Insurance Games

I'm getting really good at playing this insurance game.  I feel like I've definitely come out on top this year!  I feel like beating insurance is not the norm...so I'm celebrating while I can.

I've been pretty upfront with my insurance dealings on here and want to pass on whatever tips and tricks I come up with to future Starbucks Mommas (or whoever else is reading this).

Benefits reset on October 1st for Starbucks so you want to use as much of your benefits as you can in the remaining time, especially if you've already met your deductible!  This goes for all doctors, not just your fertility stuff.

I was eligible to get refills on my estrogen patches (the ones where they filled 180 for me), leuprolide, and PIO.  I won't need the estrogen patches for a while, and I still have a TON left over from my last batch since the transfer was unsuccessful, but if I do get pregnant I will need more!  I'm hoping I don't need another batch of leuprolide since that would mean the 2nd transfer is also unsuccessful, but I refilled that just in case.

For the progesterone, my prescription has historically been for 2 vials at a time. I refilled that today (in preparation for the coming transfer later in October) and the pharmacy tech who I was speaking with (at Cigna) told me that if the doctor sent in a new Rx for more vials, they could fill that as well.  So I asked my nurse and she sent in a new Rx for TEN vials of progesterone.  This will theoretically last 100 days!  Plus the 4 vials I already have on hand which definitely gets me through week 12 of a pregnancy!!!  So even though my 2nd transfer hasn't even started, and won't happen until my insurance changes, I already have all the meds I need.

A few weeks ago I filled the regular pharmacy drugs for the transfer like valium and an antibiotic as well.

You may be wondering when this is a good idea and if it would be beneficial for you.  This is most beneficial for people who are switching insurance providers (I'm going from Cigna to BCBS) or people switching to a lower insurance plan (I'm going from platinum to silver).  The reason for this is that right now, I have very low copays for pharmacy meds (valium, antibiotic, estrogen patches) and copays will be significantly higher with a silver plan.)  ALSO with a platinum plan, it covers the fertility meds at 100% and with silver I will have 30% coinsurance.  So these meds will go towards my $15k fertility max, but I know I'm not close to reaching that, and since I'm switching to BCBS, I'll get a whole new $15k!