Thursday, March 26, 2015

Insurance Sucks

So, going to see the Doc wasn't much fun today.  First off he was an hour and fifteen minutes late.  That is just crazy, who has time to wait that long??  Then once they finally got us back they let us know that our insurance, Aetna, is denying our fertility coverage.  What?  On our very first visit the office called the insurance and told us that we had $3,500 worth of coverage and didn't need to do anything to qualify.  Now they are denying because S doesn't have any infertility issues, she just doesn't have a man, and so she will need to have 12 unsuccessful IUIs before we can get any coverage.  And sure enough that is what I found on their website is the policy for single women and gay couples and that heterosexual couples need to have tried on their own for a year.  So I'm guessing what happened is that the fertility doctor called our insurance, didn't mention we were a same sex couple, and were told we had coverage when if they had been more specific they would have realized that we do not have coverage.  On the one hand this is annoying because we might have done things differently if we knew we had no coverage.  On the other hand I think that our doctor will only end up billing us for the amount they are owed by our insurance which is considerably less than what we would have paid out of pocket.  Annoying as hell to hear either way.  We are going to call and try to fight it but after reading the policy on their website I'm not hopeful.  But we went into this thinking it would be 100% out of pocket so it's not the end of the world.

On to other things, we discussed fertility treatment moving forward.  Due to the insurance issues our doctor is wanting us to get the HSG blockage test done this month and skip this cycle.  I think that is what we are going to do as an April insem would end up being a Christmas baby and we don't want that and we might as well try to fight the insurance company.  What we will do for S's May cycle remaines to be decided.  One option is one last natural IUI.  The other option is doing Femara and injectables, which is what our doctor wants to do.  They have a package they do for $2,000 for out of pocket patients that covers the drugs and monitoring and IUIs if we went for the fertility drug path.  Luckily we have a month to decide.  S's mom was here watching Jude for us so I talked it over with her and she basically thinks that we should do at least one more natural IUI and that we have the money to do it and basically I'm pushing S to do the drugs when they aren't necessary.  I don't know, it's a gamble either way.  We have the money to do another natural cycle and then if that doesn't work to move onto a medicated cycle but money isn't unlimited.  I know lots of people, like you guys have said, do several IUIs un medicated and that two isn't really that many.  It's not that many, but at the same time S is 33, soon to be 34, and we have already spent over $3,000 on sperm alone.  And we just don't have the time and money to be doing more than 3 more cycles without tapping into the end of our savings.  I'm leaning towards one more natural IUI in May, but just one.  Then without a doubt moving onto meds.  But an hour ago I was ready to go full steam ahead with the drugs.  So I guess we will sleep on it and ultimately is it S's body and her decision. 

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