Friday, May 16, 2014

One-Two-Nine-Oh-Nine

Please know that this post is not meant as a gloat... if anything I hope that it will encourage you to sign yesterday's plea for signatures on the petition I shared. 

I've pretty much known I would need ART since 2007, but it was NEVER something I could afford.  Back then I did a little Google research, saw estimates in the tens of thousands for IVF treatment and stopped right there.  With no insurance at the time we had to save up for a teeth cleaning appointment cost of $900 and we could never seem to get that together.  I listened to all the people who kept telling me to relax, it would happen when the time was right.  Besides, with finances being so unpredictable maybe it was sort of best that I wasn't expecting a child.

In 2009 I approached my OB with questions.  She explained that testing me would cost more, but since my husband (at the time) has had a history of smoking pot that he was likely the issue and since his tests were cheaper we should start there. His results were not excellent, not good, but certainly not bad so we were told to move up to an RE as I likely had some things that needed looking at too.  I started saving... then we had a cracked sewer line, then we had to get a newer car, then the foundation cracked and we lost another sewer line, then the bathroom walls started buckling and leaking water... and before I knew it we were $5,000 in credit card debt without a penny in savings. Oh, and then I got divorced.

In Dec 2012, Mr R and I meet with an RE.  We know that we will need to go the ART route since Mr. R has a 14 yr old vasectomy and I know that I likely have issues based on results of 2009 tests.  It is confirmed.  We received our ballpark IVF costs and we go home to start saving.  I should add that two divorces, a move across country and a career ending shoulder surgery for Mr. R meant that financially we were in the toilet already. But at 34 years old I knew my time was running out.  We start saving, we cut everything we can think of, we announce our troubles to family on FB and start begging for help through a crowd-funding website.  We have yard sales, and sell pretty much everything.  You know how much we made? $3,000 of the $15,000 we would need.

September 2013 we hear about a trial that I would qualify for.  It's not entirely free, but with just a little more saving we can cover the out of pocket portion:  $4,500 for the trial, facility fees and for Mr. Rs TESE procedure.  We're elated when our parents offer to make up the difference. We get on the list and wait... 3 long months we wait while the government shutdown puts the study on hold.

You know how the trial went.  It's well documented here.  But after laying down every penny we had in the world for our one shot at IVF we were out of options.  I didn't qualify for a second round of the trial and we were completely out of money. I had reached the end of the road. Until we received a call from Mr. Rs urologist asking us where she should send the refund check to? Huh?  Refund?

Well she accepted our debit card payment for the TESE procedure by phone, but when she submitted it to Mr.Rs insurance company they accepted the claim and paid out.... INSURANCE COMPANY?  I mean, we knew he had insurance with BlueCross but he'd had this insurance before with another employer and they barely paid for anything so we had no clue that they might pay for TESE... but why would they?  I mean it's a fertility procedure.  So Mr. R called them to find out and he discovered that HE HAS FERTILITY COVER!!  They will cover up to 4 IVFcycles. (Lot's more fine print, but the point is... THEY WILL COVER 4 TRIES!!)

Now judge me all you like, but you should know that when this blog began Mr. R and I were not married.... *Shock!* I know... After two nasty divorces we were quite happy to never get married again. Without being married I was stuck on my company crappy insurance, while over there on his side was the Golden Egg of insurance policies!  So yeah, we got married!  It was the two of us and a Judge friend of ours.  We wore blue jeans, it was a Sunday and he married us at his desk in the back of his courthouse in our country town on a Sunday.  I have plans for a proper wedding, but the marriage wasn't too bad. The very next day Mr. R added me to his insurance and we were all set! I called our RE and they checked and yes, she confirmed what Mr. R had been told, 4 cycles IVF, but she wasn't sure about meds.  Meds we could cover... probably.  I have subscribed to all the discount programs.  I've had those cards for ages and we could live on peanut butter and beans and rice for a while till we had enough saved for meds.

Yesterday I called my meds around to pharmacies to get quotes.  For interests sake I asked what the out of pocket would be for each drug... Let me just say that there is a group of VERY wealthy nuns out there somewhere.  Follistim = $1,618 each and I need 4 of them - though I did find much cheaper options for that later in the day.

One of the pharmacies that my nurse had sent the prescription to called me to give me their "after insurance" quote..... My palms were sweating...
Her: "So your doctor says we cannot put through the order for Micro Lupron just yet, you'll need to add $10 for that to the total I am going to give you.  But your order comes to..."
*I held my breath*
"one-two-nine-oh-nine..."
Me: TWELVE THOUSAND?
Her: "No.."
Me (cutting in): One thousand...
Her (cutting in): NO! One hundred twenty nine dollars and nine cents."
Me: *faint!*

Ladies and gentlemen... I am about to do a full IVF cycle for an estimated $2,639.09 total which includes facilities, TESE, and drugs. And the only reason it's so high is because the RE's surgical center is out of network.  I'd like to remind you that my "free" trial cycle cost us $4,500... and I had no say in anything.  I wish that ALL of us had this cover.  It is ridiculous to me how many insurance companies will cover bariatric surgery, but infertility is a no-no.  Something MUST be done about this!

I am over the moon excited, but at the same time I feel sick with guilt because  after 7 years of panicking about the money, I got lucky. Mr R. happens to work for a mostly-male company where I guess they just didn't think about fertility claims?  I don't know how it happened, but my heart aches for all who are having to pay this out of pocket.  Who are having to fight to save the money, before the fight for a take home baby.  Infertility is a medical issue.  Medical insurance should pay for medical issues. We should ALL be covered. It's that simple.

2 comments:

  1. OMG OMG OMG I'm SOOO elated for you!!!! Wow that amazing news!!!!!!! Please keep us posted. Yay!!!! Hugs to you girl!!!!

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    1. Thanks for the support and for checking by with me. We're gearing up to start now. T minus 11 days! Eeeeeeep!

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