pickel I'm sorry about the test. I am keeping my fingers crossed it's just too early for a true result.
Thank you! I told myself I (1) would not test before 12 dpiui and (2) would not be disappointed unless and until AF came. That...did not work out. LOL I’m kind of rolling my eyes at myself for being disappointed by an early BFN, but hope is hope I guess.
pickel I'm sorry about the test. I am keeping my fingers crossed it's just too early for a true result.
Thank you! I told myself I (1) would not test before 12 dpiui and (2) would not be disappointed unless and until AF came. That...did not work out. LOL I’m kind of rolling my eyes at myself for being disappointed by an early BFN, but hope is hope I guess.
Don't be too hard on yourself. It's hard not to have hope and get swept up in disappointment even when it's not entirely rational.
Post by pinkpeony08 on Aug 8, 2018 15:43:44 GMT -5
We had our hematology appointment earlier today, and she isn't convinced I even have the protein C deficiency given the results of the lab, stating it wasn't low enough. She ordered more bloodwork, including repeating prior test. She also says she wouldn't recommend lovenox even if I do have the deficiency. Frustrated because RE said she would strongly consider lovenox if I were pregnant again given my history of repeat losses (11w measuring 9.5w, 15 w measuring ahead and 12 w measuring right on time- last two genetically normal including micro array). Now I have hematologist saying no lovenox, which means even if RE thought I should have it, highly doubtful I could even get insurance to cover it. I was feeling like I might be up for trying again if we had something to change, but now it doesn't look like there would be anything to do differently. It's so hard to think I will get a different result by changing nothing.
I have been going to acupuncture with a fertility specialist, and the acupuncturist has me on a gluten free, dairy free, no soy, low sugar, low alcohol diet to do everything we can with diet to decrease inflammation, but I did all except the dairy free last time and clearly it didn't make a difference.
Feeling so down about the whole thing, and even more terrified of being pregnant again if we change nothing, yet I would really love to have a third. We feel like the "clock is ticking" and if we want to go for it, it's now or never. Plus we add in the factor of who knows if I'll even be able to get pregnant again.
Post by Jalapeñomel on Aug 8, 2018 20:30:31 GMT -5
Le sigh. They officially changed my transfer date. I’m really irritated at how I am being punished for their mistake TWICE, but what else can I do?
I see the actual doc on Friday, and I will let him know my displeasure, so maybe he can do something for me (he is very patient friendly, and when they screwed up my RX for the trigger shot, he got on top of them to make sure it was done immediately, I was charged appropriately, and it was shipped overnight).
Ugh, I'm sorry Jalapeñomel. I think I missed some back story, but whatever happened, that's super frustrating. We had so many delays our first IVF cycle due to insurance back and forth and it was excruciating.
Post by compassrose on Aug 9, 2018 10:37:21 GMT -5
Last home monitoring appt to check my lining. 7.94 mm uterine lining, perfectly trilaminar. They like it to be over 8 so we’ll see but I’m hopeful. If so, transfer is the 16th.
My FET is set for Weds! Woo hoo! I'm terrified, but excited. I'm doing acupuncture before and after, too.
So excited for you! Did you start your progesterone yet? The procedure itself was very easy, other than the feeling that I was going to pee on the doctor. At my clinic, the procedure room is very relaxing with spa music playing. I didn't do acupuncture, but I bet that will help you relax as well.
Mine had a cheesy slideshow of different landscapes and animals from all over the world with calming music. It would have been delightful if I wasn't about ready to pee all over myself.
pinkpeony08, that sounds so frustrating, I'm sorry. I hope you are able to get answers and the best path moving forward soon. Jalapeñomel, I would be so mad! I hope they can move it up for you! compassrose, fingers crossed for you!!
I'm 12 dpiui and got another BFN so I'm pretty sure I'm out. We'll probably do another IUI, again with Gonal-F, but if that doesn't work, I am not really sure where to go from there. IVF is likely not an option for us. I have tried everything under my control, diet, acupuncture, supplements, getting HSG, hysteroscopy, etc. and "everything looks good" physically, but nothing is working. My FSH was high (17) but I've been able to get it down to 11, my AMH is ok, though slightly low (1.07) and my AFC was 15 before my IUI, up from the 8 I had in March. So things aren't great, aren't bad there but my RE has no concerns about those numbers. It is so frustrating because I got pregnant cycle 2 with my DS and then got pregnant again two years ago on cycle 2 with another that I lost at 11 weeks, 5 days, and have had no BFP since then. I don't get it.
