not infertile enough

Orchard27 · June 2010

We've been trying since April 09 and had two losses at 5 weeks. My gyno referred me to an RE and I had my first appointment with him the middle of March. He's diagnosed me with unexplained infertility and recommended a medicated IUI cycle.

My insurance has denied the claim and tells me that according to their definition of infertility, I can't be treated until February 2011. If I have a loss between now and then I will have to push my treatment date so it's 1 year after any pregnancy, regardless of whether it's a loss or not. They told me the only way to challenge this successfully is to have my doctor provide a reason for my losses. If they remain unexplained, then I'm out of luck.

I know that many people are out of pocket and I have no business feeling so blindsided, but I thought I had great insurance. I guess we might be able to pay for two more Clomid IUIs ourselves, but that's it. So now do I hope to not get pregnant between now and then because I'm so sure that I'll have another loss? I'm beyond angry to just terribly sad.

eminbmore · June 2010

Ugh, I am so sorry, that sucks! WTF is wrong with the insurance companies of this world? Insurance coverage of infertility needs a major overhaul.

mindyesq · June 2010

this is really frustrating, but that is the definition my RE uses as well. (so my diagnosis went from habitual aborter (nice) to unexplained infertility after a year of trying after last pg/mc

redstars93 · June 2010

I'm so sorry

I'm going through the same thing: been TTC over a year, but had a loss in Sept and according to my OB/insurance company, I can't even be tested until this Nov (because it has to be 1 year since I was cleared to TTCAL). Oh and I'm 35.

Medical insurance blows.

johannaknip · June 2010

I'm sorry sweetie.

Court1 · June 2010

That sucks. I hate insurance companies & this kind of thing makes me sick. I'm sorry you're dealing with this.

KiKiMe · June 2010

Oh, I am sorry - that is totally unfair! :::hugs:::

rjl07 · June 2010

I'm so sorry. I can't believe they start over after an unsuccessful pregnancy. I hope you either get a BFP or a diagnosis soon so you don't have to wait. GL!

Orchard27 · June 2010

Thanks for the support, ladies.

I suppose it might be time to start seeing a counselor. It says something to me that I've already considered this cycle to be a bust when I'm only 8dpiui. I'm developing too much of a fatalistic perspective. :0(

3ltlones · June 2010

I'm so sorry. I don't know what is wrong with insurance companies either, it really sucks.

kew243 · June 2010

I'm soo sorry. Maybe your insurance would cover it under another diagnosis if you did get pregnant again and it wasn't successful. After three losses you are considered a recurrent spontaneous aborter (I hate this term) by insurance guidelines. Maybe you could go that route instead of waiting another year.

I am going to hope that you just get PG and none of this matters. ((hugs))

BeachCole · June 2010

I am so sorry Sad

That is incredibly frustrating and unfair.

KristysRedBarn · June 2010

What?? I'm so sorry. That's just horrible.

dondraandluis · June 2010

I'm so sorry (((hugs)))

bbhalphen · June 2010

I'm sorry! Insurance blows. I had to wait until I had 3 losses to get things covered.

Scout05 · June 2010

I am so, so sorry. Insurance companies are the devil's minions. Seriously.

ERICA21779 · June 2010

Unfortunately thats the way it goes with insurance companies.............it took me 14 months to get pg with my ectopic pregnancy and they told me that restarts the clock even though my dh has 1% morphology and I now have only one tube........they just keep saying, "but you got pregnant" that is their line of defense....they're pretty "F"D up if you ask me.....somehow I ended up under the radar and was approved for three IUI cycles, however because of my deductible it is still costing a good amount of money.

Has your DH gotten checked out?? Did they do an IF work up for you?

Lots of (((((hugs)))))) try to hang in there and I hope this IUI you had does the trick.

surfergirlkona · June 2010

I am sorry. Insurance companies suck IMO. I only have my meds covered. Hopefully your doc can help you out and see what they can do for you.

triple_sevens · June 2010

That sucks donkey balls. My insurance only covers meds, not procedures, so I'm hoping that won't affect my seeking an RE's help in August (I've been trying a little longer than you, but have only had one loss/pregnancy).

islelily · June 2010

I'm so sorry. It sucks that INS companies choose the statement of "well at least you can get pregnant" outlook even when it ends in miscarriages. Thats not fair at all.