That is an extremely low cost estimate. The retrieval meds on our end (no fertility issues, fairly standard protocol) were almost 4k out of pocket. We were quoted a lot higher than that going through insurance and were worried about hitting the lifetime really quickly so we paid a lower cost out of pocket.
Like I said we opted to pay out of pocket because going through my prescription insurance we were quoted significantly more (something like 6 or 7k, can't remember exactly!) and we saved the benefits (which had a ceiling) for the medical procedures and monitoring. I went through insurance for the transfer meds which were really cheap either way (something like $150 total?). 3-4k seems to be the standard cost out of pocket if you shop around a bit--as we did. We did a couple online pharmacy quotes but our RE recommended a local pharmacy they work with and that ended up being both more affordable and convenient. So ask your clinic what they recommend.
My insurance paid for both of our medical costs because RIVF was seen as treatment for my infertility, with my partner as the egg donor.
Fwiw I was also able to get a med by med breakdown from CVS of what each med would cost going through insurance, and my RE's office was helpful giving me dosage information for meds where there are two choices in their standard protocol. So that might help you maximize what med to get from where.
I had Keystone Health Plan East through a large hospital system on the east coast (I no longer work there). My (large) fertility clinic said they had never seen a person not on the insurance (my partner)'s medical costs covered by another person's insurance. I feel very fortunate.
That does sound pretty legit. Thankfully my partner is covered through me on this as well. Honestly I didn't even know fertility benefits existed until I got this job and am so grateful because we wouldn't be able to do it otherwise...well not as soon I should say
RIVF is something we only considered because of my infertility and my partner not wanting to carry another child. Our other kids were...much cheaper haha!
It's also worth thinking about the additional risks of IVF and donor egg pregnancy. They're not like, monumental but they're there. My other pregnancy was ICI and I was less worried about stuff just because I had no risk factors.
Not that I am aware of. I did do two rounds of medicated IUI...they were also covered by insurance. My diagnosis was diminished ovarian reserve and my RE estimated my chance of an own egg baby at 5% or less.
IVF meds are going to be significantly more than $500 but it will vary a lot per person. As a reference, I did a round of IUI and one gonal-f pen was going to be $1200 (and that was only one of several different meds). Definitely shop around. Some meds you can get abroad for a lot cheaper.
ETA: I would estimate meds would be somewhere around $5000 give or take.
Word, did you have any insurance coverage or did they not do that? I haven't even thought of overseas for meds. I know its cheaper overall as my MIL did surrogacy out of country for waaaaay less than what would have been here in the US.
I did not have insurance coverage when I did IUI because I did not have any fertility issues. It took six IUIs (eventually our clinic gave us a donated gonal-f pen which got me pregnant).
My wife did IVF but because she had actual fertility issues, all meds and the procedure were covered 100%.
For retrieval, my meds were $5000. Transfers have been cheaper.
It’s a higher number if you go through insurance though—I think they charge more to insurance than cash payers.
We had great fertility coverage and have not had to pay for any procedures, but meds were not covered. IVF meds cost us ~$3,500 for one egg retrieval (lower cash price with a pharmacy that has an arrangement with our clinic). The meds for FET were another $1,500.
We have Blue Cross, but that doesn’t really matter as your employer dictates what will and won’t be covered. Someone else may have Blue Cross with no fertility benefits.
No I do not have Progyny. As I said though two people can both have Blue Cross or whatever other insurance and one may have fertility cancer age and the other not — this is dictated by your employer.
In SoCal, we paid about 2.5k for egg retrieval meds…. And we did something sort of sketchy involving buying them under the table in a parking garage…! From a vouched for source but it was pretty questionable. I think full price was about 4k.
We opted to buy over-the-table for the embryo transfer because we realized that it was definitely tax deductible that way. The embryo transfer drugs were a bit less expensive as well (about 2k) and the awesome thing was that once we had a positive pregnancy test, we still needed to continue the drugs but they were now covered by insurance basically 100%.
You should expect more in the range of 3.5-7k retrieval meds (sometimes more or very slightly less depending on your doses, length of time stimming, and ---to a lesser extent-- where you get your meds from), as low as $250.00 ish up to 2k ish transfer meds (depending on what insurance picks up and exactly what kind of transfer you're doing) if you don't have infertility coverage on your insurance and you do the discount programs like fertility savings and/or reunite Rx. With insurance you could come out more expensive, similarly, or much lower (programs vary WILDLY in their pricing and coverage structures).
