Sunday, November 29, 2009

And the insurance company said...

I have not been looking forward to writing this post. I am beyond upset, really upset. Here is the deal. I called the insurance company several times in regards to fertility treatments. They let me know I had some coverage but not much, about five thousand dollars for diagnostics and meds. It felt generous enough and I was grateful until I found out that what I needed was IVF. I was told I did not have coverage for that. I didn't know what to do but I made an appointment at the new clinic anyway, just to see what my options were.

Went to see the new fertility docs and they told me 26k for IVF. I went home and cried, Steve doesn't want a baby and he wants a 26 thousand dollar baby even less. BTW that is 26 thousand dollars to try, that is not a guarantee. The following Monday I called the insurance company about the IUI meds I had to send a claim in for and I asked about IVF and if the meds for that would be covered under the fertility benefit. I was told that I needed to access my IVF benefit, I told her I didn't have one and she told me I sure did, 100,000 bucks for IVF. I almost fainted, regrouped, and called Steve's company to be sure, HR told me "you certainly do" this time tears of joy. I felt like the universe was whispering in my ear.

I called that day and got my appointments scheduled, did the paperwork for the insurance company, had all the tests (not fun ones) the blood work, and got all the instructions to start IVF in December.

On the following Monday I got a call from the insurance company letting me know that I was not going to be able to qualify, it seems that my husband has had a vasectomy and that knocks me out of the game. Even if he reverses and especially if I use donor sperm I am not going to be able to access the benefit. What Steve did was voluntary sterilization, that isn't exactly infertility, it is a choice to be infertile. They didn't take into account my age, and they don't cover me if I have a child by anyone but my husband.

It sounds wrong and unfair and it is. Can they do that, cover you only if you have a child by your husband? What if he would have had cancer or we chose not to use his sperm because of genetic concerns?

Well I cracked in half. The hormones, the trying, the thumbs up and thumbs down, dealing with Steve's fears about a "late in life" baby, I just fell apart. It is funny what taking a little bit of hope away does to a person.

I am trying to come to terms with this, trying to see all the reasons it is for the best. It seems to be for someone Else's best not mine. The reasons are all about money not about love.

In a perfect world my life would look a lot different.

I know I will get through it, I am use to getting through things but I would like to not have to and just once have it go my way. Do I sound like a big baby? I am feeling sorry for myself because for a while I felt like I was waiting for this child to arrive, I was doing all the work but in the end there this child would be.

Steve thinks it is for the best, there must be something else I want to do. He doesn't get it, he never has, he never will. He is always pushing me in a direction he wants me to go not one I want to go. I tried so hard to hold us together but I can't anymore. This feels so last straw.

I am an idea girl, always busy doing something, dreaming up a new plan and new adventure always trying to keep it interesting. Sometimes it happens and sometimes it stays in the idea drawer.

I am tired now, out of ideas, out of dreams, running out of hope.

I think this is depression...I will recover, I always do but right now I am in the thick of it and need to spend sometime bandaging up the wounds and putting me back together.

Mid-life blows.

My daughter was strong, she knew how to find the next thing when she lost the last thing. She endured so much and she still stayed beautiful, funny, and interesting. She always made the best of what she had and rarely complained. I don't know how to be like her, I wish she was here to tell me how to take the next step.


turquoise cro said...

O! Gina! That was a roller coaster out of hell, to think YOU don't have a chance then to think YOU do then back to no chance for $$$$$!!! All I can think of is maybe adopt a tiny lil' baby but knowing YOU, we are down to Earth people and want to experience everything we want to firsthand! I'm sorry Gina!

Kathy said...

I read this yesterday and I wish I could think of something comforting or perhaps something that doesn't sound totally stupid to say but I can't.

I'm sorry, Gina. It's not fair, any of it.

But I do believe you will do something, someone as full of ideas, creativity, love and nurturing as you will find something, or it will find you. Something big. Something important.

Love to you.

Anonymous said...

"It sounds wrong and unfair and it is. Can they do that, cover you only if you have a child by your husband? What if he would have had cancer..."

Yes, Gina, it is wrong and so unfair. And, yes, they -- the insurance industry -- can do anything they want. They can come up with a reason to justify a denial of any kind of treatment like they did with my five-year-old daughter when she was dx with cancer. The doctors recommended radiation, but even that was too much for Aetna. I am so sorry, but don't let them take away your hope. Appeal their decision. Call your representatives. Contact the CEO of your insurance company. Never doubt that you have a powerful voice. Good luck.

Anonymous said...

No, no, no!!! I don't know you, but I was right there with my fingers crossed for you. I even prayed. I've heard that when all is bleak a light will find its way. I really hope a light finds you. There has to be another straw.

Anonymous said...

G -- use someone else's sperm. Not a donor, and don't ask for insurance coverage to pay for it. Just ask a friend and say it is Steve's.

Who's going to know? They would know about donor sperm because you would have to pay for it, but they are not going to run a genetic test when you carry in the sperm you say is Steve's.

If Steve doesn't like it, well, then maybe it is the last straw. But I bet you can get it done before you get taken off his medical coverage even if he divorces you. I'm not sure he CAN take you off his medical coverage even if you do divorce.

It's going to be your baby regardless. It doesn't have to be Steve's.

Just something to think about....

iggy k said...

i randomly came upon your blog.
keep your faith in hope and dreams. i think you already know how your resilient daughter would have advised you.
people often forget that the most important part of having a child is having the unconditional love to give that child. that child may already be in this world today.

IVF Land on Surrogacy World said...

Don't know if this helps, nut we live in San Diego and couldn't afford another try with IVF in the US. We went to Guadalajara, Mexico.

The IVF with ICSI and Meds is $6,500. If your insurance will cover the Meds. IVF/ICSI is only $4,400.

We really didn't expect it to work, but we will be 8 weeks pregnant on Tuesday.