With Chris's new job also came new insurance. So, when we got our new insurance cards 3+ weeks ago, I gave that to our financial lady at our doctor's office since all finances have to be settled prior to an IVF cycle. If you pay out of pocket, you have to pay everything up front so they make certain that your insurance is valid at that time as well so that we aren't charged the out of pocket price by the doctor's office. A little over 2 weeks ago, I got a call from our financial lady saying that Aetna has an approval process where they need bloodwork and medical history so that they can make the call on whether or not you're "infertile." I didn't realize that there was a possibility that the doctor was wrong in my diagnosis and that an insurance company would be the ones who determine my fertility status.
Part of the process was a phone interview where they ask about your fertility history and pregnancy history. Great, just what I wanted to do. Let me explain to a stranger about how my son died over the phone. I made the phone call and we went over how many IVFs we've done, how many IUIs, etc. Then, they get to the pregnancy history. They ask you how many pregnancies you have and if they were abortions (haha - seriously? You think an infertile person going through IVF would have an abortion?), miscarriages, or full term. I picked explaining my miscarriage first since that's the easiest. Then, I told them about Nathan. I caught her off guard and she had to speak with her manager about what to classify that as. I sure hope they classified him as full term and not just some miscarriage. I didn't ask because I just wanted to get off the phone at this point. They told me to wait a couple minutes on the phone while they reviewed my information. After a couple of minutes of waiting, it was confirmed that I am infertile. Hooray! It was a good feeling knowing that my doctor wasn't wrong. Definitely some sarcasm included.
So, I passed the first test and the second test was a blood test that then had to be faxed to Aetna. If your number is over Aetna's threshold, they won't provide coverage for own egg IVF, only donor eggs. I was extremely nervous about this part since the test they measure is actually the test that confirmed I had an issue conceiving. I got the test completed on the 17th and we were supposed to hear by the 23rd. When we didn't hear by last Thursday, I called our financial lady and she confirmed that they hadn't heard anything yet. The financial lady called yesterday and again, said they hadn't heard so it might be a good idea for me to check in (considering my IVF cycle officially started with my first ultrasound, which was last Friday). I called Aetna and they explained to me that they didn't have any of my records and proceeded to ask me about my previous history. I refused to tell them again and they "found" the information, which I'm pretty sure was sitting in front of them the entire time. They told me to call my doctor's office and have them resend the information and they would put a rush on it. I called the financial lady, who called Aetna this morning, who had my medical records and confirmed that I passed both tests, am quite infertile, and qualify for coverage.
So, in summary, I am infertile but we do get coverage for all of our cycles. Yay for the coverage! I'm glad this headache is over with and we can focus on bigger and better things like getting and staying pregnant.
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