Tuesday, May 29, 2012

I really hate insurance companies - this is insane

So while I am grateful for the insurance coverage of the fertility treatments (Illinois is one of only a handful of states that mandates insurance to cover the treatments - not necessarily at 100% or anything, but somewhat), the hoops we often have to jump through are quite time consuming and annoying.

When we went through the cycle last summer, we had insurance coverage through both my insurance and Aaron's insurance. So what one didn't cover, the other one did. Yes, there were the whole hoops to jump through, fill out this form, blah blah blah. But this is getting somewhat stupid with this different insurance that started in September, the amount of hoops I have had to jump through since we decided to start the second round has gotten ridiculous.

Things I have had to do with this company above and beyond other steps I have done with the insurance companies:

1. I had to do an intake phone interview where I relived all the steps we have done so far in this journey. It was over 20 minutes of going through everything (stupid part: they had my damn medical file from the specialist before this interview).

2. Additional copies of medical protocols from the doctors to be sent to the insurance company,

3. Additional blood tests looking for additional issues that could have contributed to the infertility above and beyond all the lengthy and in depth tests that the RE had us do when we were getting started with IVF.

4. Now they want other tests to be done as soon as I get my next period before we can get full approval of the IVF process.

5. Also once they got the treatment protocol from the doctor to approve the cycle, the insurance company does not like the particular drug regimen the doctor has recommended for us. They want a particular drug and are standing their ground on it.

6. I cannot use the local specialty pharmacy that we used last year to get the medicine (because of course we cannot just call in a script to the local regular pharmacy to get them). I have to use their pharmacy who will have to ship us the meds and I won't have them right away when we will need them for this treatment plan.

What does all this mean???

Major annoyance.

Since we are waiting for the next cycle, if it doesn't come on time that pushes us back further than we have waited so long to this point.

Since they want additional blood tests before they will approve it, the meds cannot be shipped the same day so I would have to pay for the medicine out of pocket to get it started but may not be able to be reimbursed by the insurance company.


We can do the blood tests, get approved, but not start IVF until the next time I get my period (which will be hard to judge since I don't ovulate on any kind of regular basis at all).

After talking to the nurses and doctor at great length at the end of last week, we decided to go ahead and pay out of pocket for the few days of meds so we can go ahead and get started as soon as possible. It sucks and I hate it all, but waiting is not an option that we are comfortable with after waiting all this time.

Then, today I get another call from the doctor's office that this is yet another problem with the insurance and I have to call them tomorrow to see what the next obstacle this insurance company is placing in front of us.

It feels like this is never going to end and we are never going to get this next cycle started.

I am so frustrated and people just don't understand why it bothers us to wait any longer.

It's frustrating because we have waited so long, invested so much in this process, put many areas of our life on hold to focus on this journey and the idea of putting it on hold AGAIN is similar to a sharp knife to the gut. We put it all on hold in the fall due to other issues and doing it again is not something we are ready to do at this time.

Just give us the green light and let us get started so we don't ever have to do this again. This has to work this time, it just has to work this time.

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