Monday, October 18, 2010

Money For Nothing

Today I was hoping to write a happy post (we sure need one around here!) about our new insurance that kicks in on November 1. Before Q took his new job, we asked about the infertility coverage and were told that there is $5000 for medical. They refused to tell us if there was also coverage for drugs until we got a member ID#, but we were hopeful there would be some $ there as well.

The new insurance cards arrived today. I immediately got on the phone to see if there is any drug coverage. I have most of the drugs for next cycle, but still need more Follistim and Menopur. Can't get anywhere without those. Since I'm supposed to start those drugs on November 5, I was hoping I'd have some insurance coverage as of November 1 to help finance it.

As you know if you follow this blog, things are never easy around here. Not only is there no drug coverage, there is also NO INFERTILITY COVERAGE. None at all. Not even for blood work and monitoring ultrasounds. This is according to the representative at the insurance company. I, of course, am forbidden from seeing the actual policy myself until November 1. This really throws a wrench in our plans. Can we even go through with this cycle? We can't be throwing thousands more into this!

All the actual IVF is already paid for out-of-pocket, leaving our pockets pretty empty. It's the monitoring, bloodwork, drugs, and consults that are at issue. Our current COBRA policy has maybe $1000 left for infertility but the drug coverage is exhausted. It does cover the monitoring and blood work without a limit. So I looked into whether we could keep that policy beyond when Q becomes eligible for crappy coverage at his new job. Here's the scoop from COBRA's website:

If you start a new job and enroll in their group health plan, you can still qualify for COBRA if your new plan imposes limits, exclusions, or waiting periods on your coverage.

Well, it imposes an exclusion on coverage for my medical condition, infertility. So does that mean I can/should keep the COBRA? Or would I end up in jail or something? After all, infertility isn't a real health problem (please sense the sarcasm here). It's just an inconvenience. It's just a lifestyle issue. I know I often think so when I'm so depressed I wonder how I can go on. Or when I'm sobbing on the floor because of endometriosis pain, which can be put into remission by having a baby.

That "just relax" thing? Still not working out so well. It was all I could do to remain civil while getting the run-around on the phone with the insurance company today. It doesn't help that I already had a visceral hatred toward this particular insurance company. I used to do medical billing and everyone in the office hated this company because they are always finding ways not to pay claims. And now they're going to be my insurance company. [Bad word.] [Very bad word.]

I have two days to sort this out, because then we are off to exotic Illinois and I really don't want to take this worry on vacation with me. I've got plenty of baggage already, including that beastly endometrioma that makes it feel like I'm being stabbed repeatedly in the ovary. Also, it KILLS when I sit still for more than an hour. And we're driving to Illinois.

This blog noir phase is dragging on and on and on, isn't it? The next post will be #100. I promise it will be a happier one!


Jana said...

so sorry. insurance companies sure don't seem to have their customers best interests at heart do they?
infertility is a disease, not just an inconvenience.
i think keeping cobra for infertility would be legitimate

hope things start looking up
hope u have a good vacation

Rachel said... frustrating. wishing i had some magic loop hole knowledge for you. thinking of you though.

Lizzy said...

ARG, sorry the insurance companies can be SO frustrating! It's so important to us and hard to often get a straight answer - and even worse when you get the wrong answer!

Suzy said...

oh it never rains it pours, right? Sometimes I feel that we are being tested, by some greater force, to see how far we can be pushed before we snap.
I'm sorry you got even more shitty news. I sincerely and completely hope you get some good news soon, thinking of you xxxx

Nick and Kristi said...

Gosh Im so sorry you are having to battle this:( After 11 long weeks of battleing my LTD insuance I finally won so dont give up....I def think you should look into Cobra covering the fertility tx def doesnt hurt to ask...I guess all I can say is I feel ya and hope soon everything will work out:) Take Care

daega99 said...

Oh my - insurance companies piss me off! I hope it gets all sorted out before November starts!


Lori said...

I know I'm a week late on this one, but man....this post just makes me so aggravated for you!!!! It reminds me of our Tricare won't cover fertility drugs...UNLESS you don't use them for assisted reproductive technology. If you want to shoot yourself up with follistim and menopur, they'll cover all you want--PROVIDED you DON'T do an IUI or IVF.


I just can't believe your policy doesn't have coverage AFTER you were told you'd have some. Like I said, I know I'm behind, but I sure do hope something fabulous was resolved!!!

RELH said...

Ohh geesh!

ICLW #26

Ashley said...

That sounds like a nightmare and you can't exactly go running to the new employer and ask them to fix this. I hope this works out for you somehow.

Kim Wombles said...

Visiting from ICLW. I'm sorry for your losses and your difficulties in getting your treatments covered.

Hope your vacation goes well. :-)