Due to the complexity of our type of medical benefits, we do not obtain the details of coverage for fertility medications. Often times these medications are not covered under your medical benefit, but under your prescription benefit and we do not obtain that insurance information. There are many stipulations for these type of prescriptions such as requiring that you receive them from a mail order specialty pharmacy (often times they cannot get it to you in a timely manner) or only being covered prior to any type of artificial insemination. There may be no coverage at all. Medication benefits and authorizations are the patient’s responsibility and we will help out by supplying whatever information we can. Please keep in mind that if a covered benefit, you need to find out if it is covered under your medical insurance or prescription insurance, where you can obtain the medications, and to get authorization (if required) ahead of time.
Common medications used during infertility treatments are: Clomiphene Citrate (clomid), Letrozole, Follistim, Bravelle, Menopur, Gonal-F, Menopur, Human Chorionic Gonadotropin (hCG), Pregnyl, Ovidrel, Lurpon, and/or Progesterone.
The average cost of medications for an IVF stimulation is $4,000 (usual range is from $3,000 to $6,000). The amount needed by each individual is different, and most often influenced by age. Medications are generally ordered through mail order pharmacies to obtain the best price. Payment for medications is made directly to the pharmacy. Certain couples may qualify for free medication through EMD Serono’s Compassionate Care program. This is available to US citizens or permanent residents that qualify based on certain income considerations. For more information and/or application, please call Fertility LifeLines @ 1-866-538-7879.