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Saturday, July 16, 2016

Trigger Warning

Yesterday afternoon, at 3:45, I finally got the call from my RE's office. They wanted me to trigger. But the trigger shot that I had gotten via my insurance? The one that had taken multiple phone calls, extreme stress, and required DH to stay home to sign for? Did they want me to use that? Nope. Because of my bloodwork results, they wanted me to take a different product.

The new trigger shot was a brand called Pregnyl. Since this is a specialty mediation, there is only one pharmacy in the Twin Cities that has it in stock. So I drove there. At rush hour. And because this isn't my insurance's specialty pharmacy, I had to pay out of pocket, the full cost, with no hope of reimbursement. What was the cost, you ask? Well, if I'd ordered it online from a different specialty pharmacy, the cost would have been between $70 and $84. The cost listed on my doctor's office paperwork was under $100. If I'd ordered it via my own insurance's specialty pharmacy, the cost after insurance would have been $34 and untold aggravation. Instead of that, I paid $330. For the bloody generic, because they were out of the brand name.

$330 for the generic.

I am Not. Happy. My blood work was largely unchanged from yesterday. If they'd told me they wanted to change the trigger yesterday, I could have jumped through the insurance hoops, or rush ordered from the other online specialty pharmacy. But they didn't. So I paid nearly four times what I should have.

Adding to my annoyance is the fact that the 'Estimate of Charges' for this procedure provided by CCRM is substantially inaccurate. They estimated only one set of blood draws. But that's patently wrong, because they draw blood at both baseline and at monitoring. That's a minimum of two draws. They also draw progesterone, LH, and estrogen, but the estimate only includes the first two. Their estimate includes a blood draw fee of $20, but they've charged me $25 each time instead. At $115 per test, plus the blood draw fee, it adds up fast.

In my case, I wound up with an extra monitoring appointment and an extra blood draw. I'm more than happy to pay for more monitoring to get the cycle right. I'm not happy that their original estimate left off testing that they always perform. That's sloppy and misleading at best.

So what's my overall out of pocket for procedure and medication? Including the trigger shot I didn't use, $2,754.

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