OHIP Coverage?

Baby4nat · 03-01-2008, 03:46 AM

Hello girls,

I'm new around here and still learning a lot about trying to conceive and fertility treatment, I tried Clomid but just through my OB/GYN with zero monitoring, it's was prescribed on my first visit I guess to speed my visit, I choose not to go back to him again, so my family doc is referring me to a clinic.
So my question is.....

Are fertility clinic visits and IUI covered by ohip? Is all of the fertility monitoring covered? besides IVF and meds, is everything else covered?

mommy1 · 03-01-2008, 07:58 AM

Your dr visits, b/w, and u/s are all covered by OHIP but your meds and IUI's (and IVF's) are not covered by OHIP. If you or your dh have benefits through work for your prescriptions you may have coverage for those (you would have to find out what the specific amount covered for fertility meds is as some packages don't cover fertility meds). HTH.

ETA~ Any surgeries or procedures (ie hsg dye test) are also covered.

Baby4nat · 03-01-2008, 03:45 PM

I thought IUI was a procedure? what part of that costs money?

mommy1 · 03-01-2008, 08:20 PM

I meant like u/s and the hsg tubal dye test, and that sort of thing. IUI is a "procedure" but it's not covered by OHIP. Every clinic has different prices for IUI's. At my clinic (in London) it's $200. When my dh had benefits through his work we had a lifetime of $1,000 coverage for fertility meds (which isn't much if your doing injectables, it would cover approx 1 cycle and it wouldn't include the $200 for the IUI). Even when you have a monash sperm test done (regular semen analysis is covered by OHIP) you have to pay out of pocket to have done. I know it can be confusing but that's OHIP for ya!

I'm not sure if this will help or not but here is what I paid for a cycle of Clomid (50mg), hcg trigger shot with an IUI..... $35 for Clomid, $96 for the trigger shot, and $200 for the IUI.

Baby4nat · 03-02-2008, 04:06 PM

Thank you, Mommy1.

That information helps a lot, to be honest I was looking at a lot more money than that. I have a lifetime maximum of $5000 with my insurance so I will probably save that just in case I need to do IVF one day, and pay for my IUI if the clinic I go to decides to give me one.

I noticed that there is a PCOS clinic in Toronto at Womans College, has anyone been there?

BeetleGirl · 03-04-2008, 12:30 AM

If your tubes are blocked, OHIP will cover a set amount(3, I think) of IVF cycles. If your tubes are not blocked than procedures are done out of pocket or paid by secondary insurance.
There are also numerous tests that OHIP doesn't cover but most are not required until there are extenuating circumstances like numerous failed cycles, or multiple pregnancy losses.
Good luck!

Nantucket · 03-07-2008, 12:03 PM

At our clinic in Ottawa IUI's are covered-the procedure part of it...the sperm washing is $300.00.

You will usually encounter an administration fee as well. Ours was $400.00-which is not covered and was not covered my DH"s insurance.

For my cycle of injectables we paid :

$400.00 admin fee
$597.00 puregon (6 doses)
$297.00 puregon (3 doses)
$297.00 puregon (3 doses)
$79.50 HCG trigger shot

We were told DH"s insurance (Blue Cross) covered 100% up to $15, 000 but we got a nasty surprise when they only covered $400.00 of the first $600.00 we submitted.

Mya · 03-08-2008, 09:57 PM

wow it can really add up .. i need to find out what we have from greenshield ... the IUI/sperm wash is $200 .. and trigger $100 ... so i was figuring i would get out of the first cycle @ $300 (as clomid would be covered) ... but now i am wondering if i will get a surprise?

Newfie76 · 04-04-2008, 01:10 PM

Nantucket- you mentioned that you are going to a clinic in Ottawa, which one???

SanH_2006 · 04-05-2008, 09:36 PM

Nantucket - I'm curious as well, which clinic in Ottawa?
I am currently going to the Ottawa Fertility Clinic. It would be sweet to know that part of the procedure would be covered.

Newfie76 · 04-08-2008, 10:42 AM

I too am with the Ottawa Fertility Clinic and I was told that the sperm washing there was $1000 plus the $400 admin fee so I am quite curious to know if there is another clinic in Ottawa where the sperm washing is only $300. Why on earth would there be such a huge difference in price???

blueoceanflower · 04-10-2008, 10:12 AM

Yes, I would like to know, also. I went to the Ottawa Fertility Center 2 yrs ago and am gearing up to go back, but I need my endo to re-refer me....but if there is another clinic with better pricing, I would love to know!

slsi · 04-10-2008, 10:21 PM

Hi ladies - for anyone in the Toronto area you will find that Costco has one of the lowest dispensing fees and fertility drug costs. Another one is Glen Shields Pharmacy in Thornhill which does not charge any dispensing fee on fertility medication.

