Infertility Support Group

INSURANCE IS THE DEVIL!

I just spent over an hour calling various medical providers, then the insurance, then the medical providers, then the insurance, etc. etc. ad nauseum. This is a fairly normal occurance for anyone struggling with ANY medical issue (much less infertility) but I gotta say today really chapped my hide.

My insurance provider, Primary Health, is notoriously bad for NOT covering anything remotely related to infertility. So much so that they once denied to cover my annual pap with my regular OB/Gyn cause we happened to DISCUSS infertility while I was there. Talk about a pain in the keister. Anyhoo....they are just known for being pains in the *ss about this stuff. As such, they didn't cover the 9 months of Clomid, IUI's and such I did after my miscarriage and I was more than prepared to start battling them both barrells blazing when we went to the RE's office.

Now - my RE is a godsend and she understands the battle. She's has attempted to code as much as they could in such a way to get SOME modicum of coverage. For example, my initial bloodwork, and the HSG, and the Hysteroscopy and the follow-up water sonogram in her office in fact were not coded as infertility treatments but rather as diagnosis and treatment of scar tissue/painful periods/asherman's syndrome. In short, a medical issue - NOT infertility. All of the bills from my RE's office specifically are still pending with Primary, but the bills from the Medical Imaging place that did the HSG were denied - carte blanche denied. I called the Medical Imaging place and asked what codes they used to submit the bills and the primary code they used was for Dismennorhea (painful/abnormal periods).

Well this just irked me to no end!!!!

So I called the insurance company and they confirmed the denial and I spent 20 minutes explaining to this man on the phone all about my surgery, the need for it, and the prior and follow-up appointments that they DID approve and how they were all tied in together. He finally agreed to resubmit the bills for consideration with the notes that this HSG was specifically a diagnostic tool for find scarring from my miscarriage and causing painful periods etc...and NOT necessarily infertility realted yada yada yada....

That's all well and good but here is my beef....

WHY THE HELL AFTER ALL THE HUMILIATION THAT WE HAVE TO GO THROUGH....ALL THE PAIN....ALL THE LESS THAN SEXY MOMENTS IN THE STIRRUPS HAVING HAVE OF CREATION UP TO THEIR ELBOWS IN MY 'JUNK' AND EVEN MORE PEOPLE STANDING AROUND TO WATCH....AND AFTER ALL THE IDIOT STUPID PEOPLE WHO ASK US STUPID QUESTIONS AND MAKE STUPID REMARKS LIKE "JUST RELAX".....AND ALL THE HEARTBREAK AND HUMILIATION OF HAVING THE LADY AT THE DRUGSTORE SAY "MAYBE THIS IS THE ONE" AFTER SHE SEES YOU BUY HPT's MONTH AFTER MONTH AFTER MONTH.....AND AFTER THE HEARTBREAK OF SEEING YOUR FRIENDS AND FAMILY HAVE BABIES....AND AFTER THE ANGER OF SEEING CRACK WHORES AND DRUNKEN FRAT DUDES BECOME PARENTS ON ACCIDENT....AFTER ALL THAT -- WHY ON GOD'S GREEN EARTH DO I HAVE TO HUMILIATE MYSELF TO GIVE MY ENTIRE UTERINE HISTORY TO SOME GUY AT PRIMARY HEALTH JUST TO GET THEM TO MAYBE CONSIDER PAYING FOR SOMETHING THAT THEY SHOULD HAVE COVERED TO BEGIN WITH!!!!!!!!

Now I'm a reasonable woman....all hormone injections aside mind you. I know that insurance companies are in a business and as such need to turn a profit. I can see excluding coverage for things that are truly voluntary like facelifts, tummytucks, and dental veneers. But infertility diagnosis should be covered in full....if not partial treatment options. Afterall, whether we have children or not, our body organs are SCREWED UP! IT's not like we wake up one and CHOOSE to be infertile.....it's not like we decide one day to just undergo invasive vaginal exams by a team the size of the Harlem Globe Trotters cause we think it'll be good fun. NO! Our internal organs are broken somehow. Our tubes are blocked, our uterus scarred, our ovaries cystic, our back is lined with Endo and/or any other sundry list of ailments we can struggle with. All of which typically come with SOME hormonal imbalance or deficiency which then precipitates multiple other physical issues. For example, the diagnosis of PCOS is considered largely a female reproductive issue....and yet, PCOS is systemic and causes not only weird periods, but hormonal imbalance, insulin resistance, weight related struggles, thyroid/hair/skin concerns, heart damage, and more if left untreated. And yet, THAT was the discuss my Ob/Gyn and I had on that fateful pap smear that Primary denied. How is discussing treatment of a systemic hormonal issue INFERTILITY RELATED!?!?!?!

Wake up providers - the men and women who struggle with infertility aren't looking for free medical handouts. We aren't wanting you to cover procedures that aren't required and we'd gladly be willing to jump through any hoops you mandated if it meant you would give us some financial aid in the end. We are reasonable women who just want to be healthy and have a family (which...HEY....would give you more children to cover and earn you more money in premiums). Using infertility with such a broad paint brush to deny treatments and meds and diagnostics at random is tantamount to emotional blackmail. We live in fear ENOUGH that the docs will tell us one day that family is just not in our future....why add to that the fear that WE have to tell ourselves that simply because of money!!!! Again I say, insurance companies are the devil.

To all the Primary Health Insurance companies in the world -- I firmly give you the finger! On behalf of every woman on this board and in the world struggling - KISS IT!!!!!
Posted on 07/24/08, 12:07 pm