Wednesday, February 24, 2016

Insurance is My New Hobby & A Glimmer of Good News

After the insurance company started jacking me around, I was totally lost.   How can an insurance plan both cover and exclude IVF?  It makes no sense!  I paid a TON of money for this insurance, and now they are saying they don't even cover the reason I signed up for it?  Health insurance is screwed up in the US, people.  Seriously screwed up.  But you probably already knew that.

Well, I'm barren with nothing better to do, so I have made the insurance company my new hobby.  I am nearing what is called "exhaustion," which means I have almost done all I can within the insurance company.  It is appropriately named.  I did every claim separately, I appealed, appealed, appealed, met every deadline, provided every document.  I faxed hundreds of documents to a half dozen people and agencies.  There's even a delightful laproscopic photo of my deformed lady bits I always include.

I got the state involved.  I now have something called an ombudsman.  The first round didn't work with the state, but hell no, I'm not done.  The second round has been out for months, I think even the state is confused.  It is now on responses to responses to responses.  There are a lot of forms involved, a lot of people.  I am annoying as hell, but I'm not going anywhere.  I've got all day, and I can get a lot louder.

The next step would be to lawyer up and sue, and that's where I'm out of my depth.  This has to be in federal court and has some kind of process called ERISA, and I am TERRIFIED of losing my anonymity in a public court.  There's also maybe one more state appeal.

But something good happened!

While I was screaming very loudly, the insurance coughed up some cash!  They paid for the scans, the non-embryology labs, most of the drugs, and every itemized part they could, down to the hydrocodone and the Crinone.  That left my bill at about $8,000, and about half of that is CCS, which we knew would be out of pocket anyway, plus the straight fertility drugs, about $3,000, and anesthesia.  The anesthesia bill is in collections, so it's either the $550 cash price or the $1000 billed to insurance price.  No idea.

I think this is intended to back me off.  And don't get me wrong, this is pretty awesome.  But I made it this far.  The insurance company LIED to me.  I'm fighting for the women who don't have the resources I have, and I'm not going to shut up until they make me.

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