Frustrated with insurance :(

[melnzai]

I hate my insurance, hate it, hate it, hate it. It doesn't cover a darn thing related to infertility, not one. No bloodwork, no u/s, no doctor visits, nada. However, since we started seeing my RE, the insurance has negotiated savings for us. So, instead of paying 275 for and u/s and visit, we were only paying 150. This was huge for us. Well, I just had some EOBs come in without the negotiated savings. What I was told by the insurance company is that when my RE or the lab filed it electronically, the computer provided the discount. Nothing they can do about it (HA!), they can't go in and change it to make me pay full price. However, when it is a paper filing, they will not pay or negotiate a savings because it is infertility and not covered. :evil: I am so pissed. So, I have to ask my RE to file all my insurance claims electronically and pray that they will negotiate the cost for me.

If we are not successful this month, we are going to have to take a long time off to pay off the close to $5000 we will owe after this cycle. :( I plan to ask my RE about femara to try while we are taking a break. I don't think I need u/s with femara, so maybe that would do the trick for us. I was feeling really positive this cycle, but I just feel the timing of everything is off for us. I need to find my optimism again. :(

[mommaphoebs]

I'm so sorry Melanie. It is so wrong that people have to pay to have medical care. At this point, we don't have those worries, until we go further with possibly IUI etc. I don't know how Americans do it. In Canada, most health care is automatically covered, doctor visits, ultrasounds, blood tests etc, but prescriptions and things that are infertility related, like IUIs are not. I hope this cycle works for you and your only worry and expense is when you'll need to buy maternity clothes! Try to keep thinking of your pot-of-gold at the end of the rainbow!

[melnzai]

Thanks so much! IMO, the US is in a huge health care crisis, but no one seems willing to step up to the plate and see if there is a way to fix it. The poor either have government insurance or are uninsured. Many middle income earners, like me, end up declaring bankruptcy for medical bills or are uninsured because insurance premiums are so high. It is ridiculous. All the loopholes the insurance companies have are frustrating also. Because I had to schedule my son's wellness visit on 12/31 instead after January 1, the insurance refused to cover it because it was maxed out our wellness maximum for a 12-month period. It is awful. Plus, insurance companies here will pay for viagra, but not for u/s, doctor visits, or blood work for inferility. Discrimination? Yep, in the grand ole US, we still have white, yuppy men calling the shots and discriminating against others. Anyway, I will get off my soapbox. Thanks for your kind words. I just needed to vent.

[cat morgan]

I'm so sorry about your insurance! Who's your provider? Knock on wood, DH has been lucky w/ his plan so far. We're with United Healthcare, and they have several options to choose from (at least at Dh's company). So far, anytime we've needed anything we don't have coverage for, Dh just switches plans. Yes, it increases our premiums, but that's better than paying out of pocket ourselves! I may be going the injectable route myself, soon, so I'll have to find out if we have coverage for that. I've got an appt w/ a new ob Friday...and may be seeing an RE this month. I've taken 2 rounds of clomid, and am pretty sure I didn't even O. So I went from O'ing late to not O'ing at all !?! So I'm interested to see what they're going to say...maybe increasing clomid to 150...maybe Femara...maybe Gonal F...UGGH!!! And Dh is out of town the week I should O this month, so that pushes me back a cycle. Why does having another baby have to be so hard for all of us?
Melanie, I really hope you get your BFP this cycle...STICKY BFP vibes your way...