Right now health insurance is in the news ... a lot. There's the whole "War on Women" birth control debate having to do with the implementation of the national health insurance mandate that employers, including religious groups, be made to provide contraception to their employees through their insurance plans, even if it is against their beliefs. I have never had my birth control pills covered by my health insurance and don't necessarily believe they should be covered by health insurance, but that is a debate for another day. This is today and the $3,000 bill I just received from Mass Gen for my HSG because my insurance has declined to pay for it.
In the little descriptive outline of my health insurance benefits, it states that I have a lifetime limit for infertility coverage of $5,000. In the IF world we all know that this is peanuts. I don't know exactly what $5,000 will get me, but I do know it won't be a whole hell of a lot. When we returned from vacation, I checked to see the status of my pending insurance claims, and there it was, the entire HSG ... unpaid. I've been awaiting my bill for a few weeks now, and it just arrived in the mail yesterday. On our statement of benefits, it stated the claim was unpaid "based on the diagnosis code reported. When I called up the insurance to investigate, they stated that I only receive my paltry $5,000 worth of infertility coverage after I have held the policy for one year. The diagnosis under which my HSG was submitted was "Infertility, female, of unspecified origin," or 628.9. Never mind that I have yet to be diagnosed with infertility, but apparently what diagnose you are given and what code a procedure receives can be two different things. Who knew?
I understand an insurance company choosing not to cover assisted reproductive technologies, but I can't believe that they won't cover the diagnostic testing to diagnose infertility. Forget about the birth control debate, this is the real War on Women, and I am angry. According to my insurance company, anything that gets coded "Infertility" will be rejected until September 26, 2012 ... my doctor's visits, my bloodwork, my imaging studies, everything. The truly ironic thing is that George's semen analysis was covered. I don't know what it was coded as, but is there anything less having to do with infertility than a semen analysis? I don't think so. I haven't investigated this, but I'm sure if George was having difficulty getting it up, our insurance would cover his diagnostic testing to determine the problem. More than likely, they would cover his Cialis too. The sad thing is, we all know, there is no way to fight insurance. What they say is law, and they don't budge. It is incredibly unfair and just leaves me feeling helpless.
The good news is my HSG came back completely normal. They say that after the HSG one is highly fertile for the next few cycles. So far it hasn't made much of a difference for me, but you never know. Maybe this will be my cycle; there's always that faint glimmer of hope. If I do get lucky, I'll think $3,000 for a baby really isn't all that much, especially when compared with the sum some couples pay for IUI and IVF, and I'll be bragging about the deal we got. It'll be the equivalent of having found a pair of Jimmy Choos on the rack in TJ Maxx.
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