$$$$

We are required to have a “financial obligation discussion” with the practice’s IVF financial advisor before they will begin any procedures. I figured we would call them sometime next week, but in typical exceeding all of our expectations fashion, the lady called Chris this morning. It is SO NICE to go to a practice where they all talk to each other, they all read the charts, and they are very prompt. In fact, they order my hCG trigger shots from a pharmacy in Cleveland and that pharmacy always calls within an hour of us leaving the appointment to confirm our credit card and mailing address.

She went over all of the insurance and financial aspects with Chris:

• Office visits: considered in-network, my insurance will cover 100% after my $30 per visit co-pay.  Estimate out of pocket without insurance is ~$2,500.
• Lab and embryologist: considered out-of-network. My insurance will cover 70% after a $750 out-of-network deductible. We have to make a deposit of $4,000 before any procedures and then be reimbursed by the insurance company for whatever they will cover (at their rates, of course). 
• Medications: not covered by health plan, but are covered by a prescription plan. No word yet on our OOP cost. We already told the IVF nurse that we have to order from CVS Caremark to receive any drug coverage. They will order from wherever is the least expensive for us, but apparently CVS is terrible to work with. Great. If no insurance, I think the meds are $3,000-$5,000.
• ICSI if added at the retrieval is an additional $1,500. They will submit to insurance, but not sure it is covered.
• Assisted hatching if added before transfer is an additional $500. They will submit to insurance, but not sure it is covered.
• Cryopreservation (aka freezing) of any embryos is $675 for the first year and $306 each additional year. Not covered by any insurance, 100% OOP.
• Chris's insurance company will not cover any infertility treatments so everything related to him will be OOP. Unfortunately only a few states require insurance to cover infertility. 

At least my insurance will cover most of this. And the good news is that if for some reason this doesn’t work the first time, it looks like we will have insurance money left over for another round. My lifetime maximum infertility coverage is $10,000 for medications and $20,000 for services.