Can I jump back in here? We had success with IVF in 2016. We're going to cycle again in September/October (I have no frozen embryos).
Insurance is so confusing though. We were self pay in 2016, so I am happy to have coverage after spending $35k the first time, but they make it so confusing. According to Cigna's website they require precertification from the physician for meds so I emailed the dr and asked them to submit something and they said that Cigna told them they don't need to do anything and Cigna will just confirm once I go to the pharmacy. Ok...so I guess there's no way to know if it's covered beforehand.
THEN--my RE told me that my plan has a $100k lifetime limit and a limit of 3 cycles and those cycles include FETs. I see nothing about this in any of the coverage documents on Cigna. My coverage document says I have no lifetime limit and mentions nothing about cycle limit. UGH....if my 3 cycles really includes FETs too then it probably doesn't make sense to bill any of those through insurance if we have to do them. That's so stupid and I hate that I can't just find a document that spells it all out for me.
End rant. I think I need to just let it go and see what happens, but I am very Type A!
Can I jump back in here? We had success with IVF in 2016. We're going to cycle again in September/October (I have no frozen embryos).
Insurance is so confusing though. We were self pay in 2016, so I am happy to have coverage after spending $35k the first time, but they make it so confusing. According to Cigna's website they require precertification from the physician for meds so I emailed the dr and asked them to submit something and they said that Cigna told them they don't need to do anything and Cigna will just confirm once I go to the pharmacy. Ok...so I guess there's no way to know if it's covered beforehand.
THEN--my RE told me that my plan has a $100k lifetime limit and a limit of 3 cycles and those cycles include FETs. I see nothing about this in any of the coverage documents on Cigna. My coverage document says I have no lifetime limit and mentions nothing about cycle limit. UGH....if my 3 cycles really includes FETs too then it probably doesn't make sense to bill any of those through insurance if we have to do them. That's so stupid and I hate that I can't just find a document that spells it all out for me.
End rant. I think I need to just let it go and see what happens, but I am very Type A!
The good news is it sounds like, aside from the medication authorizations, most of these questions about coverage limits and differences in information won't affect this first (under this plan) retrieval.
I wouldn't trust the RE's interpretation of the plan unless they can produce documentation of the requirements they're saying Cigna has that are specific to YOUR plan. Was it your RE/the doctor who gave you this info? Or someone in their financial/billing department? My provider has basically no clue about the insurance rules. I have had good success escalating questions about coverage to the head of the financial department.
I also wouldn't trust any general info from Cigna that isn't in your specific plan documents (so if the website you got info from isn't affiliated with your specific version of the plan I would be cautious.) Your plan's individual coverage as outlined in the explanation of benefits and/or schedule of benefits and/or benefit handbook is the most important thing to find out. If it says explicitly it has no lifetime limit it likely doesn't have a lifetime limit (although sometimes the medical benefit and pharmacy benefit are split up and one or the other or both may have separate lifetime limits.) You should be able to find a document that details all of this but different plans call them different things and have different levels of detail (usually will be called explanation of benefits or schedule of benefits - and you can request these documents from your insurer if you don't have an online portal where you can access them.)
Sometimes you can also have luck if you call customer service and continue to escalate your questions until they put you on the phone with a benefits coordinator specific to IF coverage. They exist somewhere in the system and they will be able to look and see what YOUR plan offers vs. giving standard advice based on broader assumptions about what "Cigna" covers (which is often different depending on the specific plan you are covered by.)
In my experience many insurers who cover IVF meds require pre-authorization and often it can be a bit of a lengthy process. The pharmacy should be able to confirm this for you before you actually place the order and pay, as they will be able to see if the necessary authorizations are in the system. My recommendation would be to get the ball rolling well in advance of needing the meds so you have time to sort it out if you do end up needing authorization from your provider/additional approvals from the insurer before it can be covered.
Insurance - a blessing and a curse. They make it really hard. It will definitely be worth it when you get it covered and it's a HUGE savings but it may make you want to claw your eyes out. Good luck getting it all sorted.
Can I jump back in here? We had success with IVF in 2016. We're going to cycle again in September/October (I have no frozen embryos).
