Follistim, Gonal-F, and Insulin? – OH MY! (Updated)

I knew IVF required more than medication-assisted intercourse, but I didn’t realize I would encounter a preverbal buffet of medications and supplies! (And my insurance lied and said it was all covered, too!) I was told I would pay McDonald’s prices and got a bill for Ruth’s Crist! 

I’m so confused! I don’t even know what half this shit is for! Here is the list of prescriptions (“scripts”) sent to my pharmacy…


When they told me to call my pharmacy to ask about drug coverage they didn’t tell me to ask about anything other than HCG, FSH, and Progesterone. Wait! There’s more!


In case you’re wondering, yes! I am pretty sure that says Insulin near the bottom there. I’m not diabetic. Wtf??? 😳 (Update: I think it’s just an insulin syringe, not actual insulin.) The picture cut off the Sharps container, which I told them I already have from before, but I guess they forgot. I have two, actually, so I guess I’ll just tell the pharmacy when they call? 

Now, I took out that whole last s cation from before because it is all irrelevant now…

So, I got a call from my specialty pharmacy telling me I owed them roughly $680 before they would ship all that crap (pictured). I argued back that my out of pocket (OOP) for the entire year is only $462 away from being met so they need to check again. They told me to call my insurance. 

I call BCBS of Illinois and I get this Christa bitch who laughs at me and tells me the Lupron isn’t covered because it’s a compound and is $270, the progesterone isn’t covered the way it was ordered and it’s about $100. “To top it off” (she chuckled) “since the [OOP] isn’t met and non-covered items don’t count toward [OOP] you have to pay a $150 copay each for the FSH and HCG. That’s a grand total of roughy $675 for just the meds, when my OOP is {this} close to being met!!! I all but told Little Miss Chuckles to go fuck herself. 

My doctor has this amazing setup where he assigns you to your own nurse, coordinator, biller, and patient support specialist. You share them with other patients, but it’s nice knowing I have a “team”, and I can communicate with each of them directly through this app called eIVF_Mobile. The messaging feature has its quirks, but I work every day. I can’t spend all day on the phone. I have poor people relying on me to save the day! 

So, I sent my nurse (Jen F. – there are 3 or 4 Jen’s) a frantic message. I’m pretty sure the wetness from my tears could be felt through the computer screen! I apologized for freaking out, but explained that NO ONE from the clinic told me I even needed Lupron, or whatever the fuck Cetrotide is, or ever mentioned any of the meds would be compounds. I mentioned that I knew all along compounds weren’t covered, and that the FSH needs a prior authorization, or a step-down or medical statement of necessity (SMN) for approval. I reported that if someone had given adequate information ahead of time we never would have signed a payment agreement and would never EVER have given them almost $1500 up front before knowing the cost of meds. And then I apologized AGAIN. (I see a lot of apologies in my future.)

Now, it does seem like there were some missteps here – on everyone’s part- mine, the clinic, the pharmacies (I have two), and the insurance (especially Miss Chuckles), but I THINK it is resolved. I got an email from the nurse saying they found the Lupron in a “covered” form – a kit. I have no clue how much this will cost, but “covered” sounds good. Also, she got the pharmacy to get me a progesterone that’s only $15 (not $100). If nothing else we have saved about $85, and my OOP is DEFINITELY met after we pay for these meds!!!

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One thought on “Follistim, Gonal-F, and Insulin? – OH MY! (Updated)

  1. I think the insulin line is referring to the fact that they want you to use an insulin syringe to draw up a certain medication. It looks like they’ve ordered you a few different types of syringes and needles. Just hope they give you instructions on which one to use for which medication (although I’m sure that will be based on the volume being injected.) Best of luck! πŸ’—

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