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Monday, June 20, 2005

BAD BAD BAD NEWS... (with a brief update)

So I went in for my mid-cycle monitoring today expecting that the worse thing that I could find out is that my follies were not mature and that I would have to up the clomid dose next time... but that was not the worst thing...

As I got to the sign in window I was told that my insurance doesn't cover infertility (which I knew) what I didn't know is that the minute this doctor prescribed the clomid I was "officially" marked as infertile... So.. I was expected to pay a $450 monitoring fee for my sonogram and office visits... EACH CYCLE... I burst into tears in the office... The nurse was very kind... and told me all about using "OPK's" to find out my "O" time for this month... (Thanks... uhm... I knew about that about 2 years before I got to infertility...) So... unless I have a "fluke" pregnancy this month... we have no choice but to got back to trying au natural... And since I now have PCOS... the likelihood of getting a good egg on my own... seems slim... (Although Metformin does increase your chances of getting pg).

So... I did not see the doctor... I do not know the size of my follicles and as far as I can tell our journey is OVER right here... We can not afford to pay that kind of $$$ per month.... If we were to go to IUI's the out of pocket would be $850 per month... I am so depressed and shocked... The worst part is that I will probably be charged for my LAST u/s since that is when I was deemed officially infertile and prescribed the clomid... We'll have to wait and see if I am sent a bill. Niiiice.

I checked and I can not even upgrade my insurance to get infertility coverage... They just do not offer it. So I am stuck.

If your insurance pays for infertility treatments... I really want you to get on your knees and thank God right now...

Last year two days before vacation I found out that I was having my second miscarriage... This year two day before vacation I am told my insurance sucks... Wow... sort of makes you never want to go out of town...

UPDATE:
Thanks for all the concerns... My doctor is not going to code it as anything else... So... It is start over with my 5th doctor... or just hope things happen naturally... The insurance company is no help either... they don't cover any "fertility" treatments and there is no upgrade that will include it... So basically I am just SCREWED...I have been bawling all friggin day and I am just exhausted...

We decided to leave for Florida in the morning afterall... because I want to get the hell out of town before I explode!!!!

Our laptop can't be fixed so I don't know when I will update... I plan to be back home in TX on the 6th of July... But I hope to find a computer to check in at before then! I will do OPK's all week (even though they have never worked for me) and PRAY that things happen this month while I have clomid in my system... Who knows? We all know God can work miracles... Maybe he will work one for us this month...

Depressed and leaving for Disney World... I will update as often as I can...

I will miss you gals while I am gone!

17 Comments:

Anonymous alex said...

Jamie,

oh man that sucks...I wish I could do something...oh I know I could send you the chai I promised a year ago. I bet that would totally make up for this huh....

Since this is your blog I will not cuss but I really hate insurance companies and medical workers who assume we are idiots. I am really really sad and frustrated for you.

alex

10:12 AM  
Blogger Chee Chee said...

I just happened upon your blog from a link on someone else's blog. I am so sorry about this. Health insurance should absolutely cover infertility. It's just awful that IF coverage isn't mandatory in every State.

11:56 AM  
Blogger Claudia said...

Wow, that's really terrible to hear. Is there any way that you can get the doctor's office to be a little creative with their insurance coding? Lots of docs do it, and even if they won't maybe another doctor will.

Sorry to hear about your roadblock, and I'm hoping you'll find a way around it.

11:58 AM  
Anonymous kiwi said...

I am so sorry for the bad news. That really sucks. Infertility is hard enough on itself to deal with, emotionnally and physically, without us having to live with the financial side of it on top of everything.

I really hope you can find a way for your journey to continue and end in a happy ever after way.

12:15 PM  
Anonymous Catherine said...

I totally understand your situation. With my first round of monitoring, the u/s tech coded me as "diagnostic" b/c I wasn't responding to Clomid. I had NO IDEA what a gift that was until my second round when I went to check-out and was told I owed $370 for the u/s alone. Its sooo miserable!!

Try to think positively at least through this cycle . . . you've got a good dose of Clomid in you and you are heading for the famous "just relax and take a vacation" remedy. Good luck . . .

