Tuesday, March 2, 2010

Goddamn it.

As I write this, please know that I know that we are extremely lucky that our insurance covers anything. That there are so many people who literally go bankrupt trying to have a baby. That there are people who have to stop trying to have a baby because they can no longer afford to do any more treatments.

That said, with insurance comes hoops. And they have us jumping through all of them.

We had to wait a year before we could have any infertility testing done.
We had to do two clomid cycles before we did injectables.
We had to do three IUIs before we did IVF.
We had to have a completely failed fertilization to be approved for ICSI.
We had to have a miscarriage and then additional testing to be approved for PGD.
We had to use all of our frozen embryos before we could do a fresh cycle, even though there was a very, very slim chance of it working (due to the PGD post-thaw).

As we approach the twenty ninth month since beginning trying to have a baby, I get a letter from our insurance company saying that we are approved for the IVF, the ICSI, and the PGD.

Today, I call the pharmacy to order the refill of my stim meds, and they call me back three hours later to tell me that, apparently, my insurance no longer covers any of them.

WHAT THE HELL??????????????

Of course, they called thirty five minutes after my insurance company's offices close, so there is nothing I can do about it until 8am tomorrow morning.

But riddle me this- what is the rationale behind paying for the procedures, but not the meds that will help insure that the procedures will be successful? Do they want me to do the IVF cycle WITHOUT the meds? (Yes, I know that probably they don't, they just don't want to be the ones to pay for them, but FUCK THEM.)

III's away all week and I'm stuck home dealing with this alone while I'm jacked up on Ap.ri.

I hate my life.


Meg. said...

Ugghhhhhh. Health Insurance = THEEEE most frustrating thing ever. In existence.

I'm so sorry for this lastest KAP-OW! It really doesn't make sense.

Get this: My insurance claims it will cover my IVF cycle at 80% (I think. I'll believe it when I see it).....but they don't cover any of the ultrasound monitoring during the cycle. Um........ultrasound monitoring during an IVF cycle is sorta like, um, important. DON'T GET IT.

I'm the one in my relationship who ALWAYS ends up phone wrangling the insurance folks. It's exhausting.

I wish you luck as you continue on with the Apri.

Lara (NoodleGirl) said...

That just seems wrong, especially since you live in MA. I really hope you just got an idiot on the phone at the pharmacy.

I had a similar panic attack in January, when my pharmacy (IV.P C.ares) told me that rather than the flat $25 co-pay per medication I had last year, that it was now 25% per med. Like you, I know that's alot better than most women have, sadly, but with as poor a stimmer as I am and the amount of meds I need to be on, it was going to increase my per-cycle IVF med cost from $125(5 meds) to about $4000.

However, when I called my insurance (Har.vard Pil.grim), they explained that it was 25% up to a MAXIMUM of $50 per med - so $250 total. A TOTALLY different story. So definitely don't put too much stock in the pharmacy and wait til you speak to the insurance company tomorrow. I'm not a big fan of insurance companies, but in this case they might not be the evil ones...GL!