Monthly Archives: April 2013

out of pocket

Since I just did my taxes (yeah, I know) and had to come up with a figure for medical expenses, I thought it might be illuminating to share exactly what we paid for the IVF cycle from beginning to end.

When I started my current job last May I was able to get on new health insurance, which has turned out to be better than what I had through my husband’s job before. Infertility treatment is still specifically excluded, but my current insurer is much more generous in parsing what they will and won’t cover. For example:

  • All office visits with the RE were $20 co-pays instead of totally out of pocket like before.
  • However, things that went on at those visits (ultrasounds, blood draws, etc.) were not covered.
  • My IVF drugs were partially covered (I still don’t understand why, but I didn’t want to question it in case they changed their minds!).
  • However, none of the procedures involved were covered at all.

So this is what an IVF cycle looks like financially, for someone with partial health insurance coverage and in a part of the country with very low cost of living relative to big cities.

Some more details about our cycle:

  • I was on relatively low doses of the stim drugs.
  • We ended up with 7 eggs retrieved, 5 mature.
  • We did ICSI and all 5 eggs fertilized.
  • We transferred 2 embryos on day 3 with assisted hatching; the other 3 didn’t make it to freeze.

 costs

Repeat of Day 3 bloodwork: $117.00 (not covered)

Clinic visit to discuss IVF: $20.00 (copay)

Repeat semen analysis: $165.00 (not covered)

STD blood panels: $55.12 (mine was fully covered; my husband’s was partially covered)

IVF meds: $1,100.44 (this is a copay – I was quoted about $2400 if the insurance hadn’t picked up some of it)

  • Gonal-F 300iu pen: $133.04
  • Gonal-F 900iu pen: $398.52
  • Ganirelix (4 doses): $132.22
  • Menopur 75iu (10 vials): $314.02
  • Novarel (HCG trigger): $50.83
  • Endometrin (32 doses): $71.81

Prepayment for IVF cycle: $10,578.00 (this was due in full on the day I started stims)

  • This was an estimated cost for everything involved with the cycle from the day I started stims to the second beta

Refills on Endometrin through 10 weeks of pregnancy: $188.50 (this is a copay, and also my clinic had a discount code that knocked about 1/3 off of the cost)

Refund from the prepayment: – $873.43 (because none of the embryos made it to freeze and we had fewer eggs than the estimate allowed for)

TOTAL OUT OF POCKET COST FOR 1 IVF CYCLE: $11,350.63

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happy

My life is so different now than it was a year ago. Two years ago. Three years ago. Four years ago.

Four years ago I was starting to wonder if there might be something wrong with me. Three years ago I was stuck. Unable to get pregnant, no diagnosis, and no idea what to do next. Two years ago my depression/anxiety was eating me alive. Last year we were grieving the third failed IUI and I was really coming to terms with the idea of IVF-or-never-have-a-baby.

And now? It’s like the magical Life Fairy has waved her little wand and made so many things better. I mean, obviously, Cayenne is almost freaking here (holy shit) and I am in a state of constant gratitude for that, but it goes beyond that as well, and a lot of it has to do with money.

I know I write about money a lot in this space and I probably seem a little obsessed with it, but it has really astonished me over the past year as I have watched how much of a difference it makes. People go on and on about how money doesn’t buy happiness, and they’re right to a certain degree, but on the other hand, yes it fucking does.

I would not be pregnant right now if I wasn’t able to borrow the money for the IVF cycle. It is so hard for me even to write that, but it’s true, and the sentence I’m about to write is so fucked up in so many ways that I almost can’t begin to parse it:

Cayenne would not exist if I hadn’t been able to pay for him.

Because my husband landed that magic tenure-track job (go husband!), and because I totally lucked into probably the only job in the world that actually uses my weird collection of skills, we are able to live in a way that wasn’t even thinkable for us in the first nine years of our marriage.

We have less debt every month now, not more. We are talking about buying a car that doesn’t come from Craigslist. When we needed to buy baby furniture, we just drove up to Ikea and bought it instead of spending weeks combing thrift stores. When I need new clothes, I go to the store and buy them. Sometimes I even pay full price. I like paying bills now because there is always enough money to pay all of them. I know I’m not supposed to care about stuff. I’m supposed to get all my happiness from intangibles and to meet life circumstances with equanimity. But really, there is a quality-of-life difference when I don’t have to live in fear of our 13-year-old car breaking down because how the hell will we get it fixed and then how will I get to work. Everything is easier now, and the only difference is money.

I make twice as much money as I used to; I’m not smarter, or harder-working, or more congenial, or more anything than I was then. They just pay me more. I’m also not smarter, or harder-working, or more congenial, than the similarly overqualified person who is now doing the job I used to do. So what, exactly, is different now that makes me deserving of this demonstrably better set of circumstances?* It feels like dumb luck.

And I keep circling back to Cayenne: am I somehow better, or more deserving, or more ready to be a parent than I was before, because this year I could come up with the necessary scratch for his conception?

I am going to love the living heck out of him (I already do), and I am going to teach him compassion and tolerance and how to make mashed potatoes, but I would have done all of that when I didn’t have any money too.

* And the ugly, sweat-drenched, 3-in-the-morning corollary: what makes me think it isn’t all going to vanish one day in an equally capricious way?