent around $2,500 by ordering the very minimum and then carefully ordering more as needed. I priced everything out at multiple pharmacies and SMP had the best price. |
Anonymous
| As others have said - if you are paying you tell the pharmacy you are out of pocket. You should be at 4-5k max |