IVF Orientation (or, My Pharmacy is Garbage)

I can picture it now: a group of insurance execs sits at a table in a slick board room. They stare pensively at charts and tables of information on a screen at the front of the room.

“We’re going to give them three funded IVF attempts,” says the leader. “We have to if we want to be competitive, for a plan at this level.”

“But sir!” cries an underling. “It will cost us a fortune!”

“Don’t worry,” smiles the leader. “We have a plan.”

“We’re going to make the entire process incredibly fucking difficult for everyone involved.”

I mean, I can’t think of any other plausible explanation for how much of a nightmare it’s been just trying to get my god damn prescriptions. Seriously, I’m about at my wits end. All I can say is, if you have the opportunity to use any other insurance besides United Healthcare, for the love of god, do it. Because if they’re your insurance, they’re going to force you to use OptumRx mail order pharmacy – the absolute worst pharmacy on the planet – to fill your prescriptions.

I actually foresaw this entire thing. I have had to use these clowns for my CF specialty medications for years and I know what an incompetent hive of knuckledraggers they are. That’s why, on October 6th, I sent a message to my fertility doctor to ask him to get things in place so we could order the IVF meds as soon as possible. Then, as soon as the nurse called me on the 19th to set up my cycle, I asked her to send the prescriptions to the pharmacy that day to be processed. I warned her that my insurance takes forever to deal with these things. And still, despite the fact that the prescriptions had already been written, she didn’t get around to sending them until 5 days later – despite my repeated begging phone calls to please just send them.

Today, after three separate phone calls to OptumRx at various points in the day, I discovered that a) they never received two of the prescriptions, b) all of the prescriptions for injectables require a prior authorization (which can take up to two weeks to process), and c) they actually can’t fill my prescription for the injectables, so they’re transferring them to a different pharmacy.

A list of all the medications I’m supposed to be taking. The ones without checks have apparently disappeared into the ether, because no one knows what happened to the prescriptions. The ones marked “FF” are now being transferred to Freedom Fertility.

I’m supposed to start my injectables in 9 days. I have very little faith that they will get all of this sorted out on time, so my plan is to call my insurance company, the pharmacy, and/or my doctor’s office every single day until they all get it together and get me my meds. When I told my nurse today that there is a very real possibility that I won’t get my meds on time, and asked what the back-up plan was, she didn’t really have an answer. Maybe that’s why you people should have taken care of this THREE WEEKS AGO, WHEN I ASKED YOU TO.

I am going to be such a freaking charmer once I actually start my hormones. I haven’t even started yet and I’m already pissed off at everyone.

It just frustrates me to no end. Our medical system in this country is so, so broken. I have no choice in insurers because this is the insurance my husband’s job offers. I have no choice in pharmacies because we have to use the one(s) the insurance requires. The people I talk to on the phone at these places work for giant corporations and don’t give two shits about whether or not I get my medication when I need it. I have zero agency in this process except for being incredibly annoying and calling everyone every day to get them to do their jobs. Good thing I don’t have anything else to do besides spend hours of my life on hold (NOT).

How do people who have never even dealt with specialty pharmacies navigate this stuff? I mean, I have to do it every month anyway to get my CF meds, and it’s no freaking picnic, but at least I know what level of incompetence to expect. People doing all of this for the first time must just be totally screwed.

Ok, I need to quit ranting. Honestly, I know that this is not good blogging. It’s not interesting to anyone but me. But I had to get it off my chest.

In other news, I had my IVF orientation with a nurse today. She gave us our schedule of medications, the price list for everything we need to have done, and a packet of information on what to expect. She also taught us how to use the injectables. However, aside from pricing info, she wasn’t able to answer any of our other questions such as whether we should be considering PGD or whether my husband should provide a back-up frozen sperm sample in case the quality of the fresh sperm sample isn’t good. So we sent off our list of questions to the doctor via email and we’ll see what he says.

Our IVF schedule, subject to change.

A price list from our clinic. The items highlighted in purple have been recommended by the doctor for us. Since my hysteroscopy was done last week it’s not included on this list. We’re also considering EEVA and PGD, but it would be out-of-pocket, so we want to discuss with the doctor whether or not it’s really worth it.

Our total estimated cost for this cycle, not including the medications or hysteroscopy. Thank god it’s covered by insurance – even though dealing with them sucks!

Tomorrow I’m going to get back on the phone with the pharmacies to try to get all of this sorted out. Once I have the medications in hand I’ll be so much less stressed.

This evening I made a joke to my husband that this has got to be the most complicated way to make a baby. He responded that no, it’s not – we could be using a surrogate! And an egg donor! And a sperm donor! I had to laugh. Yeah, it could be a lot worse. But it could also be a hell of a lot better.