Insurance Blues

kreedhernandezkreedhernandez Posts: 6
in LGBTQ+ Couples
Hi everyone!

My wife and I are new to this. I have been reading many of your posts and wish all of you the best of blessings!

We are excited to begin this process but have also realized that it is not always an easy road. Since we are new, I'm not familiar with all the "lingo", but hope to become familiar with them soon.

We have just completed bloodwork this past Friday to check my progesterone levels after taking clomid earlier this month. If it is 15 or higher than doctor says next month will be a go!

I'm disappointed to find out that the insurance can be difficult to deal with. For a heterosexual couple, 12 months of no pregnancies defines infertility. Well, I have been diagnosed with PCOS and having no male partner means I have to pay for 12 cycles before they will cover me. How does this make sense? Any words of advice or encouragement would be wonderful!!

Thank You!

Comments

  • CarobarnhartCarobarnhart Posts: 10
    My wife and I are convinced that insurance companies are the devil. We went through the same thing with our...actually they said they would pay at first and then changed their policy when we were neck deep in it and we had to pay for it all ourselves...I'm sorry, it's really awful but just know that your determination will not let their "sneaky bigotism" win. Good luck to you.
  • jkquinn23jkquinn23 Posts: 28
    Right?? We found out WAY after the fact that ICI's don't count!! How is that even possible!? They count a hetero couple 'trying' at home but they don't accept an ICI?! I have receipts!! We tried for 4 months at home before we switched to IUI's and only THEN found out that our first four tries didn't count. So while we SHOULD be on try 8, we are only on try 4. It is infuriating. And this month, which is IUI #4, my wife's surge was.. weak? she took the 2 different types of tests (the lines and the smiley face) all weekend and while the lines came up dark, she never got a smiley face.. so we decided (after a lot of talking) to just go in and pay for another IUI just to not end up back at square one with our insurance. Who knows if she surged, if we were in time.. we just didn't want to start all over again so we did it. Like we have tons of extra money floating around.. grr..

    On a positive note, the day we realized that something was not quite right with her surge, we read through her insurance doc's again and realized that her insurance only requires 6 cycles since she is over 35!! woo-hoo!! We are close! Hopefully we won't need it but it feels so much better knowing, if it isn't successful, we only have to go through this 2 more times before everything is covered. So read the fine print, especially if you have a diagnosis, there might be a loop hole that they aren't telling you.

    Good luck!
  • kreedhernandezkreedhernandez Posts: 6
    Thank you! It is good to know that we are not the only ones to go through this, but saddens me to know that this is just another example of how we just don't get the same benefits...inequality at its best yet again!

    I received my bloodwork results today and my progesterone level was a 1.5!!! What?! After taking clomid?!!! Not sure exactly what this will all means...need to do some research, but it doesn't sound good if I needed to be at 15!

    To top off the day (and off topic), some crazy storm rolled in and took my beautiful porch with it! Thankfully, everyone is safe...material items can always be replaced. I'm keeping the faith...I believe everything happens for a reason!
  • CSSCSS Posts: 161
    Just so you know, not all of us heteros are peachy keen with our insurance coverage (or lack thereof).

    My husband and I couldn't try for 12 months because he's HIV positive and we always use condoms. So we've had to pay for everything out of pocket and it's been (7 IUIs later and one ICI, plus testing, doctor's fees, etc) almost $15,000. And I suspect other straight couples dealing with issues that rule out the husband's sperm (plenty of them on this board) have had to do the same thing.

    Plus, it just seems like most insurance plans hardly cover anything fertility related as it's considered "elective." IVF is most definitely out and as far as I know, they don't cover donor sperm. But I've heard that some insurance will partially cover IUIs (ours doesn't, even after 12 months), some testing (under the "diagnostic" category), and doctor's visits.

    Nonetheless, I feel for you ladies and all of us who've had to go through this and pay for it out of pocket. Insurance sucks. And it ain't cheap getting pregnant these days!

    --CSS
  • kreedhernandezkreedhernandez Posts: 6
    CSS,

    It is very unfortunate to hear your news as well. Goes to show that they (insurance companies) don't take a lot into consideration.

    We have just started, and we can't put a price on family planning, but you're right...insurance sucks and any way you slice it, $15,000 is a lot of money! And I'm sure there are many more that have spent a ton more too.

    Either way, most of us are all in the same boat in that we ride the same emotional rollercoaster one way or another.

    So, baby blessings for you and everyone else too!

    -krh
  • CSSCSS Posts: 161
    Thanks, krh. We're all dealing with the drawbacks of this process one way or another, but hopefully it will "pay off" in the end.

    My 2WW ends tomorrow and my test today (and for the last couple of days---couldn't resist) have all come up positive (plus some potential early pregnancy symptoms), so I'm cautiously optimistic. And I firmly believe it will all have been worth it in the end.

    Good luck ladies!

    --CSS
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