April 2010 Weddings
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My health insurance sucks!

I got a bill yesterday in the mail from my OB's office for the FULL amount of my appointment including the ultrasound. It seems that my insurance will pay 0% of what they consider an infertility treatment. I call our HR director to see if she could help & explained that there was no "treatment" just an ultrasound of my reproductive system to make sure there were no blockages & then a presciption for Clomid. She said that she'd see what she could do but it wasn't promising. Needless to say I cried & then cried some more. At this rate Nelson & I won't be able to afford to even get pregnant.

It really pisses me off b/c (and please take this with a grain of salt - I don't mean to offend anyone by any means) I was careful & waited to try to get pregnant after I was married. It seems so unfair that b/c I didn't find the right man until I was in my early 30s & didn't get married until my mid 30's that I should be punished for being responsible. I know that I've said from the begining that this was in God's hands but I didn't expect it to be in the insurance company's hands.

What makes this even worse is that my brother & his wife are unable to have kids so my parents may never have any grandchildren of their own.

I just want to go home so I can hide & cry. I can't really talk about it at work b/c I'm the only female in the office and I don't want anyone to know that I'm trying to get pregnant.

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Re: My health insurance sucks!

  • Unfortunately, a majority of Americans are in the same boat. It's common to not have insurance coverage for infertility diagnosis and treatment. Believe me, I know what a load of BS that is. Twelve states (including NY, NJ and MA) have mandates that some fertility coverage has to be provided, but even that has loopholes.  Meanwhile, if you got pregnant at 16 both your maternity costs and your baby would be completely covered. Don't even get me started on the ridiculousness of this.

    Hang in there, I'm sure your doctor's office can work out a payment plan for you and Clomid itself is pretty cheap.

    Also, you may want to reach out to your or DH's employer (whoever provides your insurance). It's really up to each individual employer whether they want to provide the coverage or not, so a letter to HR wouldn't hurt. It may not help you short term, but if they hear complaints about this from enough employees they may consider adding coverage.

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  • that is absolutely CRAZY! IS there anyone you can call at the insurance company? (even though I know that is the last thing you probably want to do). on what basis did they say it was "infertility treatment"??? That doesn't make sense AT ALL. Can you appeal it somehow?
  • I'm so sorry that you are dealing with this. Insurance coverage really needs to grow with the times. More and more women need it and there is so much available to help but without the coverage it just can't happen!
  • The insurance industry in this nation sucks!!  I really hope your HR person can talk some sense into them.  I'm praying that you get your BFP soon!
    ~Melissa~
    Shmel's Blog
  • That really sucks. Jeff's insurance is really good (I know how lucky I am for that), and they cover all testing, just no procedures. But, with my endo, all the surgical procedures are covered since it can be looked at as a procedure to help with my endo pain. I know if, or more likely when, we have to try the AI (Artificial Insemination), it will not be covered, but it is much cheaper than the IVF. 

    I just can't believe that people that take absolutely no care of themselves and their health are covered completely, but for me to have a baby takes thousands of dollars out-of-pocket!

    *~~Danie~~*
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  • I'm sorry that this is so frustrating. It is so tough that $$ has to be such a deciding factor when you have such an emotional investment.

     

    I hope that they can get something worked out for you.

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  • George-Anne I'm so sorry to hear that you got stuck with a huge bill for this. Like someone else said, usually the doctor will work with you and at least hopefully you can pay in payments.

    It makes me really sad that you're associating this insurance crap with not being able to have a baby (and give your parents grandchildren). You WILL make it work - even if it means having to pay more out of pocket than you expected. And I am also confident that you will get your BFP soon, and then (I assume) insurance coverage will be better.

    I know the sinking feeling of an outrageous bill that you didn't expect, and how unfair it is that those doing the right thing often get screwed. Take the time you need to be angry about this, but know that your insurance company is NOT in charge of your fertility!

  • This makes me mad and sad.  I am sorry that you are having to deal with this.  I can totally understand your hurt at feeling punished for being responsible, it just all really stinks.  I have my fingers crossed for you that you get your bfp sooner than later!  Hugs!

