#*@%&# insurance…

Yup…my insurance, which is normally fantabulous (seriously, I think they just paid out close to $2000 for me last month…and I didn’t have to pay anything but co-pay) really pissed me off today.

When I had my beta tests, they also checked my progesterone levels.  They were low both times (10.3 and 11.4).  When I went in to see the MFM doctor for my ultrasounds I asked him about this and told him I had some left over prog from my last IUI.  He suggested I take it and when I run out to get a new RX from my ob/gyn.  Okey dokey!  I thought I had about 2 weeks worth, enough to get me to my appointment (which is next Monday, fingers crossed) and then get the new RX then.

Did you know that if you have 21 pills and take 2/day, that’s only 10 days worth, not 14??  Yeah, I didn’t either!  However, maybe you don’t suck at math as much as I do – I mean really, I suck at math.

So, once I realized my error, it was this past Friday.  I didn’t get time to call during the day, so I left an after hours message, hoping they would get back to me at least by Monday, as I would run out on Tuesday.  Monday came and went, no phone call.  I think, “well, maybe they were closed Monday due to the holiday.  I’ll give them Tuesday.”  So, yesterday came and went – no phone call.  Getting pretty frustrated, as they always call me back!  So, I took my last pill last night and hoped it would all work out today.  Left a VM for the nurse at 9 am (knowing my doctor would not be working today, but hoping someone could give me the RX anyway…).

I get a call back relatively quickly.  Give them the name, amount and the location of my Target pharmacy.  Done!  No problem!  Figure I’ll run to Target over lunch and pick it up!  Great!

Well, about 2 hrs later, Target calls.  They tell me that they just got my prescription, but that my insurance does not cover any of the cost and it’s going to be $437 – WHAT THE &#)(&)%(@!!!!  Not only that, but they didn’t even have that medicine in stock and would have to order it.  I was livid to say the least.  Call the nurse back right away and she actually answered the phone instead of VM.  I told her the situation, asked if there was a generic?  She had put in a RX for 30 day supply.  We decide she will call Target and see if they can get a generic.

I call my wonderful, loving husband.  I think he had a small heart attack  when I told him how much money they wanted.  I remembered that when we got this last batch of progesterone, it was at a smaller pharmacy that had it in stock.  He agreed to track down the name of it, and we decided to just get a 10 day supply to get me through until my appointment and then go from there.   I decide to also call my insurance company and see what the heck is up.

I call them.  Here is the conversation:

Me: I’m trying to get a RX that I very much need and I’ve been told there is no coverage for it and I’d like to know why.

Insurance Guy: Let me look that up.

***on hold***

Insurance Guy: Yes, it looks like there is 0% coverage on that particular RX

Me: I know, I want to know why.  I’ve had it before and it wasn’t covered then as it was part of IF treatments, which are not covered – but this is for a pregnancy and prescribed by my ob/gyn.

Insurance Guy: It doesn’t give a reason why, just that it’s not covered.

Me: *deep breath*  Okay, this is very frustrating.  I need this medication.  If I don’t get it, my baby will die – I’ve already lost one pregnancy when I stopped taking this due to cost.  I don’t have the money for it.

Insurance Guy:  Well, in that case, would you like to file an appeal?  I can send you the forms and you fill out your reason and can even get your doctor to sign it.  It’ll take about 2 weeks.

Me: That will be too late.  Thank you. *click*

I know it wasn’t this guys fault, but I just get really flustered and angry when stuff like this happens – when I have no control over something this important.  It’s easier to just hang up on them rather than releasing the fury.

So, plan 2.  Justin does manage to find the name and address of the other pharmacy.  I call my doctors office back, and leave a message with the name and address, tell them just to order 10 days worth and we’ll figure the rest out later.

About 20 minutes later the new wonderful pharmacy calls me back and says they have my RX and when can I come pick it up?

Me: Well, I have a question first.  How much will it cost?

