Insurance (vent)

leahoulicky

Inequality for all!!!

Okay, I live in California, one of those 13 states that have laws that require insurance companies to provide infertility coverage leaving out IVF. However, the state healthcare program has a different “view” on infertility or “family planning” coverage. I get it, don't want to promote more women to be welfare queens. That term should be on the list of swear words, right up there with F***, and C***! It’s very frustrating! All I have access to is a family history, lab work, and birth control. I’m currently going through a gantlet of tests. We were hoping it would be a condition easily treated and covered, like hypothyroidism and/or endometriosis.  I’m disabled, I can’t go to work, and I won’t ever get a corner office with an HMO that can pay for a few rounds of meds in the hopes it works. Believe me, I would gladly be working full time at McDonald's if it could get me off "The System" another foul word. DH is worried what the final diagnosis is going to be. He seems to think that if the news is bad, he will have to have me under a 72 hour psych evaluation. I personally don’t know; this has been a dream of mine since I was a little girl, and I refuse to let it go. DH does not qualify for insurance from work, and it wouldn’t cover me anyway. POOP!

Sorry just very frustrated and needed to vent. My dear family is a little over saturated with my venting at the moment and wants a break.

jjgrl55

Sorry you are going through this. Insurance companies can be the worst. And, sorry insurance, but the proper working order of your reproductive organs IS a health issue and SHOULD be covered. 

I'm assuming your DH doesn't have access to insurance coverage you can utilize, either? 

Unfortunately I don't have much advice to offer, but I can commiserate with being uninsured 

(as I was a few years ago) and even now with insurance it's still hard to navigate the infertility insurance circus and I've only just started!

jaztastic

Vent on sista, vent on. We get it 100%. While our situations vary, I think we can all understand the insurance headache on some level.

leahoulicky

@jjgrl55, Right DH doesn’t currently have any insurance, we are hoping for a promotion that would give him benefits, but for legal reasons I would still not be able to get IF coverage, however little, through it.

I was even looking on the covered California site trying to find if I could buy a policy for myself so I could have coverage just for it. With no luck, it’s not even listed… grrr. I have MediCal (California’s version of the welfare program, Medicaid) and Medicare, which gives me coverage for my doctor visits, ER and hospital visits, and vision care. I have no dental, which I do have need of, but have to buy my own separate policy, also grrr.

Personal note, if you haven’t seen my other post, I was hit in the head by one of my parents when I was 3 months old. (DA told my grandmother that had the blow been either a centimeter to the left or right I would have died. I had blood in my nose, behind my ear, and retinal bleeding in my right eye.) So I have been on MediCal since I was transferred to California as a Ward of the court. I ended up with Fibromyalgia which the pain started in 2006, didn’t get a clear diagnosis until years later, and only just managed to get Social Security Disability income granted in 2012. So, I’ve been on “the system” my whole life, not by choice. With all my struggles I had to choose which dreams and goals in life to let go, or hold on to.

This past week I’ve had blood tests that all came back normal, and an exploratory surgery scheduled next month which is covered, but my GYN thinks that I will need Clomid, which will have to be 100% out-of-pocket.

Today has just been a very bad day. I spent a few hours in an ICU waiting room to hear news of my Uncle. For both of my Dad's brothers (who are republican) the ACA has really helped them, or both of them would be in the grave already. However, one may only have months weeks or days. He's only 40. My stress level is a bit worn today.

Lillovebug79

I'm sorry about your insurance struggles. I do have some IF coverage but still have paid thousands and thousands out of pocket and I'm not done yet! At least your testing is 100% covered! trust me that adds up quickly when you are paying 20-50%.
On a good note Clomid is a fairly inexpensive drug. The monitoring with it , however, can be costly. But a lot of OBs and REs are able to code the ultrasound and lab monitoring as necessary instead of fertility. Hopefully for you that's the case.
Best of luck getting your testing under way!

leahoulicky

I don't think an RE is covered, and all my doctors have to have Medicare (as in AARP) licenses. DH and I were hoping for Hypothyroidism, which is covered. The surgery is to see if there is Endometriosis, which is also covered. everything else, I don't think so.

Lillovebug79

Did you have an HSG to check your tubes? That may be covered as well. I'm sure the fertility drugs, IUI, and IVF aren't covered but hopefully diagnostic tests are.

leahoulicky

I am having laparoscopy on May 19^th to check to see if I have endometriosis, and see if my tubes are clear (that’s what he said anyway.) Thank the gods that testing is covered; just no treatment except for hypo or hyperthyroidism endometriosis and estrogen replacement (aka the pill) for Primary Ovarian Insufficiency.

The pictures on my last reply are the California law for Insurance to offer coverage, and the Coverage offered to those on Medicare/Medicaid.