Tuesday, September 13, 2005
And a Weight Was Lifted Off of Her Shoulders...
Through my entire battle with infertility there has always been one thing on my mind; how are we going to pay for this? You see, my POS plan doesn't cover infertility except for diagnosis. I have spent the past few months doing research about the programs that were out there, shared risk (my doctor doesn't participate in one), special financing (good rate - but another loan... ICK), loan from family, etc, etc, etc... Husband and I had finally made the decision to go with the financing plan. The interest rate was okay (much better than a credit card) and the payment schedule was something that we could live with. I was okay with this decision, but the idea of going back into debt (been there, done that, very UGLY) weighed so very heavy on my heart. I planned to meet with the financial counselor at my RE next week before the IUI so we could fill out the paperwork and get the ball rolling. Rewind 6 weeks....

In August Husband accepted a promotion within his company. The pay is better, the opportunity to advance is much greater, the hours are more steady and the office is closer to home. The only drawback was that it was a non-union position and we would no longer have free benefits. Yes, I said free. We have been spoiled for seven beautiful years - we have had FANTASTIC health coverage for nothing. When the time came we went over all the available options, the co-pay and deductible schedules, the premium amounts, etc. until we finally decided on the EPO plan. It costs a bit more money than the others available but was the closest plan we could find to our old one. We were happy with our decision. We couldn't use out-of-network doctors, but we had manageable co-pays and no deductibles. The plan took effect on 9/1.

Yesterday on my way home from work I stopped at the local grocery to pick up my Cl0mid and my prenates. When the cashier rang me up the amount was too low. I told her that I thought she had missed a prescription and she insisted that she did not. I asked her if the Cl0mid was accepted by the insurance and she said, "Yes". I asked her if she thought it was a mistake and she emphatically said, "NO". Unable to believe that it wasn't a mistake I RAN (okay I drove, and I only sped a little bit) home and logged onto my insurance company's website. Sure as shit Cl0mid is a covered drug! In a frenzy I went digging for my infertility benefits and this is what I found:

Services for treatment of infertility

100% of eligible expenses up to a maximum of $6,000 per covered person, per calendar year. $12,000 per covered person, per lifetime. Diagnosis and services to treat a medical condition are covered. Injectible drugs are covered through the medical plan. Oral drugs are covered through the prescription plan.

Covered Services:
· Ovulation induction with menotropins
· Artificial Insemination
· Injectible fertility drugs


Can you freaking believe it?! I couldn't! I ran around the house hooting and hollering and scaring the living daylights out of my dog! I swear I just received a $12,000 gift. IVF/ICSI is not covered but at least we have a few more IUI's left to try before we have to bring out the big guns and bury ourselves in debt. Sometimes I just need a reminder that a) everything happens for a reason and b) when God slams a door shut in your face he always opens another one. Happy days ladies, happy, happy days.


11 Comments:

Blogger Julie said...

That's wonderful news!!!

Just a little assvice. Before you take out the loan, please look into a home equity line of credit. You (usually) get incredible rates, you only pay back what you use (as opposed to taking out a loan and then pay the entire amount back with interest) and the interst is tax deductible.

Blogger Donna said...

Wow! Isn't it great when you find little surprises like that? I agree with Julie about the line of credit, if you have equity in your home you should use that first.

Blogger Miss W said...

That is awesome news! So thrilled that it doesn't all have to come out of pocket for you :)

Blogger Jamila said...

great news!

Blogger PJ said...

Excellent news P.

Blogger Sheryl said...

Congrats! That's soooo great to have coverage that you didn't know about!!

Blogger Larisa said...

That's great, and almost better than knowing from the beginning that the new insurance would pay. At least the IUIs are covered!!

Anonymous Z said...

that's wonderfully awesome news!! CONGRATS!

Anonymous Anonymous said...

Hi- I'm new.
That is freakin' fantastic!!
It probably felt like winning the lottery. I was fortunate too, as my insurance covered treatment for recurrent miscarriages (which I had) but nothing for infertility. Which seems weird, because why do I get covered just because I can get pregnant, but can't stay pregnant. Weird, but I was grateful to have fallen on the right side of the coin.
Good luck with your iui!!
Kristine from Perpetually Pregnant

Blogger elle said...

Woooooooweee. That's fan-freaking-tastic. Our ins. sucks big ones - $2000/yr for ALL if (diagn & treatment) AND we are only reimbursed 50%. HA! We get $1000/yr! Thank goodness yours is so much better!

Blogger k #2 said...

that is the best news I have read in a long time. What a gift!!!!

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