Lovely Pharmacy Man: Well, let me ask you a question, do you have any insurance I should know about?

Me: I do, but they’re not covering any of it, bastards (I didn’t say the last part, just thought it.)

Lovely Pharmacy Man: Okay then, when I’ve already enrolled you in our discount insurance program.  It dosen’t cost you anything, just saves you money.  So, it would normally be $150 but with the discount it’ll be $124.

Me: Thank you!  I’ll be there during my lunch hour!

So, still kinda spendy, but no where NEAR the Target price, even for the 10 day supply!  I remember liking this pharmacy a lot last time we went there.  It’s just a small little building, and all they do is RX’s and over the counter stuff – nothing else.  They are always very helpful and friendly as well.  I may have to go there more often.

So – that was a very long tale.  Basically it boils down to my insurance screwed me over and I love this new pharmacy.  I’m also very happy again with my switch to the new ob/gyn.  It’s hard to get an appointment with her, but she and her staff are always helpful and willing to work with me.  Thank you!  Oh, and if you’re in Chicago and want a new pharmacy, let me know and I’ll give you the hook up.

Um, wow…

Some of you may remember that June 25th was RESOLVE‘s Advocacy Day in Washington DC.  I couldn’t be there myself, but I did all I could here.  I posted a blog, I put up twitter posts all day about it, and “donated” my facebook status.  I even wrote to all the senators and representatives that speak for me in DC as an Illinois resident.  I only heard back from 2 of them, but I felt good that I had done something here.

Well, I was looking at my blog stats today and it shows you where people who have read your blog come from and there was a weird link that I didn’t recognize so I click on it and it took me here.

I don’t really know much about “Blog Her” but I’ve been meaning to find out more about it, and now I’m in one of the articles!  If you scroll down to the bottom of the article this blog is mentioned and is quoted!!!  I can’t believe it…it’s pretty crazy that something I said would be quoted by anyone!  Let alone the Stirrup Queen herself!

I hope that what I said and what RESOLVE was able to do in DC will help us all to reach our goals with less stress and less worry about money.  It’s hard enough to go through all we do with infertility without the added stress and pain of having to pay for it all without the help of insurance.

on winning the lotto…

Yeah, that is a wishful thought.  I guess you have to play to win, but it’d be really nice right now if I could win the lottery.

Well, as the last IUI didn’t work my husband and I were trying to decide what to do next.  Insurance doesn’t cover anything and we’ve now cleaned out our savings account.  We were hoping we had a good 2 weeks or more to work something out.  We’re looking into possible grants, loans and other sources.  Unexpectedly however, AF decided to show up on Thursday!  Bah!  She never seems to want to cooperate.  When you want her, she’s never there.   When you don’t, there she is!!

So anyway, we had about enough for the baseline u/s and blood work appointment and one box of meds.  We decided to go ahead and do that, hoping that we would be able to figure something out to help cover the rest of the appointments that will be needed this month.

Had that appointment this morning.  I had talked with my nurse about our situation.  I told her if we can’t figure out some funds to cover the rest, we may have to cancel this cycle, but that we wanted to start it, just in case.  After the appointment we requested to talk with her and she came in with 5 boxes of donated meds.  Bless her!!!!  With the dosage that I usually get, she said it should get us through 10 days.  I would be SO HAPPY if all we had to worry about paying were the u/s and blood work appointments.  We’ve worked it out so that we’re being tested for the very minimal amount of things with each blood work, so we’re saving a bit there.

So, small blessings in the form of meds.  Now because we didn’t have to buy the 1st box ourselves we have enough for one more appointment.  Hopefully by then we will have worked something out to get us through this cycle.

Have I ever mentioned how frustrating all of this money crap can be?  Come on national healthcare coverage!!!  Save us all from this neverending loop of insurance company fights and empty savings accounts!!!

