Thursday, April 17, 2008

Advice needed for a friend

Hubby has a very close friend M from grammar school whose wife, J, is going through a struggle with secondary IF. Technically, she would have been dealing with infertility earlier since it took her about 12 months to finally conceive their 3 year old DD - but, as she was prepping to meet her doctor about it, she finally ended up PG after about half her cycles being annovulatory.

J just turned 37 years old. She is not always ovulating, has tried a few rounds of clomid in which she is ovulating but not getting PG, just tried one round of Clomid/trigger/IUI (the IUI and meds out of pocket) which just resulted in a BFN.

When I talked to her last night, she was obviously upset that they have been trying for over a year now...and she didn't start the testing earlier (her HSG was all clear; b/w all normal). But, there were some very strange issues surrounding her sister that she had to deal with...and put TTC in full force off the plate.

Anyways, she is running out of options because both her insurance and her husband's insurance don't cover IF well - hers has no prescription plan (so all meds she has take up to this point have been paid for out of pocket) and does not cover IUI (it did cover the long as she was NOT given the title Infertile); his covers most things, but with at least a 20% co-pay; if she tried to get on his insurance with hers (co-insure), then she has to pay parts of two insurance premiums for an entire year.

So, in other words, any way she tries, she has to spend a lot of money and they can't afford that right now. They are on a tight budget after M having lost his job twice in two years (he works as a manager in retail - which is not always stable). There were some financial burdens with the issues with her sister. And, they have some major debts to still pay from M prior to them being married. So, there is not much available to pay for IF procedures and medications.

I suggested a whole slew of things to her (Femara since Clomid is causing CM issues, hence the need for the IUI), checking for other issues that could be causing annovulation (like thyroid disease and PCOS), using things like Green Tea or PreSeed for CM issues. But, she could use some advice on how to get an IUI cycle covered without too much out of pocket cost since they are on such a tight budget.

Any advice from ladies who have been there would be greatly appreciated. I can't really help her with the financial aspects of this because all I have ever had to pay were office visit co-pays for any visit or procedure done - I have a thorough prescription plan, excellent coverage and very minimal out-of-pocket expenses (i.e., all I have had to pay for were OPKs, HPTs, etc.). Just one reason I remain a slave to the State here...

Thanks a million for the help!


jp said...

I don't know much about New Jersey's laws, but some states, NY being one of them, have mandatory coverage for some fertility issues (my insurance covers IUIs until I am 45 but no IVF, but it does cover my meds under the prescription plan).
Financially, I have seen some folks on very tight budgets do fertility studies and research programs to reduce the costs of treatment.
Sorry I don't have more helpful info-

Antigone said...

I think some RE's offer financing services. There's always loans and credit cards as a last resort.

Dianne said...

hey Tina
I know my RE has a finance program.. but also petitioning the insurance company can also work.., it sped things up (barely) for a friend of mine but she now has IUI's and stuff covered and it helps... some people do buy their own meds online from trusted sources.. it is always worth a shot, someone always has some clomid laying around extra ;) and i always said i would use the credit card if i had to!