A light at the end of the tunnel for OOP Maine Ladies?

 

Bill To Mandate Infertility Treatment Coverage Debated

Legislation Would Require Insurance Companies To Cover Infertility Treatments

AUGUSTA, Maine -- Lawmakers in Augusta heard emotional debate on Wednesday that would require insurance companies to pay for infertility treatments.

Massachusetts, Connecticut and Rhode Island already require insurance companies to cover the treatments, which can run in the tens of thousands of dollars.

Megan Brooks testified about her struggle over the past four years to get pregnant.

"I feel that infertility treatments should be covered for all people. I don't think motherhood is an option. I think that we should all have the opportunity to be mothers," said Brooks.

Brooks was not the only one struggling to hold back tears during Wednesday's hearing.

"Doctors have suggested to us over the years that we move to other New England states to get coverage, and we continue to stick by the state of Maine and still do," said Mike Staggs of Bar Harbor.

The bill would mandate insurance companies to cover infertility treatments. The bill's sponsor, Rep. Gary Knight, said it would only apply to married couples and people who are infertile from reasons other than sexually transmitted diseases.

Critics said the bill is discriminatory.

"As the legislature moves forward, and considering this legislation, its important for them to eliminate the provisions that discriminate against women who are not married and women and men who have contracted a sexually transmitted disease," said Shenna Bellows of the Maine Civil Liberties Union.

Others who oppose the bill said the coverage mandate will also raise premiums.

"Every mandated benefit has a cost and that has to be born by somebody, and in this state most mandates fall most heavily on the small businesses," said Peter Gore with the Maine State Chamber of Commerce.

Fertility treatments are covered under the health insurance state employees receive, but with some exceptions.

The legislation will go to a work session on April 1.

** To check the status of your States Mandated IF Coverage please see the Insurance Help Tab above**

Infertility Tax Credit

 

** This information was copied from the Resolve.org website **

What is the Infertility Tax Credit Bill?

RESOLVE supports a bill that would create a tax credit for the out-of-pocket costs incurred for the medical treatment of infertility.

Who will this bill help?

While all the details of this bill are not final, RESOLVE feels strongly that when this bill passes it will help thousands of couples defray the cost of medical treatment for infertility.  The financial burden of an infertility diagnosis is significant, and any means to help offset these costs is a positive development for women and men who are faced with infertility medical treatment.

Are there similar tax credits already in place?

For many years families have been created with the help of the Adoption Tax Credit, and we hope this new tax credit will achieve the same level of success for those trying to cover the costs of medical treatments.  Read more. 

Has a tax credit bill been introduced?

As of March 22, 2011 a bill has not been introduced in the House or Senate.  RESOLVE is working closely with legislators in both the House and Senate on draft bill language. We anticipate that the bill will be introduced soon.
RESOLVE is thrilled to be working alongside legislators and others in the infertility community who have already expressed very positive support for a tax credit bill.

What happens once the bill is introduced?

Once the bill is introduced, it’s up to YOU to talk to your elected officials in the House and the Senate and ask for their support of this bill. RESOLVE will lead this effort and provide everyone with information on how to ask for support.

How can you help get the Infertility Tax Credit passed?

Right now participating in RESOLVE’s Advocacy Day is the event that will be key to getting this bill introduced, co-sponsored, and passed. Learn how to be part of RESOLVE’s Advocacy Day. 
Your elected officials need to hear from you about why this tax credit is so important to those diagnosed with infertility.  It is your right as a citizen to talk to your lawmakers who will be voting on whether or not this bill passes.  If they do not hear from you they will not realize the positive impact it will have on so many women and men trying to build their family. Also, pass this information on to your doctor, friends and family and ask them to support our efforts. 

Need a refresher course on how a bill becomes a law?

TheCapitol.net has some very easy-to-follow information about how a bill becomes a law.

Jamie's Journey to Success

I went through my first and only IVF cycle in August of 2009.  I had saved for 3 years and obsessed for many more than that.  I was ready, nervous, stressed and excited.   We ended up paying for a Shared Risk program through attain for a little “insurance” in case it didn’t work.  I had told my husband about the OOP meds program that was being run by the board and he was excited about the possibility of it helping us out, I was too.  Ironically I had become friends with Jenny Z. who was on the same timeline as we were and she so just happen to become the OOP meds coordinator just before I started my cycle. 

Needless to say, Jenny Z. is a wonderful person and organized this program beautifully.  She matched me with several girls who had extra meds.  These girls shipped me their left over meds, took the time to pack in ice packs and all I did was pay shipping.  Can you say AMAZING!  I was blown away at the kindness and generosity of the girls on this board.  I would venture to say that the program saved me thousands of dollars in meds and made the whole process a little less stressful.

I had 5 eggs retrieved, 5 were mature, 5 fertilized, 2 gorgeous embies transferred on day 5 and 2 more made it to freeze.

I was stunned on Sept 2, 2009 (my birthday) that I was pregnant and even more stunned 6 weeks later that I was carrying twins. 

