We had a great time. I will post pics & ruminations soon. But for now, I am just catching up on all the blog-action I have missed in the meantime.
Unfortunately, I'm out of the ttc running for another month. AF appeared a week early (and in concert with some disastrous digestive distress in a place with no running water and no toilet paper. It was ugly, let me tell you!) I'm on CD10 now, so better luck next month.
In January, my job will be switching health insurers, which is very scary to me given how easy I have had it until now. My current insurer, GHI, is renowned for sucking, but they happen to have a nice deal with my RE, so while their network blows and I have no primary care doc under them, I have enjoyed hassle-free coverage for all manner of treatments, including two elective surgeries. We are switching to Aetna, which on one hand, means I will be able to go back to my previous primary care doc, but on the other hand, the cozy deal my RE has with GHI is over. I don't know what Aetna's coverage is like-- anyone have any ideas? Of course, I will be attending the open enrollment and pulling the rep aside afterwards for a thorough grilling on their infertility coverage. What kind of questions (apart from the obvious) should I ask? Is it necessary to state that I am effectively "infertile" because my partner is female, or can I simply ask about infertility coverage in general?
I have Aetna and you know about my trials and tribulations the last 3 months:(
ReplyDeleteDon't let them know anything. Just ask about fertility coverage. If they offer let's say a basic,intermediate and premium see if all three have the same dollar cap amount.
They only offered three through my company and all three had a 10K cap.I hope your company didn't go the cheap route,because Aetna does offer better fert.coverage.
And sorry to here you had the poops.lol
Welcome home! I can't wait to hear your exciting stories.
ReplyDeleteI don't think it's necessary to tell the rep why your asking about infertility coverage - they should just be able to tell you what they cover. One thing that might be important is if they cover IVF, whether they have requirements for the number of IUIs you have to do first etc. Basically, what you need to do to prove your infertility to them. Good luck! I hate figuring out insurance stuff.
dont know about aetn.a but i am wishing you good luck. can't wait for the pics!
ReplyDeleteNo insurance advice here (I'm in the dark myself), but I'm totally stoked that you're back! I can't wait to hear about your trip!
ReplyDeleteYay! You are back! I can't wait to hear about your trip--poop and all!
ReplyDeleteIt stinks to have to deal with insurance, period, BUT I think you are going to have better coverage and range of options with Aetna than GHI.
That said, if they ask you simply say to the effect of: "I've been having sex/trying to get pregnant for over a year now and it's not working". PERIOD. No mention that you are a lesbian, no mention your partner is a woman. They cannot ask you these things and you should not offer up this information b/c some policies can deny you coverage or make you wait a year doing IUI's or some other nonsense.
Yes, I'm telling you to lie.
I had GHI when I worked in NYC and it was pretty good to us. When S. was undergoing IUIs at our og/gyn's office, we only got charged an office visit--even for ultrasounding..
ReplyDeletethat being said, everyone is right--say as little as humanly possible. I know that here in Mass there is mandatory infertility coverage, so say exactly what Pufferfish said--say how many times you've "tried" (no talking about your female partner) and see what they say.
I agree with the others, say as little as possible about your partner. BC/BS denied us coverage until we had paid for 6 IUIs out of pocket. I didn't qualify as infertile because of my lack of exposure to sperm. We went through 3 levels of appeal fighting for coverage- it seemed only fair since a woman married to a man with a zero sperm count would automatically get coverage!
ReplyDelete