Intro and advice

eener817 · November 2014

Hi everyone,
I am new to the board but have lurked for a couple years on TTC and for a little while here.

DH and I have been TTC for about 2 years (with a couple months off intermittently for our sanity/vacations/etc.). I am 31, he is 32 and we are both generally healthy as far as we know. I have extremely regular 28 day cycles with no unusual symptoms.

What we have done so far:
CD 20 progesterone test with gyno - 11.1
CD 3 bloodwork/ultrasound just today with new RE - obviously awaiting results but ultrasound tech said my lining looked good and plenty of good sized follicles. I was lucky enough that my new RE let me come in for these tests a couple days before my first appointment so I didn't have to wait another month.
Our appointment is Monday, so I am assuming DH will be getting an SA and I will be getting an HSG in the near future.

Unfortunately, DH's employer is kicking me off his insurance on Jan. 1st since I have my own available through my employer. I just found out about a week ago that my new insurance offers NO fertility testing/treatments. So after the first of the year, every thing will be OOP unfortunately. It is terrible timing since we decided we would start testing after 2 years TTC. I freaked out for a few days, but am just trying to stay positive and busy! Luckily my new RE has been very understanding and is helping to fit me in ASAP.

So, here is my question for you all...
Keeping the insurance situation in mind, what do you wish you would have asked at your first appointment? Or what do you think it is important for us to ask?

Thank you so much and I look forward to getting to know you all!
And secondary question...I created a siggy but I don't think it is showing up?

eener817 · November 2014

Never mind about the siggy, it showed up!

kef21287 · November 2014

I don't really have any advice for you since I haven't been to an RE yet, but wanted to say welcome and good luck!

SND1231 · November 2014

Welcome. Sorry that you have to be here. As for what to do before insurance ends.. All the testing you can do. The RE will know what is important for you to have. The basics you have mentioned.. but they should test your blood for quite a few other things as well. I know that a lot of insurances, mine included, do cover meds and monitoring, but no procedures like the actual IUI or ET, ER, etc... So check into it or ask your RE to. Good luck!

eener817 · November 2014

Thank you everyone for your encouraging words. I am looking forward to getting the testing out of the way so I know what we are up against one way or another! As far as my new insurance goes, sign up is for another week so I have very little information about it other than no treatments are covered. Maybe some medications might be covered? Not sure?

@rainbowbridge14 - Under my husband's insurance, I have full coverage - IUI, IVF, etc. Not that I will get that far before January though!

mshandlebar · November 2014

Welcome! Sorry to hear about your insurance. We are completely OOP and it can be hard. I hope your RE can come up with a plan to maximize the insurance time you have left.

I agree with @SND1231, check to see what your new insurance may or may not cover. My insurance covered testing up until an infertility diagnosis (not incredibly helpful, but better than nothing). Good luck!

eener817 · November 2014

@rainbowbridge14 - I do live in a mandated state but I think he's just lucky. His insurance is seriously amazing! We never have to pay anything above a $10 copay. The deductible is $200!!!
Since my employer partially pays towards my premium, they are not obligated to provide coverage under the mandate. At least that was how it was explained to me by the rep from my soon to be insurance company. Ugh.

DSculley1824 · November 2014

Welcome to 3T...sorry you're here. Hopefully your stay is short and sweet. I guess for Monday I would ask when you can get the HSG and SIS done. Typically they do those tests between days 5-11 or so of your cycle (I could be off a day or two). Since you're on day 3 today it may be great timing if you can get in for those tests this cycle. My OB/GYN ordered bloodwork and a SA and HSG before my RE appt so I would be ready to go when I saw my RE. However, once I had my RE appt I needed lots more bloodwork and a SIS which kept me benched an additional cycle. FX your RE will be able to get everything that needs done in this cycle so you can at least start one medicated cycle before the end of the year!

Rachaeleigh · November 2014

Ugh, im sorry about the crappy insurance situation. I agree with pp in regard to getting testing done and possible stockpiling of meds.
GL!

