The Wicked Witch

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Money…and medical insurance…two sources of evil that seem to get in the way of so much for so many of us.

Does this resonate with you?

I’ve always been financially responsible, making sure I pay all my bills on time and maximizing my investments to secure my future the best I can. In that sense, I’ve been lucky. But by doing this, I struggled with my everyday spending – feeling as if I lived paycheck by paycheck.

So, when I first made the decision to have a baby on my own, I had concerns about being able to afford it while continuing to invest in my family’s future. It would be a struggle, but I told myself that women have babies every day with a lot less than I have.

But does that really make it ok for ME?

Enough about being able to afford/live comfortable once I had a child. At this point, it was putting the chicken before the egg…literally!

What about the cost involved in actually trying to conceive. I certainly didn’t have enough disposable income saved to afford in vitro fertilization (IVF), which costs somewhere between 12k-15k per cycle…without any sperm!

But, again, my mind was eased a bit when I found out my insurance would pay for unlimited Intrauterine inseminations (IUI). Granted, it’s not IVF, but I was pretty positive IUI (or basting, as I referred to it in my previous blog) would work its magic for me.

After twelve IUI’s, many tests, and countless vials of sperm, we were now talking about over $25,000…a drop in the bucket for what many have endured, I know, but for me, I could not have gone down this road without the security of my insurance coverage…or so I thought!

Enter the witch…and I’m NOT talking about Glinda!

Everything was going along smoothly (other than the fact that I wasn’t getting pregnant)…

until

my insurance company changed their minds!!!

One year of fertility coverage behind me without any problems. I hadn’t gotten pregnant and decided to take a break.

As if that wasn’t depressing enough, I started noticing that my insurance claims, that had all been covered, were suddenly denied!?!? This had to be some sort of mistake, right?

Yes, in fact a mistake the insurance company felt they had made. They actually uncovered all the claims that were originally covered. Can an insurance company even do that???? Apparently so!

I thought I had cleared all my bases to get coverage, but evidently there is a lot more to it than I knew. They don’t provide classes for this stuff.

Note to anyone trying to get fertility coverage: Every state seems to have different laws to determine whether you are infertile and therefore, cleared for any type of insurance coverage (which also varies – see state coverage laws here). This is important for you to keep in mind when you start talking to doctors and insurance companies. Best to be safe and just tell the Dr. you’ve been trying on your own for over a year unsuccessfully (single ladies…you’ve definitely tried with an ex, of course!).

For a year, I fought an uphill battle with my insurance company – writing appeal letters, spending countless work hours on the phone, consulting with attorneys and shedding way too many tears. I even hired a company to help me in my fight.

In the end, some of it did go away, as my fertility clinic didn’t pursue full payment…I think they knew they were partially at fault for not doing their due diligence up front as well, so I just plain got lucky.

All in all, the cost to build a family while struggling with infertility (I will talk about the cost of adoption in a future blog) is a huge barrier for so many people. For those of us longing to be parents, it’s a struggle that just doesn’t seem fair!

The good news is that there are more and more resources available to people who struggle with infertility.

I have listed a couple resources below and would love to hear from you about others – please share in the comments. Your knowledge may empower someone else going through this stressful time right now.

Resources

There are many counselors/support groups available across the country. If you would like to connect with someone, I’d be happy to help you find the right resource for you.

Next up: “The Ruby Slippers,” coming April 19th

Until next time,

{ 4 comments… add one }
  • Leila Golding April 5, 2014,

    Thank you Rebecca! You always seem to have a silver lining to your otherwise painful experiences. Perhaps taking the route of adoption has made those woes a distant memory?

    • Rebecca Gruenspan April 5, 2014,

      Aw, thanks Leila! I always tell my client that after you become a parent, everything you went through to get there soon fades and becomes a distant memory. And it’s usually worth it in the end.

  • Ollie / My Dog My Guru April 10, 2014,

    Having studied commercial law, worked for an independent insurance broker and made a fair few number of claims on my medical insurance – I am well aware of how insurance companies can be. It can be so frustrating when the only thing standing between you and your happiness is nit-picking of specific wording in an insurance policy. Always pays to triple check these things and keep up to date with any changes being made to wording of policies that may affect you now or in the future.

    • Rebecca Gruenspan April 10, 2014,

      Ollie, absolutely! I have a Masters Degree and thought I was a pretty intelligent person until it game to navigating insurance. I needed a counselor to guide me through…it’s horrible. Not sure if it’s gotten any better, but if there are such people to help you through, it would be great to let other people who do need it, know.

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