Ha ha ok funny story. Remember how I wrote yesterday about fertility coverage and how all y'all were commenting and telling me how lucky I am, how great it is to have fertility coverage?
Hold on, let me just put down this crossbow here for a second. (Don't want to accidentally knock over the kerosene.)
Ok, we're good now. So, all that I told you? Well, there seems to be one little nurse at the insurance company who insists on being a little bitch and ruining our lives.
Chris talked to the insurance company today. A week and a half ago, somebody there told him he may or may not be required to enroll in this "program." I'm not sure what exactly the "program" is for, but I think it has something to do with "helping" people achieve their dreams of a child. In the cheapest way possible. At the utmost emotional expense of the parents-to-be. Also, I think they kill puppies.
This nurse from the "program" called him last week and hung up without calling back. So she finally gets back to him today.
Puppy-killer: We have to ask some questions before we can enroll you in fertility benefits.
Chris: Um, well we have already been getting benefits for 5 months now..
Puppy-killer: Silence, you. So how long have you guys been trying?
Chris: Four years.
Puppy-killer: Oh. And did you try-
PK: And have you tried-
Chris: Did it.
PK: How about-
Chris: Didn't work.
PK: Uh huh... So have you tried Clomid?
Chris: Yep, The first time was three cycles, then 6. Then when we went to CRM we did another 4.
PK: I see. Well statistically if Clomid didn't work in 4 cycles, then you need to move on.
Chris: Ok, well let me just get back in my time-machine here...bitch.
PK: And what else have you tried?
Chris: We did four cycles of IUI.
PK: WHAT? What do you mean? That was done at a clinic that is not accepted.
Chris: Well, the claims went through just fine.
PK: Well, those claims never should have been paid.
Chris: Well, they were...
PK: We only have two clinics in Minnesota that are approved Centers for Excellence, and your clinic isn't one of them.
Chris: We are starting an IVF cycle in a week. So what are we supposed to do?
PK: Well I don't know. But if you go there, we won't be paying for any of it. If you want coverage, you can go to one of these other clinics. Your clinic was obviously not billing the procedures correctly because we never would have approved those IUIs. And if you have a puppy, I need to see it. We need to take a look at it.
So. Chris then called the Customer Claims department, because Puppy Killer didn't have access to the claims (wonder why). Guess what? They told us our clinic was in-network, our doctor was in-network, ART is out of network, but still approved for reimbursement. So then he called his HR department and explained the situation, hoping the poor lady understood what he was asking. She wrote everything down and said she will look into it.
Here is where we stand, 6 days from the start of our cycle: If this nurse from the "program" is correct, going against what everyone else has said, we have two options.
A) We can stop the cycle, spend a few months trying to get into another clinic that this lady says is a place they will cover, get set up with another specialist, make sure all the records are sent, and try to get pregnant with a clinic with a worse success rate.
Or, we stay here, give up our fertility coverage, pay $12-14,000 out of pocket at the best fertility clinic in the state, with the highest success rates.
We have absolutely no idea where to go from here. We don't know who is right. We don't know if our IVF is truly covered anymore. We have had no idea if we have to enroll in this program with Sataness herself. Whore. I bet she has five kids. I bet she eats little children.
Or, this women is completely bat-shit crazy and doesn't know what she's talking about. I am hoping for this.
What to do? What to freaking do?
No really, I'm asking, what the hell do we do?
Labels: Fertiles, Insurance, IUI, IVF, Money, Rantings, Reasons infertility sucks