Eta, damn autocorrect

BunnyBerry · November 2014

Welcome! I'm so sorry about the timing for insurance.

Maybe I am just naive, but...is it even legal for them to kick you of YH's insurance? If his employer provides the option of family coverage, what business of it of theirs if you have another employer-based single coverage available? Why wouldn't an employee have the right to the benefits of family coverage? And what difference does it make if you had employer insurance available anyways, since Obamacare creates insurance options for all? Do you have the option of paying OOP for the difference to upgrade YH's single coverage to couple/family coverage?

longhornwino0907 · November 2014

So sorry about the insurance crap! Good luck with all the testing and your appointment. My only advice is to ask your questions. We had our first appointment Friday, were thrown a curveball, and I was so dazed after hearing we would be benched for a month that I didn't ask not one damn question. And I had a list with me. Regretting that now, but luckily I have my clinics nurse's info and can email her. So yeah, whatever you decide to ask, make sure you ask it. And best of luck to you

eener817 · November 2014

Thanks for all the advice ladies! I will let you know how it goes tomorrow.
DH says he checked again with his HR person and there is nothing I can do to stay on his plan. I actually thought about getting her # and asking if I could pay a higher premium or anything. Would that be totally inappropriate?
The most frustrating part for me is that I am kicked off DH's insurance thanks to the affordable care act, thus making my health care WAY less affordable. And from the reading I have done, some of the government subsidized health care plans offer fertility treatments (since we are a mandated state). So frustrating!

hardlyhannah · November 2014

Have you looked at the cost of the govt healthcare plans vs your employer? If the ones that do cover fertility treatments aren't insanely expensive in the long run you might save money paying oop for that instead of using your employers healthcare plan and having to pay oop for the treatments themselves.

Good luck!

deelopi9 · November 2014

Welcome and good luck

eener817 · November 2014

@hardlyhannah - That is actually a great idea! The premiums aren't THAT much higher for the govt healthcare plans and fertility treatments are covered. I am waiting to hear back on more specifics. Thanks for the advice

eener817 · November 2014

@iputketchuponketchup - I agree that it is pretty aggressive, but I made it clear to the doctor that I want to do as much as possible before January. If he gives me the option, I most likely wouldn't turn it down! Thanks for the honesty

BunnyBerry · November 2014

BlueFairy5 said:

@BunnyBerry The precise mechanics vary by state, but yep, it's legal. There has been a lot of that activity since the ACA kicked in and the exchange plans were about to roll out. UPS got a lot of bad PR for doing exactly this, in summer or fall 2013. They mandated that if an employee's spouse has access to his/her own employer-provided health insurance, then UPS would not offer the spouse coverage.

I'm so sorry for this, that really sucks.

BunnyBerry · November 2014

iPutKetchupOnKetchup said:

eener817 said:

Thank you everyone for your encouraging words. I am looking forward to getting the testing out of the way so I know what we are up against one way or another! As far as my new insurance goes, sign up is for another week so I have very little information about it other than no treatments are covered. Maybe some medications might be covered? Not sure?

@rainbowbridge14 - Under my husband's insurance, I have full coverage - IUI, IVF, etc. Not that I will get that far before January though!

You have FULL coverage under your H's insurance for IVF? I know it sounds ridiculously aggressive with where you are in your testing, but if I were in your situation I would try and start cycling before January and get a shot at a "free" IVF. I know it sounds like working from the top down, but I would use the fuck out of that opportunity before it was snatched from me. Is this a popular opinion? I don't know. Am I being honest? Yes.

I thought the same thing too! But then I figured that insurance would require a certain # of IUIs first and/or proof that there was an IF cause that required IVF to solve it.

eener817 · November 2014

@BunnyBerry - I bet you're right now that I think of it. An insurance company probably wouldn't pay for IVF right off the bat. Maybe an IUI though?
I am actually looking into alternative insurance options that would provide coverage. We will see!

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