Saturday, April 20, 2013

F-ing Insurance!!

So I received a letter in the mail from my insurance company that after reviewing my medical records, they determined my hysteroscopy falls under "fertility" and therefore is not covered by my plan. Are you freaking kidding me?

Honestly, I don't think this has to do with fertility whatsoever and from my research the hysteroscopy is typically covered. In fact they even TOLD me it would be covered because I asked them prior to the surgery. I think they noticed that the surgeon was a fertility specialist and therefore decided to be a-holes and make me pay for everything. Here are my reasons why it should be covered:

1) It's correcting a congenital birth defect
2) By fixing it I will have much better chances of a normal pregnancy with less complications
3) How does this surgery in any way affect conception (i.e. fertility)?

So I wrote them a one page letter, I tried to keep it short and to the point, discussing this and hopefully they reverse their decision. Especially since I will need a 2nd surgery, I definitely want them to pay for it. I will fight as hard and as long as I have to to make sure my insurance company approves this because I think it's just ridiculous! It's not like I'm asking them to pay for IVF or something (that would be AWESOME if they did though...)

So if my appeal goes through and they pay the coinsurance for my surgery, I will post a copy of the letter I sent them to this blog so others can see it. I won't post it yet because if it's not approved, I don't want others using a bad example ... :-/

Other than that no hubby will be going to see a urologist next month to figure out his MFI and see if it's anything that we can correct. Just to give you an idea of what we're dealing with, his count and volume are fine, but his motility is about 20% and morphology around 2%. So if there is a varicocele or something like that then we can fix it so that's what we're hoping for. Of course he is nervous about it but I say, it's better to find out what is causing the low motility and morphology. We just need some answers.

Anyway I will update once I have more news on insurance, urologist, or when I'm pregnant! (Ha ha ya right on the last one) But you never know :) Good luck to all my TTC'ers!

UPDATE: I won my appeal!!! I focused on the fact that this was a birth defect, not the cause of my infertility, and my insurance finally agreed!

1 comment:

  1. Ugh!!! That sucks!!! They should cover it!! I am so sorry!!! I hope they revise their decision!!