I keep hoping that I’ll be able to avoid IVF and the accompanying headache of dealing with my insurance by, you know… getting pregnant. I seriously hate this company. Just over the weekend, I got a bill from an appointment I had well over a year ago. They claim that they sent the check to me, and not the doctor’s office. Which is horseshit. And another story.
If these winners screw up perfectly run of the mill visits, imagine the wonderland of stupidity that awaits me now!
When Dr. Petrel suggested we go straight to IVF, I was cautiously optimistic. When I spoke with someone at the Infertility Hotline, they said that they required 6 cycles of something before they would approve IVF. Since I took Clomid for 6 cycles, I should be all set.
[But before I go on, I would like to pause for a moment to share some interesting information shared with me by Dr. Petrel. In the state where I live, most insurance companies (all the biggies) have moved away from a set requirement before IVF. Why? Because they crunched the numbers and found that most patients ended up at IVF anyway. Pragmatically speaking, it didn’t make financial sense to pay for treatments that have a lower probability of working BEFORE approving the one that has a higher probability of working. Logical, yes? Alas, my employer contracts with an insurance company out of TEXAS. And Texas may be many things, but rational about women’s health issues is not one of them.]
Anyway, as I was saying before I interrupted myself… I thought it would be a good idea to call and make sure I understood exactly what Incompetence meant by 6 attempted cycles with Clomid. Does it have to be done with IUI? Does it have to be done with accompanied monitoring? What kind of monitoring? Was I required to jump up and down three times before every cycle began? Rub my abdomen with juniper berries on every full moon?
So I called last week. I was on the phone for 45 minutes before someone told me that a specialist would call me back in 4 business days. This is the exact same crap I heard last time. 3-5 business days? How is this a HOTLINE, if I can’t talk to anyone for 3-5 business days? And did I REALLY have to wait on the phone for 45 minutes, only to learn I have to wait another 4 days? REALLY?!
Because the universe likes to kick me in the metaphorical balls, I get my call back from the Infertility Hotline the same day as I get by period. Let’s add frustration and elevated blood pressure to my pile of weepiness, desperation, and disappointment, shall we?
The good news is yes, my cycles with Clomid do count. This makes me feel a little bit better about the Great Clomid Experiment. In its own way, it has served its purpose. I just need to get something from my GYN saying that he did prescribe it. And provide some kind of “proof” that I took the medication and monitored it (OPKs count.)
Erm… proof? I started to panic, thinking I needed to have saved all my spent OPKs. I’m a pack rat, sure. But I have to draw the line at hoarding discarded OPKs. I mean, I PEED on those things.
In a delightful move back to civility, my word for it is proof enough. So I pull up my apps, report the dates of positive OPKs and scheduled sexy time. For the last 6 months. As I’m sure you can imagine, this took some time– 30 minutes to be exact.
The woman I spoke with was actually nice. Granted I waited 4 days to speak with her, so I sure hope she’d be nice. After we went through all the dates, she said she would start processing it so that I could be approved for IVF (pending some FSH test, I think? I dunno, whatever I’m getting done this week.) I hung up from that conversation not actively annoyed.
But just when you’d think that this could end on a happy note, I’m now embroiled in another bit of drama with my insurance company. Some of you may recall that I’ve been seeing a counselor to help me cope with “My Life”, aka the never-ending cyclone of very bad things I’ve experienced in the last year. Dr. Macaw has been so helpful. But because of a clerical error at Incompetence, they’ve rejected her claims so I’ve had to stop seeing her. I cannot fix said clerical error, Dr. Macaw has to. And they are not returning her calls, or sending her the forms she needs. Why?
Because they are assholes.
I’ve been okay with not seeing Macaw for now, but this shit is going to get cray once IVF becomes more real. I’ve already had one solid freakout after a Google session. (Sorry, but Egg Retrieval does not sound like a good time.) As one lovely friend pointed out, this might have to do with my total aversion to hospitals and medical procedures, thanks to my mom’s health situation. I NEED to talk about this with a licensed professional, but I can’t do it if my insurance company keeps denying claims because their records are out of date (and they seem to refuse to update them.)
Suggestions on how to strong arm your insurance company into delivering the services that you pay for are welcome.