Today has sucked. That is the only way I can describe it. It started off well enough. Wake up, make breakfast, go to the gym, come home and head to work. On the way to work I notice I have a voicemail from the RE's office. I call them back, and I hear the only words that could hurt as much as "You are not pregnant." I heard "Your insurance rejected the pre-authorization for your IVF cycle." Cue meltdown.
I have spent the roughly eight hours since that conversation alternating between sobbing uncontrollably, wanting to yell at literally anyone (but preferably any and all insurance reps), and intense conversations with my HR lady at work.
Let me explain the back story here. When I first went to my RE's office in October 2009 they ran my insurance to see if I had any fertility coverage. I was told I did (something I was frankly shocked by). According to the billing lady I had 6 IUIs and 3 IVFs per live birth covered at 100% with a lifetime max of $100,000. I was relieved and grateful because this meant we wouldn't have to worry about how we would come up with the thousands of dollars it takes to do even an IUI cycle, let alone IVF. It didnt really cross my mind again until we got our insurance booklets for 2010, but I checked and nothing had changed, still covered.
So that phone call today was quite the blow. I thought the only things I would have to worry about for our March IVF were my weight and time off work. Now I have this to deal with.
The good news is I am starting to think this is solvable. After talking with my HR lady A LOT today we found the spot in this year's statement of benefits booklet that explains the infertility coverage. And it is worded exactly as I thought it would be: 6 IUIs, 3 IVFs. There has to be a mistake somewhere along the line. I am not sure where, but I have to believe that this is just a horrible mistake that can be fixed easily and in time for our March start date.
But there is this little part of me that is saying "you have had it far too easy to this point, it is time for you to suffer." That part of me thinks no matter how awesome my HR lady is and how hard she will work to get this straightened out, and how many phone calls I make, it won't work. This is the end. Because we can't pay for IVF out of pocket. Neither of us can justify taking out a $20,000+ loan to pay for one IVF cycle, because then we wouldn't be able to give any possible children the life they deserve. My husband still isn't OK with the idea of adoption. I know eventually he would go along with adoption, but he would never be as 100% on board with it as me, so I won't try to force him to be OK with adoption.
If this insurance doesn't come through we are living our life childless. I think that is the scariest sentence I have ever had to type/say/think. Excuse me while I go cry some more and read my insurance booklet once more to make sure I am not missing anything.
I'm so sorry to hear about this road block! I hope it turns out to be a mistake! I know our insurance had similar verbage and we were also denied for our first IVF but after disputing it, we were swiftly approved. It turned out to be that they said we had to try IUI first but our doctor had told us that (for our situation) would be pointless and we should go straight to IVF- but the insurance didn't want to pay for that until we tried something cheaper first. But our doctor told them his recommendations and then we were approved. So I know that is different from your situation but just wanted to let you know that hopefully there is something your doctor can do. Again, hopefully just a mistake! Did you ask your insurance WHY they denied it? Good luck!
ReplyDeleteOMG how awful! I hope you get this figured out. Now I feel like I should call our insurance just to make sure we really are covered @ 80% before I start my BCPs for IVF next month. Like we don't have enough stress in our lives, right?!
ReplyDeleteI really hope it all works out for you. I understand completely how scary it is to think about 100% OOP for IVF. Big ((hugs))
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