It may be possible to discount the cost of Lupron injections without insurance. But there is no greater discount than having an insurance plan cover a portion of your expenses. Even if your current plan does not cover Lupron injections, or any other infertility treatments, there are ways to get insurance to pick up a portion of your tab when getting pregnant.
Insurance plans will cover Lupron costs when it is prescribed for cancer treatments, or endometriosis – often leaving patients to handle a co pay. Patients often must pay the full cost themselves when used with In Vitro Fertilization, as most health plans consider these treatments as not medically necessary. On this page you will find:
- Average costs of injections without insurance
- How the tax code provides co pay assistance and discounts
- How supplemental coverage offsets fertility expenses
Average Cost of Lupron without Insurance
Lupron Depot is a drug used in hormonal therapy to treat Breast, Endometrial, Ovarian, and Prostate cancer. It is also commonly prescribed to couples trying to conceive. They may use Lupron to treat endometriosis, uterine fibroids, or in combination with other prescription fertility drugs as part of an Artificial Reproductive Technique such as IVF.
The average cost of Lupron without insurance is a question that applies mainly to couples using the injections as part of an artificial reproductive technique. Most insurance plans will only cover medically necessary procedures.
For infertility applications, Lupron acts by suppressing ovulation. Before suppression occurs, the hormone will briefly provide stimulation. Suppression is used for frozen embryo transfer, and egg donation cycles. Stimulation may be used at the beginning of an IVF cycle.
For couples using Lupron injections with IVF or IUT, total costs can add up quickly. Very few insurance plans cover the injections for fertility applications, and even fewer cover IVF expenses. The average price ranges from $500 for a 4mg dose to $2,000 for bigger quantities. Your total spending will depend on dosage and number of cycles needed before you conceive.
Also consider that Lupron may not be the only costs you incur. You may be taking other fertility drugs, or taking injections in conjunction with other infertility treatments – all of which you may need to pay out-of-pocket. Your expenses might be quite high if you are considering self-paying IVF. Supplemental health insurance covering IVF may be a consideration if projected success rates are high.
Brand Names and Generics
The medication is sold under prescription with brand names such as Eligard, Lupron, Lupron Depot, Lupron Depot-Gyn, Lupron Depot-Ped. The generic name is Leuprolide and the manufacturer Abbott Labs was granted patent protection in 1989 and 1995 for varying formulations and uses. Most drugs are provided patent rights for eighteen years, meaning the prices paid may dramatically drop when generic versions can be legally sold beginning in 2013.
In the meantime there are other drugs with similar formulations and uses that you might consider. Contrast the benefits and prices of Lupron versus Ganirelx to find the alternative that better suits your budget.
Hidden Expenses of Lupron: Side Effects
Whether you are taking Lupron as part of cancer chemotherapy, or in conjunction with In Vitro Fertilization you may experience certain short and long term side effects. These side effects may add to your costs in subtle ways. Some of the more common symptoms might include headache, hair loss, jaw or joint pain, night sweats, etc.
Those taking Lupron as part of a cancer protocol may already realize the importance of short term disability insurance, as they may experience periods where they are unable to work due to their disease, and/or the side effects of the treatments themselves. Women injecting the medicine in an effort to get pregnant have a bonus reason to buy the coverage.
If the treatments work, she gets paid a benefit when all goes well – she takes a maternity leave to recover from childbirth. She gets important cost containment for when things don’t. Looking ahead to the downstream side effects of Lupron injections is one hidden strategy behind getting insurance to cover infertility treatments.
Lupron Co Pay Assistance and Discounts
The U.S. tax code provides some Lupron co pay assistance. Your unreimbursed medical expenses are tax deductible. Two vehicles provide the assistance: your Flexible Spending Account, and Schedule A. Each vehicle has different features and limits. Careful planning provides the maximum level of co pay assistance, and discounts off the wholesale price if buying your prescription without insurance.
First, understand how your prescription drug plan works. Some have three tiered co pays expressed in fixed dollar amounts for generics, preferred, and name brand drugs. Others request a co pay expressed as a percentage of the wholesale drug costs. When Lupron costs run to the high end of the range, a plan with 50% co pay leaves you with a $1,000 expense – even with insurance coverage.
FSA Interest Free Loan
An FSA works best for predictable ongoing expenses that are expected to be somewhat smaller. It provides first dollar savings, but often the amount you can contribute is limited. An FSA provides the most assistance when your co pays will total less your contribution limits and can be predicted accurately. A hidden advantage is interest free infertility financing courtesy of your employer.
Using Schedule A deductions lifts the limits, but adds an expense floor before any tax savings assistance is realized. Your expenses are not deductible until reaching 10.0% of Adjusted Gross Income. When taking Lupron with IVF the deduction floor is one hidden advantage of IVF refund programs: the multiple cycle discounts help maximize your savings.