10-18-2023

Cost Explanation 1st Treatment IVF

IVF with PGT Cycle Package: $15,950

The following services, and no others, are included in the package fee:

Treatment plan
Cycle Coordination Fee
In-cycle ovarian stimulation monitoring
Office visits
Ultrasounds
Blood work including estradiol, progesterone, LH, FSH, and hCG processed at MLF and associated venipuncture
Egg Retrieval procedure
Semen analysis and sperm processing
Fertilization and culture of the eggs
Biopsy of embryos
Cryopreservation of embryos (includes 1st year if storage)
PGT packaging and shipping fees
All physician, IVF lab, and facility fees associated with IVF

The following items, costs, and/or services are not included in package fees:

Consultation with the physician
Pre-screening bloodwork and ultrasounds
Carrier screening
Diagnostic procedures/testing (i.e., hysteroscopy, saline tubal perfusion, HSG)
Medications
PGT testing (billed by PGT lab)
Services performed by any third party (i.e., outside labs or services not performed at MLF)
Anesthesia
ICSI
Sperm cryopreservation and storage
Embryo transfer
Any fees associated with donor sperm, donor egg, donor embryo, or gestational carrier
Pregnancy evaluation and monitoring beyond the (1) cycle-end venipuncture and hCG pregnancy test

Medications: Costs of medications, if applicable, are paid directly to the pharmacy by the patient. Costs of medications can fluctuate based on individual needs and coverage. Estimated costs for cycle stimming medications:

Oral medications for OI/IUI cycles – up to $200 per cycle
Injectable medications for OI/IUI cycles – up to $1,500 per cycle
Medications for IVF cycles – $2,000 to $10,000 per cycle

Anesthesia: The cost of anesthesia is paid to United Anesthesia Services. The amount of $500 will be collected from the patient by MLF and forwarded to UAS prior to the procedure.

If the patient does NOT have insurance, the self-pay cost of anesthesia services for the procedure is $500.
If the patient has insurance and pre-pays the $500, UAS will submit it to the insurance company and if the claim is paid, UAS will refund the patient $500 directly after the insurance payment is received.
If the patient has insurance and pre-pays the $500, UAS will submit to the insurance company and if the claim is denied, the patient will only be responsible for the $500 pre-paid for the anesthesia services.
If the patient has insurance and does not pre-pay the $500, UAS will bill the patient for the full amount billed to insurance if the claim is denied.

Cycle Coordination Fee: This package includes a $750 non-refundable cycle coordination fee. The fertility treatment and family-building process is intricate and individualized to each patient or couple. Our cycle coordination fee accounts for items such as orientation classes, medication ordering and procurement, and pre-cycle set-up or in-cycle support visits with your care team.

Cancellation Policy: If the cycle is canceled for any reason, the patient will be subject to cancellation fees for the services provided, including the cycle coordination fee. If the cancellation fees exceed the total package paid there will be no refund issued to the patient. Fees are refunded only if the amount paid exceeds the cancellation fees and the patient requests it. Refund checks will be issued approximately 4-6 weeks after the refund is requested if there are no additional patient or insurance balances due on the patient and/or partner\'s (when applicable) account.

Terms and Conditions: Self-pay prices are for patients without insurance coverage, or those who wish to pay in advance and submit their own billing to the insurance company. Insurance companies generally will not accept a package price for infertility (there is no CPT code for it). Therefore, insurance is billed by individual procedures and the total amount billed will vary depending on exactly what is done during the treatment cycle.

Acknowledgment: I understand that if there are embryos left over, I can choose to freeze and store them at an additional cost.

Furthermore, In signing this document, I and Partner, if applicable, affirm my desire for and consent to participate in the package plan and acknowledge that: (1) I have read and freely and knowingly agree to all of the foregoing, (2) I understand that the cycle coordination fee is non-refundable, (3) I understand the explanation I have received about the package plan and all of my questions have been answered to my satisfaction, and (4) I have received a copy of this document.

*All pricing and quotes are good for 90 days.

Additional Items
Intracytoplasmic Sperm Injection (ICSI) – $2,000.00

Financial Summary
Name Qty Notes Self-Pay Amount
IVF PGT Cycle 1 $15,950.00 + $15,950.00
Intracytoplasmic Sperm Injection (ICSI) 1 $2,000.00 + $2,000.00
Total $17,950.00

10-21-2023

Feeling Blessed

Tim and I are feeling both blessed and our hearts are overwhelmed with this feeling of love. The amount of sharing of this fundraiser is amazing, as well as the number of people messaging me sharing their own personal experiences with infertility and offering up great advice, tips & tricks, financial hacks, etc., and the donations we have received in the past few days have brought tears to our eyes. We appreciate each and every one of you for helping out in the way you are able <3

Love
Jenna & Tim