update: progesterone and insurance

lyndsaynicole

So-update to the post below about me being stupid

 I don't know if it's me, and I just don't explain things correctly to people or if I just deal with a lot of idiots that don't understand.

I just talked to the nurse at my doctor's office and I couldn't seem to convey to her that I was trying to figure out why the pharmacy told me that my insurance wouldn't cover the Crinone, but the Medco website (who my prescription insurance is through) says that they will cover it. 

And she just said again "well, most insurance companies won't cover infertility and it depends on your diagnosis." Here's the problem: YOU GUYS NEVER ACTUALLY DIAGNOSED ME WITH ANYTHING! I have been TTC for over a year, but I have had two miscarriages, so technically, that doesn't make me infertile, it means that I either have really bad luck, or there is something that's making me not stay pregnant. And because my doctor is a douche, I had to do my own research to find out that I most likely have a progesterone deficiency. When I presented all the information to her, she agreed with that and agreed to put me on progesterone. 

So now, I guess this nurse is calling a local compounding pharmacy that does progesterone suppositories that are supposed to be quite a bit cheaper...I told her I need prices and I need to know what my insurance covers before I commit to anything. Ugh. This is stupid and frustrating. 

ColleenS629

Wow. How annoying! I hope she gets you some info today!

BlakeG

I'm sorry it is so frustrating.  Maybe your doctor's billing department is just using the wrong coding?  They shouldn't have it coded as an infertility treatment if you're clearly getting pregnant I would think.  Insurance just makes me crazy!

GuppyAmy

I don't understand why they didn't diagnose you. Obviously if you're not staying pregnant there is a problem. Even if they put the blanket unexplained fertility dx at least you'd have something.

elisbu

I hate insurance companies!!!

have you tried calling them and telling them what's going on? Then write down who you've talked to, their ID number, and what information they gave you? This helped me dispute a fee one time.

Good Luck, I am sorry they are giving you a hard time!

mommy411

Yikes...You shouldn't be trying to diagnose yourself!

Maybe a new Dr?

lyndsaynicole

Well, the nurse called back. The suppositories are $1 each-so 30 bucks for the month. That's more like it.

My DH keeps telling me I  need a new doctor too, but the chick I'm going to is supposedly the best in town. Not to mention, she's FINALLY doing something for me. So I really don't want to change docs right now. We'll see how this goes though. 

Kristin&Adam

That is really frustrating!!  I'm glad she got some answers for you though!

CashewsMommy

Ugh I am so sorry!!! What if you found a different doctor?

I'm really shocked though. I've been put on progesterone with no problem! What if you were pregnant, would it be an issue getting the progesterone then? Or is it just because you're under the code of "infertility"?

rock-elle

wow that does sound frustrating and like a lot of work!!!

nbbride06

My compounded suppositories that I took while pregnant were $42 for 30 pills.  Hope this all gets taken care of quickly!

lyndsaynicole

Well, I got the problem solved. I picked up the suppositories, I got 30 for only $9. That's more like it. I feel better now.

 Thanks for all the help ladies!