1:57 PM  
Blogger Panda said...

Jamie,

The more I read about what you U.S. chicks have to pay for treatment, the less I think our government sucks.

I just cant believe you have to pay so much for what is basic healthcare.

In Australia, the treatment you're talking about we pay $130 (clinic visit, u/s and meds) but get $110 of that back from the public health system.

I'm really sorry they've hit you with this. Maybe a bit of creative accounting is called for on the part of your clinic.

Or a revolution.

3:03 PM  
Anonymous oliviadrab said...

Insurance companies suck so much. They are as evil as Tom Cruise. I hope you have a wonderful time at Disney. We'll keep the candles lit for you for when you get back.

3:23 PM  
Anonymous Sara said...

I am so sorry, Jaime. We are teachers, we slave, work our asses off, and make crappy salaries. You'd think the least we could have is some decent insurance. I am going through the same thing here. I am currently attempting to upgrade to a PPO Plus plan that covers $3000, but that would disappear in like . . what, two visits?

I have my fingers crossed that your vacation will do the trick for you and you will come back pleasantly knocked up and smilin' from ear to ear.

4:38 PM  
Blogger Lesley said...

Hon, It all sux big time. I am not covered by any insurance as you know either. Af arrived and I am suffering major with it. My pain is just so bad... Like it's not hard enough going through af as it is. Try and have some fun.
Love lesley

5:10 PM  
Blogger Mari said...

I'm in shock with you, I can't believe the type of b/s that you have to go through just for fertility treatment in the US. What was even worse to read was that as soon as you were perscribed Clomid (which is the most commonly used drug) you were labelled as Infertile.
I hope that you vacation does everything for you.

5:14 PM  
Blogger Crazy Me said...

James, I am so, so sorry to hear your news. This royally, without a doubt totally sucks!

7:19 PM  
Anonymous Anonymous said...

I'm sorry Jamie. I really loathe insurance companies and how they treat infertility as some 'vanity' treatment akin to botox instead of the very real and devastating disease it is.

Thinking of you.

Emily

9:01 PM  
Anonymous thalia said...

Jamie - so sorry to hear this. This whole situation is just horrible. I do hope you manage to enjoy your holiday

11:48 PM  
Anonymous Anonymous said...

Jamie, I have been reading you for a while as part of Julie's Big List O'Blogs.

I have a good friend who's going through IVF right now. Her insurance is pretty much capped out and they aren't ready to be done trying. We were researching alternate funding, and looking at companies who's insurance DOES pay.

We found out that even part time employees at Walgreens (a chain drug store, don't know if there are any in your area) pays for infertility treatments even for their part time employees. Might be worth a few Saturdays a month if you can get them to cover? I'd definitely look into it.

5:24 AM  
Blogger VHMPrincess said...

That sucks...BUT

I have PCOS. I was on metformin + clomid and got pregnant...i used opks and temping and VOILA...saw the O and caught it...You don't have to have the u/s to know when you're going to ovulate. If you're O date is later than day 19 or 20 or so, up the dose next time (if you don't get pregnant) to get a healthier egg). This is what my dr tries before we take the step into the expensive monitoring.

5:43 AM  
Blogger PJ said...

Wow Jamie, you've really gotten the short end of the stick on this one.

I am so fortunate to live in Illinois. We have mandatory coverage. There's not a day that goes by that I don't feel grateful that we have this.

The one suggestion I do have for you is to see a regular Endocrinologist to get the PCOS stuff under control. Maybe s/he wouldn't have to code it as infertility because you're really there to get your PCOS symptoms under control. Lack of ovulation is a symptom of PCOS.

I hope you have a good vacation in spite of everything that's gone so wrong.

6:26 AM  
Blogger Heather P. said...

Jamie, I responded to your post on PW. Your Dr is charging way to much for the procedure. Look for another DR. I hope that you have a great time in Disney and that Mickey sends you home with a gift!!

One of the ladies on TTC after a m/c went on vacation to las vegas and came back pregnant Lets hope the same for you

8:39 AM  

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