Insurance is so confusing though. We were self pay in 2016, so I am happy to have coverage after spending $35k the first time, but they make it so confusing. According to Cigna's website they require precertification from the physician for meds so I emailed the dr and asked them to submit something and they said that Cigna told them they don't need to do anything and Cigna will just confirm once I go to the pharmacy. Ok...so I guess there's no way to know if it's covered beforehand.
THEN--my RE told me that my plan has a $100k lifetime limit and a limit of 3 cycles and those cycles include FETs. I see nothing about this in any of the coverage documents on Cigna. My coverage document says I have no lifetime limit and mentions nothing about cycle limit. UGH....if my 3 cycles really includes FETs too then it probably doesn't make sense to bill any of those through insurance if we have to do them. That's so stupid and I hate that I can't just find a document that spells it all out for me.
End rant. I think I need to just let it go and see what happens, but I am very Type A!
The good news is it sounds like, aside from the medication authorizations, most of these questions about coverage limits and differences in information won't affect this first (under this plan) retrieval.
I wouldn't trust the RE's interpretation of the plan unless they can produce documentation of the requirements they're saying Cigna has that are specific to YOUR plan. Was it your RE/the doctor who gave you this info? Or someone in their financial/billing department? My provider has basically no clue about the insurance rules. I have had good success escalating questions about coverage to the head of the financial department.
I also wouldn't trust any general info from Cigna that isn't in your specific plan documents (so if the website you got info from isn't affiliated with your specific version of the plan I would be cautious.) Your plan's individual coverage as outlined in the explanation of benefits and/or schedule of benefits and/or benefit handbook is the most important thing to find out. If it says explicitly it has no lifetime limit it likely doesn't have a lifetime limit (although sometimes the medical benefit and pharmacy benefit are split up and one or the other or both may have separate lifetime limits.) You should be able to find a document that details all of this but different plans call them different things and have different levels of detail (usually will be called explanation of benefits or schedule of benefits - and you can request these documents from your insurer if you don't have an online portal where you can access them.)
Sometimes you can also have luck if you call customer service and continue to escalate your questions until they put you on the phone with a benefits coordinator specific to IF coverage. They exist somewhere in the system and they will be able to look and see what YOUR plan offers vs. giving standard advice based on broader assumptions about what "Cigna" covers (which is often different depending on the specific plan you are covered by.)
In my experience many insurers who cover IVF meds require pre-authorization and often it can be a bit of a lengthy process. The pharmacy should be able to confirm this for you before you actually place the order and pay, as they will be able to see if the necessary authorizations are in the system. My recommendation would be to get the ball rolling well in advance of needing the meds so you have time to sort it out if you do end up needing authorization from your provider/additional approvals from the insurer before it can be covered.
Insurance - a blessing and a curse. They make it really hard. It will definitely be worth it when you get it covered and it's a HUGE savings but it may make you want to claw your eyes out. Good luck getting it all sorted.
This information came from the financial counselor at my RE's office. They said they confirmed directly with Cigna that they don't need to get preauthorization for the meds (but again, this is not what my online portal says for the meds I looked up).
The documents on Cigna's website are specific to my plan. My schedule of benefits says no lifetime limit which is why I'm not sure why the financial counselor says I have a $100k lifetime limit and 3 cycle limit. They have my insurance details and say they confirmed them directly with Cigna.
Post by seeyalater52 on Aug 10, 2018 10:27:46 GMT -5
icedcoffee, ugh. Calling directly could help. If your schedule of benefits says you have no lifetime limit you most likely have no lifetime limit. Is there a possibility either you or the financial counselor has documents for the wrong plan year? Can you insist that they conference you in with a rep from Cigna to confirm the information about your plan? You have a little time since that likely won't matter until you get to the FET stage, but especially the 3-cycle limit (which in my experience almost always includes both transfers and a full IVF retrieval as "one cycle") could cost you a LOT of money unnecessarily if you pay OOP for transfers to avoid using up cycles toward your limit when you didn't have to. So they really need to find a way to demonstrate that their information is more correct than the information Cigna has provided you about your plan.
The meds thing will probably work itself out when you go to get your prescriptions. They will either be covered and you're all good, or there will be a flag that you're missing the authorization and usually the pharmacy will work directly with your provider and insurer to get those authorizations in. It just can take a while but it sounds like you're planning ahead.
icedcoffee , ugh. Calling directly could help. If your schedule of benefits says you have no lifetime limit you most likely have no lifetime limit. Is there a possibility either you or the financial counselor has documents for the wrong plan year? Can you insist that they conference you in with a rep from Cigna to confirm the information about your plan? You have a little time since that likely won't matter until you get to the FET stage, but especially the 3-cycle limit (which in my experience almost always includes both transfers and a full IVF retrieval as "one cycle") could cost you a LOT of money unnecessarily if you pay OOP for transfers to avoid using up cycles toward your limit when you didn't have to. So they really need to find a way to demonstrate that their information is more correct than the information Cigna has provided you about your plan.
