Out of pocket costs

MommaLee · #1 June 6th, 2009, 07:57 AM

I wanted to ask you girls whose insurance does not cover medical costs for infertility...about how much did you pay for an HSG & S/A?

I have blue cross blue shield and I know what you paid will probably not be what I pay, but I kind wanted to get an idea. I'm a finance person, so the unknown expense is nerve-racking.

I know money is a sensitive topic, so if you don't feel comfortable telling me, you don't have to.

Thanks.

Ash · #2 June 6th, 2009, 08:05 AM

I have BCBS and didn't pay anything for either the SA or HSG. I do have to pay for any medications as well as IUI or IVF if we choose to do those things. Otherwise, everything else is covered. Isn't it ironic that the expensive stuff is what is not covered (being sarcastic).

KDD · #3 June 6th, 2009, 10:52 AM

Our provincial health care pays for some of the testing (b/w and SA). I'm not sure if it will cover an HSG or not. We will have to pay out of pocket for any drugs or procedures.

fromustobaby · #4 June 6th, 2009, 12:09 PM

I have BCBS...I haven't had to pay for any bloodwork...I think I paid $130? for the HSG (original price was $600 or something like that)...S/A was full cost of $286 cause DH doesn't have health insurance (I"m putting him on mine in January 2010)...

At the fertility place, bloodwork is no cost, appointments/ultrasounds/etc are 20% (cause I've met my deductible), and medication and actual IUI will be full cost...I think IUI with the sperm workup is something like $500, and the CLomid we are using for the first go round is less that $20...$520 seems like a deal considering how long we've been trying at this point...

MommaLee · #5 June 6th, 2009, 12:36 PM

I can handle costs like that....I'm thinking the S/A will be fairly inexpensive (dh has BCBS too) but I'm just worried about the HSG because my insurance doesn't cover anything. I'm hoping not to get a bill for like $5,000.

And the ultrasound, unless they find something wrong, they will code it as infertility; however, I was told if it shows anything like PCOS, they will code it as the medical problem so that it is covered.

hearts.0nfire · #6 June 6th, 2009, 01:33 PM

I don't have insurance but thankfully didn't pay for my hsg because its part of my clinical trial, but the S/A was going to be $123 (i also didn't have to pay for that, but i had looked it up before the trial).

SavaAngel · #7 June 7th, 2009, 04:31 PM

I have UHC and my HSG was covered 100%!

When we were having insurance issues, the hospital told me it would cost $1,465.76 without insurance, but I waited another cycle and got the insurance all straightened out and it was covered completely. My insurance considers it diagnostic - which they cover.

Ash · #8 June 7th, 2009, 06:10 PM

Lee Ann, I checked into the HSG at full price just in case my insurance didn't cover any of it, and they said it would be around $500 dollars give or take $50 dollars. Since we are in the same region, you could probably expect about the same. If I were you, I would just call the facility where you will have it done and ask them what the price would be if you paid 100%. I did that, but I did have to get a diagnosis code and a procedure code from my doctor's office.

KDD · #9 June 7th, 2009, 06:14 PM

I did some research and an HSG is paid for by our provincial health care!

snsgirl336 · #10 June 7th, 2009, 08:10 PM

All of my bw was covered as was DH's SA as long as they were done at an "approved Lab" We're waiting on the HSG because we have to meet our deductable before it's covered. We haven't met it yet, and since the new coverage year begins in July, we'd rather meet it once and then do the rest of the fun stuff if needed and have it all covered. I have to call about the HSG pricing though... I'm concerned that it'll be pricey.

~*Jackie*~ · #11 June 8th, 2009, 07:20 AM

The first s/a we had was $63. Since it was diagnostic, I didn't have to pay the entire amount (it goes towards a lifetime crappy deductible that is almost gone). Same went with my HSG- the full price for mine was $1194, and I paid a couple hundred of that.

Now, we had a more intense s/a done last month for my RE, which consisted of a swim-up test (to see how well they could swim) and a sperm antibody test. It was $522, and right now is sitting as denied on my insurance website- and I'll go nuts since this is diagnostic.

I *heart* insurance companies.

MommaLee · #12 June 8th, 2009, 08:39 AM

Thanks ya'll I appreciate the info. I'm glad to hear that news to Ash. I know our plans our probably different, but hopefully the price will similar. I know the doctor put the reason as infertility but said if something else shows up they will change it so it gets covered. But I was told that anything for infertility was NOT covered.

Again, I really appreciate it. It makes me feel a whole lot better to know that we won't be in over our heads in medical bills.