Taking a Deeper Look into IVF-Land

I want to be proactive in my TTC journey and figure out my benefits related to Infertility Treatments and IVF coverage. Originally, I didn't even want to touch the subject because I don't want to jinx myself for my remaining IUI's. However, I decided knowledge is power in making decisions and moving forward.

Step #1: Determine Coverage 

I called my insurance to see what is covered for Infertility Treatments. To qualify for Infertility Benefits: 

• My FSH Hormone Level needs to be <19. Needs to be taken within 6 months and on CD 3 of the cycle. 
• NOTE: My levels met this requirement at my December blood work (B/W) on CD3. I will need to redo my B/W though, if/when the time comes.
• I need to have 6 medicated and monitored cycles that failed. 
• NOTE: I am on Try #4 right now. 

I have pretty good Infertility Coverage (once I qualify): 

• Fertility Clinic needs to be in-network. 
• My insurance will cover 80% of costs. 
• I will have to cover 20% of costs. 
• Once I meet my deductible and out-of-pocket costs, they will cover 100% of charges. 

The Good: I've met my deductible and I'm close to meeting my out-of-pocket fees in 2015! I have about $500 left to get there. 

The Bad: the coverage starts over beginning January 1st.  

What does that mean? It would be financially beneficial to do IVF in 2015 vs. 2016. In 2016, my out-of-pocket fees will go back to $0 and I'll have to pay: the deductible and the out-of-pocket fees, for them to cover costs 100%. However, it's still at the 80/20 rate. Meaning, I only have to pay 20% of the costs. So, not horrible... just a better situation if I start in 2015. 

Where I am right now, if I continue to have failed cycles: 

IUI #4 - August 

IUI #5 - September 

IUI #6 - October 

If I get to this point, I am going to aim to do IVF in November / December. 

Step #2: Deciding on a Fertility Clinic 

I really like my fertility clinic. Things I like: 

• I always see the RE at every single visit! 
• My RE does all the ultrasounds. 
• My RE performs the IUI. 
• I speak directly to my RE for consultations. 

However, they might not take me for IVF due to my BMI. I'm "borderline" for their IVF requirements at the moment. I would prefer to stick with them. If they won't take me as an IVF patient, I'm looking at other fertility clinics and asking them about their BMI limits. 

I've thought about trying to lose weight... and I know that is on my "to do" list. But with all the hormones and stress from TTC and the medication throwing me off... not to mention regular/normal life/work/mommy-duties/foster-duties...  It's not as easy as checking it off the list. The weight I lost at the beginning of the year (while waiting to TTC) I've gained back due to all of these factors. <sigh> Only if I could be Super Woman and just do it all! Or wave my magic wand and make everything perfect. But in reality, it's not that easy. 

I am going to wait to schedule consultations until I have a 5th failed cycle... at that point, I want to be scheduling consults with at least a few clinics. 

The only thing is, the consultation fee is $300 at most clinics. Yikes! I need to check if my insurance will cover the consultation fees prior to the infertility benefits kicking in. If not, then I would have to wait until failed IUI #6 before I can even have a consult. Which is concerning, as I need to make sure the IVF happens in 2015 for the insurance coverage. I'm on a strict timeline here! 

Lots to think about. At least I know where I stand on things IF things go this way. I really don't want to get here though... IVF scares me. The shots, the monitoring, the egg retrievals, the costs, the time, the medication/hormone changes. There's so much to it. It scares me to think about putting my body through all of this. 

I'm hoping and praying and crossing my fingers/toes that IUI #4 is successful.