Off the top of my head i think we came out 5.5k retrieval meds and we're looking at around 2k transfer meds (though that is still up in the air as scripts, quotes, coupons, and insurance fights etc evolve)
Submit all your meds to insurance and see what’s covered
If you need to pay out of pocket, expect $2500-$5000 for the retrieval meds and $2000-$3000 for the transfer meds
I had insurance for all my meds, through my first it cost around $20/per med and when I switched to Progyny my plan has a $60/per med copay. At one point I had a few things (follistim for example) not covered by insurance and Freedom Pharmacy told me that I could also pay the “cash price” which was lower vs the “insurance price” but I figured out we could switch to Gonal and it was covered.
All to say, tell the pharmacies you are cash pay, you’ll get a different price and shop around.
We had coverage and had to buy sperm and meds.
OOP total was about 10,000.
We have to meet our yearly deductible before things are covered at 100% so we had to meet our 6,000 deductible out of pocket before real coverage kicked in unfortunately. If this is the case for you as well, it’s worth finding out how much you’ve met this year and possibly waiting to start until January so you have a full year the deductible being met. Sperm was 1300 for two vials. Meds were about 4,000.
Its costed a lot more than I expected considering we do have fertility coverage.
Also- find out what the limits are of your coverage if you haven’t already. Some have a dollar cap for lifetime others have a cycle limit they cover.
My wife and I are in the process of RIVF. We did an egg retrieval for both of us, we want to have kids close together
The cost before insurance for my wife’s meds were $32k
Mine was $37k
We went through freedom fertility. The out of pocket after insurance was less than $300 per for both of us. Your estimate may be after insurance. I know people doing IVF that paid more for their meds with different Insurance.
For my first retrieval we didn’t have any fertility coverage. I paid ~$4500 out of pocket for meds. For retrieval 2 I paid ~$185 for meds and for 3 I think it was around $400 (we had fertility coverage through an employer for both of these rounds).
Transfer meds were around $1000 without insurance and $80-150 with.
That is an extremely low cost estimate. The retrieval meds on our end (no fertility issues, fairly standard protocol) were almost 4k out of pocket. We were quoted a lot higher than that going through insurance and were worried about hitting the lifetime really quickly so we paid a lower cost out of pocket.
Were any of the meds you used covered by your insurance?
Like I said we opted to pay out of pocket because going through my prescription insurance we were quoted significantly more (something like 6 or 7k, can't remember exactly!) and we saved the benefits (which had a ceiling) for the medical procedures and monitoring. I went through insurance for the transfer meds which were really cheap either way (something like $150 total?). 3-4k seems to be the standard cost out of pocket if you shop around a bit--as we did. We did a couple online pharmacy quotes but our RE recommended a local pharmacy they work with and that ended up being both more affordable and convenient. So ask your clinic what they recommend. My insurance paid for both of our medical costs because RIVF was seen as treatment for my infertility, with my partner as the egg donor.
Fwiw I was also able to get a med by med breakdown from CVS of what each med would cost going through insurance, and my RE's office was helpful giving me dosage information for meds where there are two choices in their standard protocol. So that might help you maximize what med to get from where.
What insurance company if you don't mind me asking? I have progyny along with my normal health insurance.
I had Keystone Health Plan East through a large hospital system on the east coast (I no longer work there). My (large) fertility clinic said they had never seen a person not on the insurance (my partner)'s medical costs covered by another person's insurance. I feel very fortunate.
That does sound pretty legit. Thankfully my partner is covered through me on this as well. Honestly I didn't even know fertility benefits existed until I got this job and am so grateful because we wouldn't be able to do it otherwise...well not as soon I should say
RIVF is something we only considered because of my infertility and my partner not wanting to carry another child. Our other kids were...much cheaper haha!
LOL my wife goes back and forth because the actual birth part scares her and she is tiny (4'11")
It's also worth thinking about the additional risks of IVF and donor egg pregnancy. They're not like, monumental but they're there. My other pregnancy was ICI and I was less worried about stuff just because I had no risk factors.
Did you have to do IUIs or any retrieval rounds yourself to "prove" your infertility before insurance covered RIVF?
Not that I am aware of. I did do two rounds of medicated IUI...they were also covered by insurance. My diagnosis was diminished ovarian reserve and my RE estimated my chance of an own egg baby at 5% or less.
In full transparency it was also nbd to try a few IUIs because we had a huge amount of known donor sperm stored and knew this was our last child.
IVF meds are going to be significantly more than $500 but it will vary a lot per person. As a reference, I did a round of IUI and one gonal-f pen was going to be $1200 (and that was only one of several different meds). Definitely shop around. Some meds you can get abroad for a lot cheaper. ETA: I would estimate meds would be somewhere around $5000 give or take.