Catwoman2005 · 04-16-2008, 02:32 PM

When I had the IUI done it wasn't covered by OHIP and neither was the progesterone suppositories for after...

You can claim the expense in your tax return under medical expenses, that's what we did... I even through in the parking fees too...

You can claim any medical that you paid that your insurance doesn't pay when you co-pay... So with that too it all adds up...

JenniferEnsoll · 04-18-2008, 12:13 PM

You know the funny thing is when I saw Dr. Redmond downtown Toronto she would always give me my trigger shot in her office and wouldn't charge me...I thought this was covered and normal.

Now I am seeing a new doc. Dr. Hepburn and his office charged me $83 and I have to give the shot to myself. I was not impressed.

sucks!!!!!

Jenn

03-01-2008, 03:46 AM	#1 (permalink)
Baby4nat Registered User Join Date: Feb 2008 Location: Toronto, ON Posts: 12 Points: 1,112.16 Bank: 0.00 Total Points: 1,112.16 Donate	OHIP Coverage? Hello girls, I'm new around here and still learning a lot about trying to conceive and fertility treatment, I tried Clomid but just through my OB/GYN with zero monitoring, it's was prescribed on my first visit I guess to speed my visit, I choose not to go back to him again, so my family doc is referring me to a clinic. So my question is..... Are fertility clinic visits and IUI covered by ohip? Is all of the fertility monitoring covered? besides IVF and meds, is everything else covered? __________________ ME 27 DH 31 Married since Aug2001 Dx PCOS 1997 Feb2008 1st round of Clomid 50mg CD5-9 Metformin 500mg

03-01-2008, 07:58 AM	#2 (permalink)
mommy1 Praying for a Miracle! Join Date: May 2006 Location: Ontario Posts: 4,570 My Mood: Points: 91,408.13 Bank: 0.00 Total Points: 91,408.13 Donate	Your dr visits, b/w, and u/s are all covered by OHIP but your meds and IUI's (and IVF's) are not covered by OHIP. If you or your dh have benefits through work for your prescriptions you may have coverage for those (you would have to find out what the specific amount covered for fertility meds is as some packages don't cover fertility meds). HTH. ETA~ Any surgeries or procedures (ie hsg dye test) are also covered. __________________ Me (31) To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. DH (28) DD (10) To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. ttc our first together since June'04 To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. Meds/Herbs: 2000mg Metformin 150mg Soy Isoflavones cd3-7 prenatals and Omega3's npc (2ww) "No matter how difficult the challenge, when we spread our wings of faith and allow the winds of God's spirit to lift us, no obstacle is too great to overcome." Roy Lessin Last edited by mommy1 : 03-01-2008 at 08:52 AM.

03-01-2008, 03:45 PM	#3 (permalink)
Baby4nat Registered User Join Date: Feb 2008 Location: Toronto, ON Posts: 12 Points: 1,112.16 Bank: 0.00 Total Points: 1,112.16 Donate	I thought IUI was a procedure? what part of that costs money? __________________ ME 27 DH 31 Married since Aug2001 Dx PCOS 1997 Feb2008 1st round of Clomid 50mg CD5-9 Metformin 500mg

03-01-2008, 08:20 PM	#4 (permalink)
mommy1 Praying for a Miracle! Join Date: May 2006 Location: Ontario Posts: 4,570 My Mood: Points: 91,408.13 Bank: 0.00 Total Points: 91,408.13 Donate	I meant like u/s and the hsg tubal dye test, and that sort of thing. IUI is a "procedure" but it's not covered by OHIP. Every clinic has different prices for IUI's. At my clinic (in London) it's $200. When my dh had benefits through his work we had a lifetime of $1,000 coverage for fertility meds (which isn't much if your doing injectables, it would cover approx 1 cycle and it wouldn't include the $200 for the IUI). Even when you have a monash sperm test done (regular semen analysis is covered by OHIP) you have to pay out of pocket to have done. I know it can be confusing but that's OHIP for ya! I'm not sure if this will help or not but here is what I paid for a cycle of Clomid (50mg), hcg trigger shot with an IUI..... $35 for Clomid, $96 for the trigger shot, and $200 for the IUI. __________________ Me (31) To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. DH (28) DD (10) To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. ttc our first together since June'04 To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. Meds/Herbs: 2000mg Metformin 150mg Soy Isoflavones cd3-7 prenatals and Omega3's npc (2ww) "No matter how difficult the challenge, when we spread our wings of faith and allow the winds of God's spirit to lift us, no obstacle is too great to overcome." Roy Lessin