The meds thing will probably work itself out when you go to get your prescriptions. They will either be covered and you're all good, or there will be a flag that you're missing the authorization and usually the pharmacy will work directly with your provider and insurer to get those authorizations in. It just can take a while but it sounds like you're planning ahead.
Yeah--For the meds I am going to order them as soon as my nurse calls them into the pharmacy so I think that should be ok since they normally call them in on CD 1 and I'll be on BCP for at least 3 weeks-ish and the pharmacy is a 5 minute drive from me. I do have time to clarify the lifetime limit and # of cycle limit since we'll go ahead with this cycle regardless.
The frustrating thing is that I spent about $30k with this place 2 years ago so if they are giving me bad information that really makes me angry. The information they quoted me is the same as the minimum benefits required in my state (a mandated state) so part of me wonders if they confirmed I am covered and then just told me the state minimum mandates or something.
Insurance could not be more confusing.
When I called Cigna the first time last month they told me I had no coverage for IVF, but if I wanted an IUD that would be covered 100%. LOL
icedcoffee , ugh. Calling directly could help. If your schedule of benefits says you have no lifetime limit you most likely have no lifetime limit. Is there a possibility either you or the financial counselor has documents for the wrong plan year? Can you insist that they conference you in with a rep from Cigna to confirm the information about your plan? You have a little time since that likely won't matter until you get to the FET stage, but especially the 3-cycle limit (which in my experience almost always includes both transfers and a full IVF retrieval as "one cycle") could cost you a LOT of money unnecessarily if you pay OOP for transfers to avoid using up cycles toward your limit when you didn't have to. So they really need to find a way to demonstrate that their information is more correct than the information Cigna has provided you about your plan.
The meds thing will probably work itself out when you go to get your prescriptions. They will either be covered and you're all good, or there will be a flag that you're missing the authorization and usually the pharmacy will work directly with your provider and insurer to get those authorizations in. It just can take a while but it sounds like you're planning ahead.
Yeah--For the meds I am going to order them as soon as my nurse calls them into the pharmacy so I think that should be ok since they normally call them in on CD 1 and I'll be on BCP for at least 3 weeks-ish and the pharmacy is a 5 minute drive from me. I do have time to clarify the lifetime limit and # of cycle limit since we'll go ahead with this cycle regardless.
The frustrating thing is that I spent about $30k with this place 2 years ago so if they are giving me bad information that really makes me angry. The information they quoted me is the same as the minimum benefits required in my state (a mandated state) so part of me wonders if they confirmed I am covered and then just told me the state minimum mandates or something.
Insurance could not be more confusing.
When I called Cigna the first time last month they told me I had no coverage for IVF, but if I wanted an IUD that would be covered 100%. LOL
Ah yes, that could definitely be what happened. My clinic did that to me once too about defaulting to the mandatory requirements. I was like, yeah, no. And I sent them a copy of my benefits documents with the coverage criteria, and they updated it in their system. They definitely seem to approach it like they know more than you, which may be true for the average patient but if you really know your coverage you likely know more than they do about it since they work with so many different plans.
The insurance customer service is so full of shit. I usually just get one person on the phone and insist they transfer me to their infertility coverage group. Sometimes they will and then you get someone who knows what's actually going on.
They make it so hard, I think so people give up and don't take advantage of their coverage. Like I said, blessing or curse... it can be both.
At my FETs, my nurse would straight cath and drain my bladder for me so that I could rest for the 45 min they wanted me to lay there.
It's interesting how differently each clinic operates. I had no rest after transfer. I literally got dressed after the doctor & nurse left the room.
At 1 clinic I waited 5 minutes then got up. The other clinic they give you a bedpan if you want and you have to pay for 30 minutes. I admit, I had to use it once or I was going to pee the bed lol
My beta is supposed to be tomorrow, but it looks like OI round six worked as I've been getting strong positives. I haven't seen lines this dark since our twins two years ago. Just praying that this will cycle finally give us our THB(s).