The absolute greatest thing to ever happen to me, my boys Colin and Cody will be 1 year old on April 23^rd.

I owe the OOP meds program so much and thank the wonderful girls who give their time and energy to run it. 

To the girls that offer to donate their unused meds, what a blessing it is to be able to help someone through this process.  I thank you from the bottom of my heart!

Jamie

journeytobaby

KaliChick's Victory

With her permission, here is an exerpt  from a fellow OOP IVF'ers Blog:

"Even though we aren’t cycling until next month, Dr. K wanted to go ahead and order the meds.  I knew there would be several, but honestly, I had no idea exactly how many.  Estimated cost?  $5,000.  That’s just the meds.

Most fertility drugs aren’t available at just any pharmacy.  You can’t just walk into CVS and pick up a syringe of follistim.  It has to be ordered and generally it’s all ordered from online pharmacies.  Dr. K prefers The Apothecary Shop.  Last week I got the call that my med order was in and ready to be reviewed and ordered.  I asked what he had ordered (since we didn’t really ever go over that with Dr. K since we weren’t sure when we’d be cycling).  She starts listing off meds.  I lost count.  She asked me if we had insurance and when I told her yes and then she told me she doesn’t deal with our insurance at all.  So I told her I would call her back.

We have Kaiser (KP) health insurance.   Actually, we have a Point-of-Serivce (POS) plan that allows us to see KP and non-KP doctors.  It even allows us to bring in prescriptions from non-KP doctors.  It doesn’t, however, pay for IVF.  As far as I knew, it didn’t pay for fertility drugs either.  However, I had to believe they would pay for the antibiotic and a few other meds.  I mean, they weren’t specific to fertility.  So, I figured I’d try.  I called KP on Friday and after 3 different pharmacy locations, I got one that could actually help.  KP Garden Grove has a fertility clinic (they do IUIs only) and so they stock many of the meds, plus they are a compounding pharmacy.  What I found out is that they would cover some of the meds at copay only and if they stock the fertility drug, it’s a 50% copay.  Victory!!!

On Monday I took all 10 prescriptions over to KP Garden Grove.  I got an awesome tech who was more than happy to run price quotes for me.  All of the “non-fertility” meds  were covered at copay only.  The total for 5 prescriptions was $120.00.  That’s a pretty big savings over having just ordered them and paid full price at Apothecary (I’m guessing about a $500 savings).  They also cover Menopur at 50%.  Apothecary quoted me almost $2,800 for just the Menopur (KP is $1100).  The remaining stimulating and trigger shots aren’t covered and are actually cheaper with Apothecary so I’ll order from there.
The breakdown is about $2900 total combining KP and Apothecary.  Had I just gone with Apothecary it would have been about $5000.   Everything with KP would be $3,300.  It pays to price shop!
And for those inquiring minds …. here’s the list of meds:
I
njections
Follistim AQ Cartridge solution 300 iui (x 4)
Menopur Intramuscular Injection 75 iui (x 40) (this is a lot by the way)
Ganirelix Acetate 250 mcg/0.5mL (x 5)
Pregnyl powder 10,000 units Intramuscularly (this is the trigger shot)
Progesterone in Oil 50 mg/mL Intramuscular (this is done after retrieval)

Other meds

Prometrium Capsules 200mg (x 60 capsules)

Medrol 8mg (x
Doxycycline 100mg (x 40)
Vivelle-Dot film (estrogen patches x 10)
Needles/Syringes
-------------------------------------
My point is, please price shop!  Even if your insurance company doesn't pay for Fertility meds, call them!  You might be surprised!!  Many of them will pay for the antibiotic, PIO, prometrium, patches, medrol, etc.  That can save you a few hundred alone.  And as well all know, when you're dealing with IVF, every single penny counts.  I saved close to $2,000!  I realize many wouldn't get that big of a break, but you don't know if you don't ask.  I almost ordered everything from Apothecary without questioning it, and then I realized that I pay high premiums for insurance just like everyone else and I should give it a shot and it paid off.
If I have meds at the end of my cycle and am successfully pregnant, I'm more than happy to donate the meds.  I'd rather have someone use them then have them go to waste."

~ KaliChick

OOP Wants to hear from you...

Have you received meds or donated your unused meds through the OOP Meds Program? Do you have experience haggling with pharmacies to get the best price? Did you receive help from a grant or patient assistance program to fund your IVF? Did you have fundraisers to finance your IVF?  Did you write your state legislator regarding infertility coverage? Did you write an appeal letter to your insurance company?
If so we want to hear from you! Besides being a one stop source for IVF OOPers, much like the program that this blog is named for: the oopmedsprogram blog is a forum for ladies to provide advice, tips, and share their stories to empower & give hope to other ladies who are also forced to pay out of pocket for their infertility treatments.

Please email me at oopmeds@yahoo.com with anything that you would like to share with the readers of this blog. You can also provide a link to your blog to receive more followers or remain anonymous - it is up to you!

Under Construction