*warning: languagepart 1while i was checking out @ my annual, the nurse asked me if
i'd like her to call my insurance company & ask what my "infertility care" benefits were. knowing they probably weren't great , i decided why not,
i'll spare myself the frustration. right?
wrong.
i received a letter in the mail from my
dr's office about a week later. here's a summary:
"...we were told you have
limited benefits and are not fully covered for infertility treatment....Excluded services will include
IUI's,
sperm wash and
HCG injections."
it gets better..."These charges (see above) must be paid at the time of your visit and will be discounted 20%. To assist you in planning, we have enclosed a fee schedule."
forget frustration! i was (am) livid! so, what better thing to do when you are livid and your eyes are popping out of your head but call the insurance company? oh what a lucky day it was for the rep on the other end of the line. this was our conversation:
me: i just got a
disturbing letter from my
OBGYN's office. i have a couple of questions regarding my "infertility care."
rep:
ok. what can i help you with?
me: all of it.
rep:
i'm sorry?
me: i want a full explanation as to why you don't cover anything other than the diagnosis of infertility. please explain my coverage, or lack thereof, for fertility drugs and treatment.
rep: well, we do cover the drugs....as long as they're not used directly prior to and to aid an
IUI or
IVF.
me: what? you'll cover them as long as i don't use them for
IUI or
IVF?
rep: yes.
me: and why don't you cover
IUI or
IVF?
wait for it...rep: because both are considered
experimental.
me: you're shitting me?
rep:
i'm sorry. what was that?
me: you've got to be SHITTING me!?! (((
EXPERIFUCKINGMENTAL?))) in 1978, the first successful
IVF baby was born but
IVF history goes back further and even further is when the first
IUI was performed (
see here). so you tell me? how the hell can
IVF and
IUI still be classified as "experimental"?
rep: i can't answer that ma'am. but our coverage changes annually; feel free to call back to see if it's been updated.
i'm truly sorry ma'am.
me: yea, me too.
********************************
part 2i've been slowly compiling research on infertility. i've read that
1 in 6 couples are infertile.
ONE in SIX. that means there is someone in
your life who is infertile. that means this is not an uncommon diagonsis. that means this isn't some obsure condition. what that means is that infertility treatment needs to be mandated and insurance companies need to be forced to offer coverage just like any other medical condition!
shortly after i had that conversation with my insurance company, i was reading
Infertility Diaries, a blog on
Redbook's website, written by Jen from
Maybe If You Just Relax. Jen did a post about the lack of coverage for infertility treatments. Jen is very lucky in that she does have some coverage. Here's an
excerpt that
thru me for a little loop-
de-loop & gave me whiplash:
So imagine my surprise when I get my explanation of benefits...
Total Charges for IVF #1: $14,650
Total Paid by Insurance: $4,750
Total Patient Responsibility: $350are you reading that correctly? do you see that? do you see that for ME, an infertile without coverage, i would have to pay upwards of 15G's for ONE cycle of
IVF. but those
motherf'ers...i mean, insurance companies, only have to pay $5K?
oh, yea.
i'm bending over alright. assholes.
but being the person that i am, i look to the brighter side of things. i like to think of life as a glass half full...which is why
i'm ever-so-thankful that my
OBGYN has offered to give me a 20% discount.
@@
to be continued....yes, there's more.
