How did this happen? I'm so brokenhearted...


#1

So today I found out that my insurance isn’t covering any of my shots from this cycle. I officially owe $1,301.80. I’m heartbroken. They kept telling me they would cover the shots, and I’m not sure what happened. My husband told me that if this cycle doesn’t work we won’t be able to do it again. I can’t believe that this may be it for me. I’m so heartbroken and sick and I don’t know what to do or think. Now more then ever I’m hoping to get a BFP this cycle. I want this more then anything. But today I am 10DPO and have AF cramps so I might as well accept that my journey is over. I will probably never be a mother. What do I do? :frowning:


#2

Don’t give up yet! Call the insurance company tomorrow! I can’t tell you how many times mine doesn’t cover things…and I get a bill. I call and ask wtf?. And it’s a mistake on their end! Insuance comaonies do this because they hope you’ll be stupid and just pay the bill! Seriously it happens alllllll the time.

And it may have worked! :babydust: :babydust: It’s not over yet! Hang in there!


#3

Yeah I’m going to call tomorrow. I just have so much on my plate right now that this is the last thing that I needed. It seems like nothing can go right for me. I just hope that this cycle works and I don’t have to worry about any of this for a long long time.


#4

If you have paperwork from HR that shows injectible meds are covered, you can tell them that. I have Aetna, and they have a department for fertility program. This is the people that I only want to talk to regarding my infertility coverage. I had a similar problem too. My meds are supplied by Aetna specialty pharmacy. I called them to get my injectibles, and they looked at my prescription coverage and it only shows oral meds are covered (clomid). But there is a section in my insurance plan under ‘infertility coverage’ where it says infertility drugs are covered including oral and injectibles. So I have to point that out to the Aetna specialty pharmacy and have the Aetna infertility program confirmed what I understood from reading my plan and have the pharmacy called the program.

Not sure if your insurance co have its own fertility program but I would start from there.


#5

[QUOTE=alexi]If you have paperwork from HR that shows injectible meds are covered, you can tell them that. I have Aetna, and they have a department for fertility program. This is the people that I only want to talk to regarding my infertility coverage. I had a similar problem too. My meds are supplied by Aetna specialty pharmacy. I called them to get my injectibles, and they looked at my prescription coverage and it only shows oral meds are covered (clomid). But there is a section in my insurance plan under ‘infertility coverage’ where it says infertility drugs are covered including oral and injectibles. So I have to point that out to the Aetna specialty pharmacy and have the Aetna infertility program confirmed what I understood from reading my plan and have the pharmacy called the program.

Not sure if your insurance co have its own fertility program but I would start from there.[/QUOTE]

No my insurance doesn’t have a fertility program, and their infertility coverage sucks. And I don’t have any paper showing it would be covered, I just have called them about 10 times and was always told they would be. So I don’t really know what’s going on. And I logged onto my account through my insurance, and it doesn’t show that they denied it, it says “Paid” but its showing “My Share.” as the entire payment. Here, let me copy and paste what it says… (I’ll just post one claim since they both say the same things)

Financial Summary
Status Paid
Amount charged $575.89
Amount paid by plan $0.00
Network savings $0.00
Other insurance $0.00

Your Responsibility
Deductible $575.89
Copayment $0.00
Coinsurance $0.00
Amount not covered $0.00
Your share $575.89

So I don’t know what the heck. It shows it was “covered” because they didn’t deny it, yet my deductible is the entire amount!? I don’t understand :grr: :grr: :grr:


#6

I have Aetna as well. l have been told for months that the injections that I require for the IUI would be covered. I spoke with the specialists in that fertility dept and was finally explained that the injections were covered, I would just have to pay 100% of the cost. I was like WTF…If I have to pay 100% then that means that you are not covering it. I was then told that because the plan will allow me to go to the local pharmacy then it is considered as covered. The copay is just the entire cost of the meds. Maybe your husband has the flex spending card at his job that can be used to pay for the meds. I understand exactly how you feel. And, check with the clinic that you are going to and see if they have any meds that have been donated. Good luck!!!


#7

krissersroro- It looks like it was covered, but it went towards your deductible. If you don’t know, deductible is the amount you owe before your insurance starts paying anything. You should find out that amount before you go any further. You also should verify your plan year. Most plan years are January to December, which means your deductible will start over again in January.

If you have any questions, feel free to pm me.

Good luck!


#8

[quote=krissersroro]No my insurance doesn’t have a fertility program, and their infertility coverage sucks. And I don’t have any paper showing it would be covered, I just have called them about 10 times and was always told they would be. So I don’t really know what’s going on. And I logged onto my account through my insurance, and it doesn’t show that they denied it, it says “Paid” but its showing “My Share.” as the entire payment. Here, let me copy and paste what it says… (I’ll just post one claim since they both say the same things)

Financial Summary
Status Paid
Amount charged $575.89
Amount paid by plan $0.00
Network savings $0.00
Other insurance $0.00

Your Responsibility
Deductible $575.89
Copayment $0.00
Coinsurance $0.00
Amount not covered $0.00
Your share $575.89

So I don’t know what the heck. It shows it was “covered” because they didn’t deny it, yet my deductible is the entire amount!? I don’t understand :grr: :grr: :grr:[/quote]

Insurance companies can be soo hard to deal with. When my DH was first prescribed HCG at first the insurance wouldn’t cover it - when we called then they told us that we needed to send it to them for pre-approval - then they would cover most of the cost - we would still be responsible for part of it. Trying to get the pre-approval took three weeks between the drs office and the insurance company. Then we had further obstacles to get the medicine sent to us - we wanted a three month supply - the insurance company will only cover one month supply - which in actuality only last 23 days since another vile would push it to over 30 days. It’s just a big pain in the butt. DH and I wanted to throw in the towel too, but decided to stick through it.

Hang in there. Hopefully you’ll be able to find a way with the insurance company so that they’ll cover it. It can be very frustrating.

I can totally understand where you’re coming from and how devastating this must be. I’m really hoping you guys get good news for this cycle and that AF does not come. Keep us updated!!!


#9

Oh yes, deductible! I did have to pay that and meet my deductible for this plan year before insurance pay the cost of the meds. You also need to find out the percentage of the cost they’re paying for the meds. Even though they said it’s covered, they may just be paying 50% of it. Deductible includes what you paid for copays, etc.