IVF 2.2 - I hate insurance companies!!!

Like the title says .. I Hate Insurance Companies!!! Why you might ask? Well let me tell you. Steve and I payed full out of pocket costs for our IVF cycle in July.  We didn't have insurance coverage so that was that.  If we had done the IVF in November as planned we would also have payed cash for that cycle too.

Then in November we had open enrollment for our insurance and in the "changes for 2012" page of the booklet I noticed that it said the more expensive PPO would now be covering infertility treatments at 50% and included GIFT/ZIFT/IVF.  So I elected the more expensive plan and figured we were good. 

That was until I got a call from the IVF clinic the week between Christmas and New Years and was told that it doesn't appear I had coverage for IVF in 2012.  Although the information about the deductible and copays was also incorrect.  The billing lady figured that the insurance company hadn't updated its information yet because it was not the beginning of the year.  So she told me she would call again after the first and verify the benefits.  But it really made me nervous!

So being the obsessive compulsive and gotta have everything together person that I am, I of course called the insurance company first thing January 3rd (because of course they were closed on the 2nd in observance of the holiday). And lo and behold, I do not actually have coverage for IVF. What??!! So I fire off an email to the Admin person on campus and asked them why I was being told I had no coverage when I had 2 documents showing I did.  I of course scanned those documents in the email and hoped for the best.

The next day I get an email back from our corporate office telling me that the insurance company would call me directly to discuss the coverage.  I check my voicemail and there is a voicemail from someone at the insurance company, her name was Jacinda.  I call them first thing and Jacinda was not available so the lady on the line said she could help me.  Long story short, we spent about 2 hours on the phone over multiple phone calls trying to figure out what IVR was because this was covered while IVF was excluded. This went on until about noon when the lady, Donna, told me she would have to talk to her supervisor and call me back once she got everything straightened out.

At 12:51 pm I got a call from the insurance company.  It was the girl I talked to the day before, the first time I called the insurance company. She told me that she had made a mistake the day before and that the IVF was in fact covered.  Apparently there was a second page to the benefits and she hadn't realized it. WTH?? I walk away from my cubicle to talk to a coworker for a moment, walk back and see that I have a voicemail. It's the IVF clinic, they wanted to let me know they had also called the insurance company and was told that there was no coverage.

I call the IVF clinic back and tell her everything that has transpired over the past few days and she tells me that unfortunately she needs to hear from the insurance company that we have coverage and not from me.  So back on the phone I go with the insurance company to find out what the heck is going on.  This time I ask for Jacinda and luckily she was available.  She verified the benefits again explaining that the system needed an update that would show the coverage. I asked her to call the clinic and let them know, so she put me on hold, called the clinic.  Then while I am still on hold I get a call from the clinic letting me know everything is fine. So yay!! Hang up with the clinic and wait for the insurance company to come back on the line.  She comes back and then gives me all the information I need so that if anything gets denied I can get it taken care of.  Huge sigh of relief, everything is going to be OK!!

Or so I thought ... because an hour later I get a phone call from the clinic again.  Apparently she called the insurance company again to find out if the embryo cryopreservation would be covered and talked to Donna.  Apparently Donna was still attempted to find out what IVR meant and what was covered under that. So the clinic didn't want to accept the 50% coverage quote they received until they heard it from another person at the insurance company.  Once again I called the insurance company to find out what the heck was going on.  I talked to Jacinda again and she was really upset that Donna had talked to the clinic again. She tells me that she will have her supervisor call the clinic the next day (because they were already gone for the day by this time) and let them know that everything is fine.  I voiced my concern that if we were having such a difficult time obtaining verbal confirmation of benefits, what was going to happen when the clinic began submitting bills for the cycle.  Jacinda told me she had the same concern so her boss was going to put a flag on the account letting the billing people know they needed to read the notes and would see that the services would be covered.  But of course things could slip through the cracks and if there were any problems I should call them immediately and they would get it taken care of.

So It's official, we have 50% coverage for our IVF cycle.  YAY!!!

On a side note - have been on the lupron for 5 days now and things are going well.  Stopped my birth control pills last night so I am expecting my period in the next few days. Thursday is my baseline ultrasound and bloodwork and Friday I start the stim medications.  It's hard to believe that in 3 weeks we will hopefully be transfering our babies back into my uterus!!  It's so exciting!!!!