  • I'm so sorry this is becoming such a headache! I hope they figure out a way to code it differently so that some of it will get covered. I cannot stand how insurance works!! Our insurance though my H's work recently changed and now we can't go to a specific hospital (the good one in town) or any of it's affiliates. We can only be admitted and treated by the county hospital or our small town crappy hospital. So I'm with you on being disappointed with my insurance.
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  • Sending you a huge hug!!!  I think it's worth talking to your doctor, he/she may know how to get around some of this crazy insurance crap!  You deserve everything that the medical field has to offer, and never think otherwise!  Good luck, I really hope your doctor can help you manage this stuff!
    ~Margaret (and Nick)~
    Post-Wedding Life Blog!
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  • Oh this is such a terrible topic to bring up because it makes me red in the face with anger. Again, to not offend anyone, but most health insurance companies will cover the full cost of an abortion because it's less expensive to get rid of a baby then it is to have one...it's so backwards on so many levels and it's disgusting. I will be saying so many prayers for you that your insurance company sees that this is worth it and be willing to cover at least some part of the expenses of trying to conceive. If not, I will be keeping you and your husband in my prayers that you will find the means to fulfill this desire to have a baby. Big hugs!
    love, jenifriend

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  • imageRachieK10:

    George-Anne I'm so sorry to hear that you got stuck with a huge bill for this. Like someone else said, usually the doctor will work with you and at least hopefully you can pay in payments.

    It makes me really sad that you're associating this insurance crap with not being able to have a baby (and give your parents grandchildren). You WILL make it work - even if it means having to pay more out of pocket than you expected. And I am also confident that you will get your BFP soon, and then (I assume) insurance coverage will be better.

    I know the sinking feeling of an outrageous bill that you didn't expect, and how unfair it is that those doing the right thing often get screwed. Take the time you need to be angry about this, but know that your insurance company is NOT in charge of your fertility!

    what she said! 

    love, jenifriend

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  • And before I put anyone in a frenzy with my statement, I want to make sure I state that I'm pro-choice...I just don't agree with the fact that the insurance companies are so willing to enable an act of abortion but not so much when it comes to creating life. It's very sad and creates circumstances just like this where people feel as if they can't afford to even have the choice to try and have a baby. My heart is aching for you!

    Something else to think about...babies are expensive...somewhere down the line you will be looking at your child saying, "How did you ever become so expensive to raise, child?!" Parents, on average, are broke while they raise their children. Here's the kicker, though: they find a way. Because they have to in order to support and care for their children. Like them, YOU will find a way to care for your children, whether they are conceived or not (yet), George-Anne! We all believe in you!! 

    love, jenifriend

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  • Thanks everyone. I'm not sure what my next step is or will be other than to talk this over with Nelson. Right now I'm just overwhelmed & confused.

    I appreciated all of your support & prayers. It means more than you know.

    ::HUGS:: to you all.

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  • wow that is ultra shitty - i know close to NOTHING about this - but would a flexible spending account help?  i know a friend of mine started one of these with our employer and it helped pay for some of the costs associated with her fertility treatments (as teachers we sure as all hell aren't millionaires).  good luck and dn'ot worry it will happen!  positive thoughts!!! 

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  • I hear ya, and I get why you are frustrated.  It IS really unfair.  For now, allow yourself to panic and be angry, but I hope that after you and Nelson, and the doctor, discuss it, you can come up with a solution.  It's really unfair when the greed of insurance companies cause us to make decisions in our lives that we don't want to make.  And I'm not offended by what you said, I know plenty of young, pregnant girls in the high school I work in, getting financial assistance.  And then I see my friends in their 30's and 40's paying tons of money, and going through hell, to try to have a baby or adopt.  How is that fair?  I'm in total agreement. (and of course I don't mean to offend anyone either!!!)

    I hope you are able to work something out, sweetie.  I'm glad you vented to us...

  • George-Anne I'm so sorry to hear they're being so difficult. I hope they're able to resolve this bill and you guys get your BFP soon!! ::hugs::
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  • Aww shucks, I'm sorry.  :(  HUGS!!!

    I hope everything works out for you and that something turns out in your favor.  Sorry for your frustration.  Good luck, with EVERYTHING!!!

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