I posted this on a board today, so I'll use it as my update:

My insurance doesn't cover infertility, so my OB has been billing my treatments as PCOS. This is now my third cycle with this OB, and I'm starting to get bills from my first cycle (where we were trying to get a diagnosis of what was going on) and my first ultrasound has been denied by my insurance company. The insurance company says that even though the ultrasound was billed as PCOS, they consider it infertility treatment. The insurance company wants the office notes from my OB to determine if it was related to infertility or not.

Now, for the second cycle, I can understand the insurance company's point (since at that point we determined I had PCOS and IR, and the second ultrasound was more to determine how I was responding to Clomid). But the FIRST cycle was really trying to get a diagnosis of what was wrong with me - and that should be covered.

I haven't spoken to my OB directly yet, so I'm not sure what she'll say. But, if the worst case scenerio happens, and my treatments won't be covered, what options do I have?

The ultrasounds are $420. The CD 21 bloodwork is $210 (the insurance company hasn't argued about this yet, but I assume they will try). Clomid costs $25 and HCG shot costs $49. Progesterone treatment is $10. Obviously, this is a lot of money each cycle, and I'm not even into IUIs or injections yet (though I'm responding GREAT to Clomid, so I assume they won't be necessary).

Here are my thoughts:

1. I might be able to "talk down" some of the prices since these are what they are charging the insurance company, and usually they give a break to people when insurance doesn't pay.

2. Perhaps I could see an RE or something who has a package deal for people who don't have insurance. Like $300 a cycle or so, right? Maybe I'll get better treatment that way too?

3. Maybe I could get additional insurance somehow? That might be as expensive as $300 a cycle though. Plus, if I enter into the insurance with my current infertility situation, perhaps they won't cover me, knowing that's what I'm looking for.

4. I could always have an unmonitored Clomid cycle, but so far I've gotten the impression that my OB's office doesn't like to do that. (Though, perhaps now that they've seen how I react to one cycle, maybe they'll be fine doing the same treatment without monitoring?)