One of 12.5%
Nov. 9th, 2007 09:43 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
judecorpAccording to Stirrup Queens, 12.5% of the population is currently experiencing infertility and recurrent pregnancy loss. That's 7.3 million men and women in this country. I am one of many.
Before I got started on this crazy babymaking journey, I was anovulatory and without a monthly cycle for over three straight years. I had tried to get a PCOS diagnosis from several doctors who did not take me seriously, and one who sent me for an ultrasound and stated that I could not have PCOS because I had no cysts on my ovaries. None of them ever did a hormone panel.
After I started taking Metformin and started having cycles, I wanted to talk to a specialist about getting pregnant. My PCOS stuff was all covered by insurance. My referral to a Reproductive Endocrinologist was covered. I live in a mandatory infertility coverage state and thought I would be set no matter what I had to do to get pregnant. At my first RE appointment, I found out that this coverage did not apply to me because even though I have a medical diagnosis that causes infertility, I did not meet the insurance company's criteria in full because I have a female partner and therefore we obviously hadn't been trying for a year to get pregnant. The insurance company wanted me to pay for 12 cycles of insemination out of my own pocket, and if those didn't work, they would consider that a year of trying, deem me infertile, and start kicking out money.
Furious, I called the insurance company and spoke to many sympathetic people who unfortunately don't make any decisions about coverage. I was ready to go ahead, get denied, and appeal. I went to my RE and told him exactly that. "Let's do it," I said, "Put it through insurance and let them deny me, and I will fight them." But, "Oh, by the way, I was previously married to a man for a couple of years and we did not get pregnant, does that count?" He told me he would put it in my file but not to hold my breath. All of a sudden, I was infertile in the eyes of the insurance company, and I was fully covered.
I took Clomid 3 times and Follistim 3 times - all covered save copays. I had 8 IUIs - all covered save copays. I had an HSG - covered; blood work more times than I can count - covered; ridiculous amounts of follicle scan ultrasounds - covered in full. My only real expense was donor sperm, to the tune of about $300 a vial. We bought 9 vials total from two different banks, and with sperm storage, shipping, and donor profiles, we probably put out close to $5000 in sperm-related expenses. But that's a drop in the bucket compared to a lot of other people in my situation. All because I used to be married to a dude and we had some unprotected sex.
I got pregnant on my third and final cycle of Follistim and IUI. If it hadn't worked, I would have immediately been approved for three rounds of IVF on the insurance company's dime. Because I have a medical condition, and had appropriate medical insurance.
And for the money we shell out in this company for insurance coverage, EVERYBODY should be so fortunate.
Before I got started on this crazy babymaking journey, I was anovulatory and without a monthly cycle for over three straight years. I had tried to get a PCOS diagnosis from several doctors who did not take me seriously, and one who sent me for an ultrasound and stated that I could not have PCOS because I had no cysts on my ovaries. None of them ever did a hormone panel.
After I started taking Metformin and started having cycles, I wanted to talk to a specialist about getting pregnant. My PCOS stuff was all covered by insurance. My referral to a Reproductive Endocrinologist was covered. I live in a mandatory infertility coverage state and thought I would be set no matter what I had to do to get pregnant. At my first RE appointment, I found out that this coverage did not apply to me because even though I have a medical diagnosis that causes infertility, I did not meet the insurance company's criteria in full because I have a female partner and therefore we obviously hadn't been trying for a year to get pregnant. The insurance company wanted me to pay for 12 cycles of insemination out of my own pocket, and if those didn't work, they would consider that a year of trying, deem me infertile, and start kicking out money.
Furious, I called the insurance company and spoke to many sympathetic people who unfortunately don't make any decisions about coverage. I was ready to go ahead, get denied, and appeal. I went to my RE and told him exactly that. "Let's do it," I said, "Put it through insurance and let them deny me, and I will fight them." But, "Oh, by the way, I was previously married to a man for a couple of years and we did not get pregnant, does that count?" He told me he would put it in my file but not to hold my breath. All of a sudden, I was infertile in the eyes of the insurance company, and I was fully covered.
I took Clomid 3 times and Follistim 3 times - all covered save copays. I had 8 IUIs - all covered save copays. I had an HSG - covered; blood work more times than I can count - covered; ridiculous amounts of follicle scan ultrasounds - covered in full. My only real expense was donor sperm, to the tune of about $300 a vial. We bought 9 vials total from two different banks, and with sperm storage, shipping, and donor profiles, we probably put out close to $5000 in sperm-related expenses. But that's a drop in the bucket compared to a lot of other people in my situation. All because I used to be married to a dude and we had some unprotected sex.
I got pregnant on my third and final cycle of Follistim and IUI. If it hadn't worked, I would have immediately been approved for three rounds of IVF on the insurance company's dime. Because I have a medical condition, and had appropriate medical insurance.
And for the money we shell out in this company for insurance coverage, EVERYBODY should be so fortunate.
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no subject
Date: 2007-11-10 03:56 am (UTC)Those were covered at 90%. Oh, and all of our meds were covered too.
We are sooooooooooooooooooooo lucky. Otherwise, we'd be up to our eyeballs in debt.
no subject
Date: 2007-11-10 04:54 am (UTC)no subject
Date: 2007-11-10 09:23 pm (UTC)I'm glad you had good insurance.