Wednesday, January 9, 2008

First RE Appointment is tomorrow

I am not nervous about it , I guess. But, I called my health insurance yesterday just to be certain that I do not need a referral...I don't. BUT, when I was talking to them, they imformed me that their definition of IF is 2 YEARS of trying.....not the one year that I was originally told and totally not what the medical term of IF means.

I asked them how they know if has been two years....expecially since we have only had this insurance company since Aug 1, 2007.

The woman on the phone said that the inital consultation is covered, it just would be the treatment that would fall under the "trying for two years" crap. And after the consultation, the doctor sends the insurance company a letter about what the problem may be, the types of tests needed, the course of action to be taken, etc. The insurance company bases it's answer on what the doctor tells them regarding how long we have been trying. They also said that they are not able to verify things that occur in your personal life - just what the doctor says.

So, now I am thinking that since they have no access to my payment records (from the payment of BCP) since this is a new insurance company maybe I can swing it.

Plus, I have been trying since 2006, so this is actually the 3rd calendar year that we are trying (2006, 2007, 2008) - maybe the doctor could be slick in the wording so that it is up to interpretation. I am in my second year of tying, so maybe 2 years is that interpretation.

Plus I found out that even if it is approved, it could take 30-45 days for that approval. Which means it could be another 2 months to start any type of testing and/or treatment.

I am so wishing that I get pregnant this cycle (positive OPK yesterday) and I do not have to go through this crap with the insurance.

Yes, I know we can pay out of pocket....and I know a lot of women do. But, as many of you know, it is really expensive and if the insurance will pay for it, I guess I will just have to wait.

1 comment:

Ariella said...

Do you have Kaiser? They pulled that two year crap on me too! Stupid people! I mean can anyone seriously exspect us to wait 2 years for even testing?

GL at your first appt and I hope you end up not needing it!

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