Hello ladies, this is my first message, though I've been a silent observer for some time. I had a day today and just had to vent. You all know how it is!
To sum up, I have PCOS diagnosed last spring, ttc#1 for 2 years and some change, I'm on metformin 500mg bid, and just started my 5th round of clomid, did 3 rounds last summer but due to another health issue, accessory neuropathy, longer story, DH and I took a break, just starting the gluc up again in the new year, and just started round 2.
So as to the reasons why I've had a day...My insurance company changed things on me and no longer covered my Clomid. I called them to have words and they told me they put Clomid on their list of "lifestyle drugs". The lady was nice enough about it, but something about that term just set me off. What the hell is that? I'd love to see this list, what is it marijuana, cocaine, though honestly most likely along with things like Viagra. However this sent me into a crying jag, and a minor breakdown, at work no less. Lifestyle drug, like I would ever choose this!?! I wouldn't wish this on my worst enemy, the emotional rollar coaster...a lifestyle drug, like this is my choice, or any of our choices. Do these insurance bozos have any idea what this is like? Lifestyle, my aunt fannie!
See, I'm getting all worked up all over again.
Anyway, I just needed to vent, and end my silence.
-C

Lifestyle drugs ?
What a joke !!!!
Any one suffering from infertility and wants to have a child needs to take the drugs to conceive .
Its not like were all having one big party here shooting hormones for kicks . I bet they cover all pre + post op meds
for elective surgurys like face lifts + boob jobs though. I dont mean to offend any one who have had those proceedures . I strongly believe that infertility meds should be covered or at least partially covered by all health insurance plans

I like how these insurance companies pay for drug addicts to go to rehab over and over! I think there should be a limit to how many times they will pay. Here we are ttc using legal drugs and they won't pay. Makes you wonder!! makes me mad and sad!!

Okay- I'm going to defend the ins companies- *ducking*

The group you are part of (assuming your ins is through your or your dh's employer) is who decides what benefits you get. The ins companies would LOVE to cover EVERYTHING for EVERYONE and get the highest premiums, but the employers tell what they want the benefits to be.

If your insurance won't cover infertility treatments, then raise cain with your group. I've seen people get things changed.

OTOH- I used to have a company that didn't pay for Clomid. I got the generic at Walgreens and only paid about $30 a month.

I hope your day gets better. http://www.healthboards.com/ubb/smile.gif

Tessa,
Actually my company's corporate benefits hotline is who told me about the "list". I hunted through all my benefits crap, found a reference to a list, but no actual list. So, yeah, Cargill did choose to not cover this, but the funny thing is they'll cover 50% of injectibles and standard office visit and hospital copays apply, though they set a limit of number of times they'll cover IVF and stuff. It really makes it sound like they cover more of the more invasive procedures.
Can anyone give me an idea how much these other procedures cost? Having only gotten as far as the gluc and clomid I am unsure of the next step.
Cathy

I have worked for the same company for more than 10 years . They have provided me health insurance the whole time . We have always had to pay a small co pay for our health insurance while employer pays the lions share. Over the last 10 years our coverage has become worse , higher co pays - less coverage . My company has switched coverage at lease once to try to find more affordable coverage . I just recently had to start paying $5.00 a week more for my insurance . The reason being the rising cost of insurance premiums to businesses, not an employer being cheap or frugal . Infertility coverages varies from state to state. I truly believe all people should be entitled to the same quality care + coverage . lets face it Insurance companies like every thing else are about making money first , providing a service second .

it's all about making the money. The insurance companies don't seem to care about the people, just get the money from them, and do everything they can to not give anything back. Don't even get me started on the disappearance of customer service, not only in insurance, but any HR issue it seems, you can't call a person direct, it's all automated voice systems. It frustrates me so. They probably hope that we all will just find our time more valuable than that and not fight it. I am going to go on record with my company and tell them it sucks, but I'll put it a bit more diplomatically.
It suckth mightily!
-C

The customer service really sucks. My HR department won't deal with HR issues any more. We have to call a toll-free number and go through 100,000 menus to finally get a person. The person on the other line won't give your their full name. And I'm not sure how to get a hold of a supervisor. I'm told "I can handle your problems, it's not our policy to pass you on to supervisors." I've had three people at the company tell me they pay for everything including IUI, but not IVF. However, even though three people have told me this, I can't get them to pay for my January IUI. One other person has told me "artificial means of conception" aren't covered. Can't I get a supervisor who can reconcile all of these difference? Not at my company or the firm they hired to manage our insurance.

I wrote a formal appeal for last year's expenses on Feb 2nd. I haven't heard anything from them yet. I requested a copy of the plan contract, and they said that my company hasn't provided it yet to the people who manange our benefits. How can they manage a plan without having a current copy of the contract?

My DH says to take it to the state insurance rep. I guess there are some laws governing this. However, I'm afraid my company will put a black mark in my record if I get the state involved. It's always a last resort option.

Anyway, I'm sorry I'm venting. The insurance company has paid in full my last two trips to my new doc. I think they have a better claims department that my old doc. While they are paying, I should probably just shut up and not rock the boat.

I can't believe these people mess with us women on hormones? lol

Good Luck with ttc and insurance companies!
Mindy

CathyW,

Regarding your question about cost.....
I pay about $30 for clomid (100mg) once/month
$13 for 7 ODK
$360 for u/s at old doc , $170 for u/s at new doc.
(However, at new doc I have two u/s per month.)
$305 for IUI at old doc, $110 for IUI at new doc.
$240 for sperm wash.

I haven't tired injectibles yet so I don't know that cost except they are about $1500-$2500 per month.

Good Luck,
Mindy

Mindy,

Thanks for the info. I guess I shouldn't be nearly so snippy about having to pay $30 for my clomid. The other stuff is so much more expensive.
Boy, I hope I get knocked up soon. I hope you do too, so we don't have to resort to the super high end stuff. Heck I hope we all just get knocked up soon.
Yikes!
Cathy

Let's raise our glasses to getting "knocked up"! ;-)

Amen!