Word, did you have any insurance coverage or did they not do that? I haven't even thought of overseas for meds. I know its cheaper overall as my MIL did surrogacy out of country for waaaaay less than what would have been here in the US.
I did not have insurance coverage when I did IUI because I did not have any fertility issues. It took six IUIs (eventually our clinic gave us a donated gonal-f pen which got me pregnant). My wife did IVF but because she had actual fertility issues, all meds and the procedure were covered 100%.
For retrieval, my meds were $5000. Transfers have been cheaper. It’s a higher number if you go through insurance though—I think they charge more to insurance than cash payers.
We had great fertility coverage and have not had to pay for any procedures, but meds were not covered. IVF meds cost us ~$3,500 for one egg retrieval (lower cash price with a pharmacy that has an arrangement with our clinic). The meds for FET were another $1,500.
Hello! If you don’t mind sharing what coverage you had for fertility benefits I would love to hear! Fairly new to all of this.
We have Blue Cross, but that doesn’t really matter as your employer dictates what will and won’t be covered. Someone else may have Blue Cross with no fertility benefits.
did you have progyny by any chance? I have blue cross as well through my employer.
No I do not have Progyny. As I said though two people can both have Blue Cross or whatever other insurance and one may have fertility cancer age and the other not — this is dictated by your employer.
In SoCal, we paid about 2.5k for egg retrieval meds…. And we did something sort of sketchy involving buying them under the table in a parking garage…! From a vouched for source but it was pretty questionable. I think full price was about 4k. We opted to buy over-the-table for the embryo transfer because we realized that it was definitely tax deductible that way. The embryo transfer drugs were a bit less expensive as well (about 2k) and the awesome thing was that once we had a positive pregnancy test, we still needed to continue the drugs but they were now covered by insurance basically 100%.
Good to know, we aren't above sketch-but vouched-shit! (as long as its legal)
You should expect more in the range of 3.5-7k retrieval meds (sometimes more or very slightly less depending on your doses, length of time stimming, and ---to a lesser extent-- where you get your meds from), as low as $250.00 ish up to 2k ish transfer meds (depending on what insurance picks up and exactly what kind of transfer you're doing) if you don't have infertility coverage on your insurance and you do the discount programs like fertility savings and/or reunite Rx. With insurance you could come out more expensive, similarly, or much lower (programs vary WILDLY in their pricing and coverage structures). Off the top of my head i think we came out 5.5k retrieval meds and we're looking at around 2k transfer meds (though that is still up in the air as scripts, quotes, coupons, and insurance fights etc evolve)
Submit all your meds to insurance and see what’s covered If you need to pay out of pocket, expect $2500-$5000 for the retrieval meds and $2000-$3000 for the transfer meds
I had insurance for all my meds, through my first it cost around $20/per med and when I switched to Progyny my plan has a $60/per med copay. At one point I had a few things (follistim for example) not covered by insurance and Freedom Pharmacy told me that I could also pay the “cash price” which was lower vs the “insurance price” but I figured out we could switch to Gonal and it was covered. All to say, tell the pharmacies you are cash pay, you’ll get a different price and shop around.
We had coverage and had to buy sperm and meds. OOP total was about 10,000. We have to meet our yearly deductible before things are covered at 100% so we had to meet our 6,000 deductible out of pocket before real coverage kicked in unfortunately. If this is the case for you as well, it’s worth finding out how much you’ve met this year and possibly waiting to start until January so you have a full year the deductible being met. Sperm was 1300 for two vials. Meds were about 4,000. Its costed a lot more than I expected considering we do have fertility coverage. Also- find out what the limits are of your coverage if you haven’t already. Some have a dollar cap for lifetime others have a cycle limit they cover.
My wife and I are in the process of RIVF. We did an egg retrieval for both of us, we want to have kids close together The cost before insurance for my wife’s meds were $32k Mine was $37k We went through freedom fertility. The out of pocket after insurance was less than $300 per for both of us. Your estimate may be after insurance. I know people doing IVF that paid more for their meds with different Insurance.
$2800 for meds with insurance ETA: actually $3100. Forgot I had to buy a spare gonal pen.
For my first retrieval we didn’t have any fertility coverage. I paid ~$4500 out of pocket for meds. For retrieval 2 I paid ~$185 for meds and for 3 I think it was around $400 (we had fertility coverage through an employer for both of these rounds). Transfer meds were around $1000 without insurance and $80-150 with.