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Aug 10, 2016

Getting Back on Track


Happy Hump Day!

I crossed an item off my to-do list this morning that has been a thorn in my side since February 11, 2016.

We were finally able to submit the huge PGD testing bill to our insurance for reimbursement.
(Yes, I am going to outline our expenses in this post. I told you I would be honest with what our situation is...)

To say making a baby has taken 9 months to do even before I am pregnant is spot on.

January 5th I met with Dr. Jacobs to go over a general time line, and from that day, it has been a never-ending series of appointments, with long periods of waiting in between.

We learned right away that genetics labs do not contract with insurance companies. While I had done my due diligence to confirm that Blue Cross of Illinois did, in fact, have coverage for PGD testing in a case like ours, what I didn't realize was we would have to pay for it all upfront, out of pocket.

I also had no idea how much it would cost.

Fertility Centers of Illinois has a genetics lab in their Highland Park facility.
This genetics lab is called Global Genetics Institute.

This is awesome for couples looking to complete PGS testing. This testing is a quick process, about a week, that determines if any embryos have abnormalities that could lead to things like downs syndrome, and other issues that could cause early miscarriages or other complications.

The base fee for PGS testing is $3,500.
Then, each embryo is $275, up to 8.

So say you are PGS testing 4 embryos, your out of pocket cost is $4,600.
Illinois does have insanely good insurance coverage for infertility, but one of the drawbacks is they still consider PGS testing to be experimental. Which means....zero coverage.

But when you need to go the extra step with PGD testing for a specific recessive mutation, Global Genetics contracts with an outside lab.
This lab is called Reprogenetics.

The base fee for PGD testing is $4,500.
Then, each embryo is $525, up to 8.
Plus you have to have these cells over-nighted as this lab is out of state, so each time this happens, it's another $200.

Well, we collected 5 embryos over two successful cycles, so our total out of pocket costs for PGD testing was $7,525.

A $3,000 deposit was due way back in February, so we have been sitting on that debt for quite a while.
And then we had to meet our insurance deductible for all these IVF cycles, which was $3,500.
And then our cat got hurt, and the cost to heal him totaled $3,750 (I know).
And then our 3rd IVF round was successful enough to actually start PGD testing, so the lab went ahead and billed us the balance of the testing, $4,525
And for each successful cycle, we have to freeze the embryo(s).
The first round of freezing is $1,200 (not covered by insurance).
The second round of freezing is $800 (again, not covered by insurance).
Plus, I had a medication that was compounded and not covered by the insurance for IVFx3, which came to $150.

I knew all this going into it...except, again, the upfront out of pocket costs for PGD testing.

Our total out of pocket costs for this year (with IVF and the cat) came to $16,925.

GULP.

The items that are not eligible for reimbursement:
Insurance Deductible: $3,500
Cat: $3,750
Cryopreservation Fees: $2,000
Compounded Medication: $150
Shipping fees for PGD testing: $400

TOTAL: $9,800

Items that should be eligible for reimbursement:
PGD Testing: $7,125

After a lot of hounding to the genetics lab, I finally gathered all the necessary receipts, CPT and Diagnosis codes, description of services and other necessary information, and faxed everything over to Blue Cross.

I am hoping to see a big beautiful check in the next 30 days because DAMN these expenses!!

I should also mention, that regardless of this huge bill for 2016, I am proud to say that after this reimbursement check, we will be completely caught up with our debt. It was a hard year, and we had to scale back a TON in frivolous expenses, but our hard work has paid off. 
I can finally see the light at the end of the debt tunnel!

As far as what's on deck this week?

I started back at the gym for the first time in over a month.
I am sore...but it's a good sore.
The perfect stress relief for these trying, waiting, times.

Our FET meds are being delivered tomorrow.
Yet another huge box of medication with endless syringes and needles and vials.
Fun.

I am scheduled on Monday for a saline sonogram....kind of like a trial transfer, to make sure everything checks out okay down there.

I still don't have PGD results, though.
That call can come in anytime between now and next Tuesday.

But knowing my patience level is zero...I am probably going to email them on Friday to see if I can get my info before the weekend!

Chugging right along!
Thanks for reading!! XO

5 comments:

  1. I'm excited for you to get reimbursed . . . my son would call the large amount of money "fat stacks" so that's what I kept thinking as you were tallying up the costs. Phew. I'm excited for the PGD results . . . the countdown is on!

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  2. Dang that is a lot! And I feel your pain! We paid about 15k between our last fresh & our current DE cycle, most of which we won't be getting reimbursed for. We had to take out a loan for $8000 of it and the rest we paid OOP. I am actually still waiting for money back from the PGS testing we were supposed to have done last december!! $2,100 that I have yet to get back! So frustrating!! Fx for those PDG results, hope they come soon!!

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  3. I can't believe the money that goes into all of this. Huge shout out to you and Mark for handling it all with such grace.

    And hey, those results need to come in NOW and they need to be fabulous.

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  4. I'm glad you totalled that all up because I totally lost count. Wow. But props to you for managing to stay on top of the debt. That is no easy task and requires not only that you have the money coming in, but discipline to scrimp and sacrifice to make it work.

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  5. WOW. Just wow. I can't wait for those PGS results!

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