03-02-2008, 04:06 PM	#5 (permalink)
Baby4nat Registered User Join Date: Feb 2008 Location: Toronto, ON Posts: 12 Points: 1,112.16 Bank: 0.00 Total Points: 1,112.16 Donate	Thank you, Mommy1. That information helps a lot, to be honest I was looking at a lot more money than that. I have a lifetime maximum of $5000 with my insurance so I will probably save that just in case I need to do IVF one day, and pay for my IUI if the clinic I go to decides to give me one. I noticed that there is a PCOS clinic in Toronto at Womans College, has anyone been there? __________________ ME 27 DH 31 Married since Aug2001 Dx PCOS 1997 Feb2008 1st round of Clomid 50mg CD5-9 Metformin 500mg

03-04-2008, 12:30 AM	#6 (permalink)
BeetleGirl Shattered Dreams! Join Date: Jan 2004 Location: Kelownafornia Posts: 14,349 My Mood: Points: 11,552.57 Bank: 624,443.24 Total Points: 635,995.81 Donate	If your tubes are blocked, OHIP will cover a set amount(3, I think) of IVF cycles. If your tubes are not blocked than procedures are done out of pocket or paid by secondary insurance. There are also numerous tests that OHIP doesn't cover but most are not required until there are extenuating circumstances like numerous failed cycles, or multiple pregnancy losses. Good luck!

03-07-2008, 12:03 PM	#7 (permalink)
Nantucket No 2008 baby for me Join Date: Apr 2001 Location: ottawa, ontario canada Posts: 275 My Mood: Points: 12,732.85 Bank: 487.57 Total Points: 13,220.42 Donate	At our clinic in Ottawa IUI's are covered-the procedure part of it...the sperm washing is $300.00. You will usually encounter an administration fee as well. Ours was $400.00-which is not covered and was not covered my DH"s insurance. For my cycle of injectables we paid : $400.00 admin fee $597.00 puregon (6 doses) $297.00 puregon (3 doses) $297.00 puregon (3 doses) $79.50 HCG trigger shot We were told DH"s insurance (Blue Cross) covered 100% up to $15, 000 but we got a nasty surprise when they only covered $400.00 of the first $600.00 we submitted. __________________ Nancy & Kevin January 21st 1995 Munchkin #1: Hannah Elizabeth Dec.2/00 (100mg Clomid) Munchkin #2: Joshua John Lorne June 16/02 (100mg Clomid/1500mg Metformin-triplet pregnancy-twin miscarriage Nov.2/01@ 8 weeks) Munchkin #3: Isabella Grace-January 27/04 (5mg Femara/1500 mg Metformin) TTC Munchkin #4 with injectibles! February...bust..AF showed ugly head on CD 28 March...have to skip cycle due to finances

03-08-2008, 09:57 PM	#8 (permalink)
Mya Registered User Join Date: Jun 2005 Location: windsor, ontario Posts: 1,516 Points: 46,435.19 Bank: 0.00 Total Points: 46,435.19 Donate	wow it can really add up .. i need to find out what we have from greenshield ... the IUI/sperm wash is $200 .. and trigger $100 ... so i was figuring i would get out of the first cycle @ $300 (as clomid would be covered) ... but now i am wondering if i will get a surprise? __________________ Dx (finally) ~ 2003 TTC ~ 2.5 yrs for #1 - she's finally here To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. ~ Baby girl Jan 11, 2007 TTC ~ 8 months for #2 - EDD Dec 7, 2008 To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. ~ 1 angel baby, Jan 20, 2006 To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

04-04-2008, 01:10 PM	#9 (permalink)
Newfie76 Registered User Join Date: Apr 2008 Posts: 2 Points: 113.67 Bank: 0.00 Total Points: 113.67 Donate	Nantucket- Questions re.IUI & Ottawa Clinic Nantucket- you mentioned that you are going to a clinic in Ottawa, which one???