RESOLVE’s Advocacy Day, June 25

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Hey all…I just found out about this today, RESOLVE’s Advocacy Day.  A group is going to Washington to fight for infertility coverage!  Click here to go to the main page for Advocacy Day.  Below I’ve cut and pasted a ton of stuff from their website.  You can go and read it there, but I thought I’d highlight some of it so you know what this is, and what you can do!

RESOLVE Advocacy Day: Why Me? Why Now?

Today we are in a unique moment in US history where the future of healthcare reform is being discussed in the halls of Congress. Together we need to make sure that the leaders of this discussion hear firsthand what those touched by infertility need in our healthcare system. There’s never been a time in RESOLVE’s 35 year history where we need you more than we do today. Grab your spouse, partner, best-friend or mom and join us June 25 in Washington D.C. 

On June 25, RESOLVE’s family building advocates will be in Washington DC in an effort to make family building more affordable.

There are ways you can help, today.

1. FORWARD THIS MESSAGE TO A FRIEND
Share this email with family and friends asking them to sign up to become an advocate and stay informed.

2. FACEBOOK
Change your status to: “Today I’m donating my status to RESOLVE’s Advocacy Day–leading the charge for greater access to affordable care for infertility patients.” (Don’t forget to become a Fan of RESOLVE)

3. BLOG
Let your readers know what is going on in Washington DC this week. More information here.

4. TWITTER
Tweet to all your followers: “June 25 is RESOLVE’s Advocacy Day, visit resolve.org for ways to get involved.”

5. DONATE
Make a generous tax-deductible online donation today to help support our ongoing initiatives to increase access to affordable care.

The infertility community needs to be on the minds of our elected officials this summer as the healthcare reform discussions continue. We can’t do it without you..take action, be generous… and stand up and be heard!

Here is a way you can do something in your area!!!

Federal Legislation

  • Contact your Representative and ask them to co-sponsor HR 697, the Family Building Act of 2009.
  • Contact your Senators and urge them to sponsor infertility coverage legislation in the Senate.

Info provided by RESOLVE on Insurance coverage…click the link! Some info about Insurance coverage from RESOLVE

There is also a form where you can submit YOUR story for the RESOLVE group to take to Washington with them!  Below I’ve posted what I wrote for them to take.  I feel like by doing this I can help make changes.  I hope you will all do the same!

“My husband and I have been trying to have a child for 2 years. After a year of trying with no success I was referred to an infertility clinic. Shortly after my first appointment we learned that my insurance does not cover infertility treatment, only diagnostic tests. After about 6 months I was diagnosed with PCOS. From that point on, it has been a struggle and everything I can do to keep going in our journey for a child. In January 2009 we finally conceived a child through IUI. It had taken us almost $5000 in drug costs (which were not covered) weekly blood tests and ultrasounds (also not covered) and the actual IUI procedure (not covered by insurance). We were so happy. It had been a long road and we were pretty much broke, but we were going to have our child. In March of 2009 I lost my child. My insurance did cover my emergency room costs, hospital stay and surgery (d&c). However, now we are trying again. We’ve put another $3000 into treatments and medications. This is our last hope. If we are not pregnant (we will find out on June 29th, though I am not hopeful that it worked) that is the end of our trying. We are out of money now. We’ve spent every penny of our savings on this cycle. My husband is starting school in the fall to become a pastor, and we will have no extra income. If this does not work, we may not get another chance for more than 3 years. We want a baby so badly. My baby will be wonderful, beautiful and an amazing child. I can almost see him, I just can not get to him. It is so frustrating that the only thing stopping my husband and I from achieving our dreams of being parents is money. Money should not be a factor in creating life. People are every day making babies without a second though, though for all of us who are infertile, we want nothing more than our babies. It consumes our every thought, our every dream, our every day. The fact that we are not allowed to be parents just because the cost of our treatments are so high is unconscionable. Please help us to reach our goals. Please help us to be able to meet our babies.”