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 |  | With Insurance: Copayments and Coinsurance |  | Clomid Without Insurance: $30-$75 per month |  | Injectables Without Insurance: $1,500-$4,000 per cycle |
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Fertility drugs often are the first treatments recommended for a couple having trouble conceiving, especially as a result of polycystic ovary syndrome (PCOS), a hormonal and metabolic disorder that affects as many as one in ten women of childbearing age. Usually Clomiphene citrate -- better known by the brand name Clomid -- is tried first because it is relatively inexpensive and is taken orally.
Typical costs: |
- The typical cost of a one-month cycle of Clomid is $30 to $75 without insurance.
- The typical cost of a one-month cycle of injectables, which usually includes three drugs, ranges from $1,500 to $3,000 per cycle, and sometimes as high as $4,000 without insurance. The average cost is about $2,700.
- It is more common for health insurance plans to cover infertility drugs than procedures such as IVF, but some prescription drug plans exclude even fertility drugs. Some states mandate insurance coverage of infertility treatment, with some restrictions. The American Society for Reproductive Medicine lists states that require coverage. In most states that mandate coverage, the law applies to group insurance plans of companies with 25 or more employees; individual plans are less likely to cover infertility treatments.
- On FertileThoughts.com, patients share their experiences with various health insurance companies and plans.
- FertilityLifeLines.com, run by an affiliate of Merck Serono, offers advice on navigating insurance benefits and a toll-free phone number 1-866-LETS-TRY, that offers help figuring out what your plan covers. The American Fertility Association[1] has a list of questions to ask your insurer.
- For patients covered by insurance, out-of-pocket costs typically consist of prescription drug copays of $10 to $100 per cycle, depending on the drug and the plan. Some insurers cover only a percentage -- usually 50 to 80 percent -- of the cost of fertility drugs, which can cause out-of-pocket costs to reach as much as a few thousand dollars.
Related articles: Fertility Test, IVF, Artificial Insemination
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What should be included: |
- With Clomiphene citrate -- or Clomid -- the patient begins taking two to three 50 mg tablets by mouth, usually about three to five days after the start of her menstrual cycle, continuing for about five days. The drug acts on the brain, tricking it into releasing more follicle-stimulating hormone (FSH), which can cause the patient to ovulate. The American Fertility Association[2] has an overview of Clomid.
- If Clomid does not work, or causes intolerable side effects, doctors can use injectable fertility drugs. The American Fertility Association[3] has an overview.
Additional costs: |
- While taking the drugs, the patient must be monitored via blood tests, which measure hormone levels, and transvaginal ultrasounds, which show follicle size and endometrial thickness -- indicators of how the treatment is working. Monitoring can costs hundreds of dollars per cycle.
- Drugs -- especially injectables -- often are used in conjunction with artificial insemination, which costs about $300 to $500 per cycle, or IVF, which averages $12,400 per cycle.
Shopping for fertility drugs: |
- It is important to take fertility drugs only under the supervision of a qualified doctor. The doctor you choose should be a reproductive endocrinologist, meaning they are board-certified by the American College of Obstetricians and Gynecologists[4] and have had at least two to three years additional training in reproductive endocrinology. The American Society for Reproductive Medicine offers a doctor locator.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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What People Are Paying - Recent Comments |
| Posted by: M.Schell in Dover, NH. | Posted: December 21st, 2021 03:12PM |
| With or Without Insurance: With | Insurer:: Anthem BCBS |
| Policy/Plan:: HMO | Doctor or Clinic: E. kinsler |
Quantity 10, taking 2 tablets by mouth daily for 5 days |
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| Posted by: trickumgirl in anniston, AZ. | Posted: January 14th, 2009 11:01AM |
| With or Without Insurance: without | Insurer:: none |
| Policy/Plan:: none | Doctor or Clinic: fletcher |
after 10 years of trying we got pregnant,only to lose the baby in the 3rd month.im thinking of trying clomid but not sure if it will help any advice? |
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External Resources: |
- www.theafa.org/conceive/amicovered.html/
- www.theafa.org/conceive/fertilitydrugs1.html/
- www.theafa.org/conceive/fertilitydrugs2.html/
- www.acog.org/About_ACOG/Find_an_Ob-Gyn
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