04-05-2008, 09:36 PM	#10 (permalink)
SanH_2006 Registered User Join Date: Mar 2008 Location: Ontario,Canada Posts: 25 Points: 809.72 Bank: 0.00 Total Points: 809.72 Donate	Nantucket - I'm curious as well, which clinic in Ottawa? I am currently going to the Ottawa Fertility Clinic. It would be sweet to know that part of the procedure would be covered. __________________ Me (34), DH (28) Married 06/03/06 3 furbabies TTC #1 since Dec 2005 Dx in Aug 2006 Referred to RE Nov 2007 Started WW Nov 2007 at RE request 04/13/08 - BFP - no meds due to being on a break! 04/15/08 - b/w - confirmation of BFP! EDD 12/12/08 WW on hold until Jan 2009 To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

04-08-2008, 10:42 AM	#11 (permalink)
Newfie76 Registered User Join Date: Apr 2008 Posts: 2 Points: 113.67 Bank: 0.00 Total Points: 113.67 Donate	I too am with the Ottawa Fertility Clinic and I was told that the sperm washing there was $1000 plus the $400 admin fee so I am quite curious to know if there is another clinic in Ottawa where the sperm washing is only $300. Why on earth would there be such a huge difference in price???

04-10-2008, 10:12 AM	#12 (permalink)
blueoceanflower Registered User Join Date: Oct 2007 Location: Ottawa Posts: 47 My Mood: Points: 1,908.09 Bank: 0.00 Total Points: 1,908.09 Donate	Yes, I would like to know, also. I went to the Ottawa Fertility Center 2 yrs ago and am gearing up to go back, but I need my endo to re-refer me....but if there is another clinic with better pricing, I would love to know! __________________ Michelle Married to DH since Oct 04 Irregular cycles all my life..years with out periods!! PCOS dx Oct 07 Meds I am on: Metformin 2000mg Clomid CD3-7 Effexor 37.5mg Panteloc for acid reflux 1 low dose asprin/day ME 29 DH 39 To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. 2 beautiful stepkids boy (11) Girl (7) 3 fur babies, Cooper (Black Lab) Margot (Lab Mix) and Patches, the cat! To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

04-10-2008, 10:21 PM	#13 (permalink)
slsi Registered User Join Date: Jan 2008 Posts: 24 Points: 352.81 Bank: 0.00 Total Points: 352.81 Donate	Hi ladies - for anyone in the Toronto area you will find that Costco has one of the lowest dispensing fees and fertility drug costs. Another one is Glen Shields Pharmacy in Thornhill which does not charge any dispensing fee on fertility medication. __________________ Me (30) & DH (30) DX: 01/08 TTC #1 HSG all clear Currently taking: Multivitamin with Folic Acid BFP: 04/03/08 (pregnant on our own)!!! EDD: 11/27/08

04-16-2008, 02:32 PM	#14 (permalink)
Catwoman2005 Mitzi Forever Join Date: Nov 2005 Location: Canada Posts: 1,324 Points: 11,001.66 Bank: 59,966.90 Total Points: 70,968.56 Donate	When I had the IUI done it wasn't covered by OHIP and neither was the progesterone suppositories for after... You can claim the expense in your tax return under medical expenses, that's what we did... I even through in the parking fees too... You can claim any medical that you paid that your insurance doesn't pay when you co-pay... So with that too it all adds up... __________________ Me: 33 H: 32 DD: Rachel - Born March 6th, 2007 To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

04-18-2008, 12:13 PM	#15 (permalink)
JenniferEnsoll Pround Mama of Isabelle Join Date: Nov 2003 Location: Oshawa, ON Canada Posts: 68 My Mood: Points: 1,792.55 Bank: 0.00 Total Points: 1,792.55 Donate	You know the funny thing is when I saw Dr. Redmond downtown Toronto she would always give me my trigger shot in her office and wouldn't charge me...I thought this was covered and normal. Now I am seeing a new doc. Dr. Hepburn and his office charged me $83 and I have to give the shot to myself. I was not impressed. sucks!!!!! Jenn __________________ ~~~~~~~~~~~~~~~ Isabelle To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. C-section 11/20/04 Baby Girl Isabelle 11 pds 5 oz 23" long 2 Angels: To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. Oct 2002, Nov 2007 TTC#2 since January 2007 Clomid 25 mg Sept,Oct: BFN November: BFP Miscarraige 5 weeks Letrezole: December 2007 BFN January 2008: BFN February 2008: BFN Moving to adoption at same time January 2008!! To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.

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