Insurance -not covered

laura080867

Hi,

I just found out some upsetting news. Apparently my medical insurance through Kaiser in Northern CA does not cover any Reproductive services whatsoever! They do cover full maternity care but its not so simple for me to get there for obvious reasons :)I am self employed and pay for an individual plan out of pocket monthly.

So I have spent all this time narrowing down my donors, had my ob/gyn check my tsh and estradiol which is really good for an old lady of 43. So my ob/gyn doc because of my age put in a referral to the Infertility department which is standard procedure due to my age and due to the fact that I need to be inseminated. I found out that I had zero coverage and so I had the infertility department send me a price list for those of us paying out of pocked and its crazy expensive!! Does anyone out there have any suggestions, are in the same boat or have past experience with this and have any suggestions?? I would be so appreciative. I feel so discouraged. I have two older children from a previous relationship and am really looking forward to a baby to care for again and its my partners life long dream to have a child and due to health reasons, she cannot have one. So here we are....Sorry for the long and venting post, I was just hoping to hear from anyone in the same boat or any thoughts or suggestions.

Thanks
Laura

teddy83ar

Hi Laura

I dont have any experience with this same problem but I have worked for insurance companies in the past. Is it possible since you are on a self-funded plan to change plans? I dont know if you had to sign up for that plan for a year or if it is month to month. I also live in northern california and have kaiser insurance. I know they offer plans that cover at least some of the cost because my plan covers 50%. I am not sure if my plan has a contingency for only hetero couples but I know the insurance does cover part of it. It would be worth looking into whether you can change plans to one that covers some of the costs?

Also when I was looking to fertility clinics I found a lot of usefull information from a clinic located in Davis. I dont know where you are in relation to that but they had information for companies that provide medical loans so that you can afford the cost of TTC. I dont know if that is something else you might want to consider but it is another avenue? Hope this helps :)

laura080867

Thanks for getting back to me! I am on a self funded plan (I am self employed) and they don't have any that I can switch to that would cover it. I have the top plan they offer individuals. I would have to be in a Group in order to have better insurance :( Is your plan that covers 50% ,with a group? I am pretty near Davis, about 30 minutes east.

Thanks!
Laura

jkquinn23

I would start calling around for low cost IUI clinics. We are in the same boat. My wife and I have great health insurance but it doesn't kick in until 12 consecutive unsuccessful IUI's. We are 34 and 38 and in 'perfect' fertility health but no pregnancies yet... we are in about $20,000 and 10 months so we have 2 more months until our insurance will kick in and we can go to a reproductive center. We found a ob/gyn dr. (in Boston) who does IUI's for $175.00. I would just start calling around. A lot of midwifes will do it a lot less expensively than a center and if you are in good health, there is no reason why it won't work for you (this is 'positive' me ;) Look into LGBT health clinics, they usually have resources for this. We took 3 months off because it was getting too stressful, we go in next week with a new donor!! Here's hoping it works this time! Good luck!

Unknown

I too, had to pay out of pocket because my insurance would not cover IVF without 12 unsuccessful IUI's. I don't know what your income is but if you need to use fertility medications, Freedom Pharmacy has a program called Compassionate Cares. It is an income based program and was very helpful for me. I had already spent alot of $$ on my donor sperm, 3 IUI procedures, office visits etc. When I switched to IVF, I was extremely grateful for the Compassionate Cares program. They were wonderful. I hope this helps.
Good Luck.