Well the last month has been a bit of a whirlwind. I don't even know where to start. You know that Kevin and I decided at the end of July that we were going to do an IVF cycle in October. So in the past few weeks I have talked to insurance reps, pharmacy reps, and the nurses at my doctor's office more than I have my family. No joke. It feels like I talk to someone from one of these three places everyday. When I call my doctor's office, all I have to say is "hey, it's Katy." Their response is "Hey, what's up?" I don't know if that's a good thing or a bad one.
Anyone who has done or planned to do an IVF cycle knows how expensive it is. We got a preliminary report about how much the procedure would cost. Then we got a list of medications. My nurse told me to call my insurance company and find out what, if any, coverage I had for those medicines. She told me how important it was to tell them that I was taking the medications in conjunction with an IVF cycle. Because of my low AMH, I have to have the highest medication protocol they have. So of course that means that the meds are going to cost more because I need more of them.
So I called the pharmaceutical side of my insurance company. (Side Note: There are two separate parts of my insurance company: the Medical part and the Pharmaceutical part. You will see that they apparently don't talk to each other) When I talked to the first representative, I told her that I was doing an IVF cycle and I needed to know how much my medicines were going to cost. I repeated to her that I was needing these medications so that I could become pregnant with the assistance of doctors. For a third time, I told her that my husband and I could not have children on our own and needed the assistance of some really smart people. We went through the list together and she gave me a co-pay amount for each medication. The total? Drum roll please (imagine it)! Less than $500. That was for 8 IVF medications. I couldn't believe it! I was sitting in my office and my jaw dropped to my desk. I was speechless. I asked her if she was positive that she was right. I reminded her that I was doing IVF and she said I know but that's what it says your co-pay is. We hung up and I called my nurse. She was just as excited as me. But being the pessimistic and cautious person that I am, I had to call the insurance company back. I called the medical side this time. I knew that I only had coverage up to diagnosis, but nothing for IVF or medications. So I wanted some clarification. The representative told me that I didn't have coverage for meds. I told her what the lady on the pharm. side said. She said "Well if that's what she told you then that's what it will be." My heart fell onto my desk, instead of my jaw. But that still wasn't enough for me. I called the pharm side back. Knowing I would get a different representative, I decided that I would trust the total if she told me the same thing. Well she didn't tell me the same thing. IT WAS CHEAPER!!! Ok this time, I fell onto my desk!
Well you know how they say "if it's too good to be true, it probably isn't right?" Well, it was too good to be true. My doctor sent the script to the pharmacy, they ran it through my insurance, and called me and said my bill was $6,300. I fell out onto my desk again. Totally skipped the jaw and the heart drop. The whole body, just collapsed. I asked them why they didn't run it through my insurance. She told me that they did but that insurance denied the claim. She followed that up with "will you be paying with credit or debit?" I wanted to say "Monopoly money," but I didn't. I told her that I wouldn't be paying for anything right now. Throughout the next week, after many phone calls to and from the pharmacy and insurance company (every call, by the way, the representative gave me wrong information or they said that my concerns weren't their department and transferred me. One lady pretended that she couldn't use her computer and hung up on me) we determined that I had no coverage for 4 of the 8 medications. 4 of the meds were covered because they were meds that are not associated with infertility. The other 4 were still going to cost close to $6,000. Still going to have to use Monopoly money for that!
So I was super excited that we had support group that week. I needed some advice from my sista infertiles and needed to just let off some frustration. Well it just so happened that we had a newcomer. She told me about a pharmacy in the UK that she was buying her meds from. They ship them here and they are ridiculously cheaper. So I rushed home and looked them up. OMG after checking out the site, I determined that my meds would cost less than $2500. The most expensive medicine that I need costs $72 a vial here in the US. I need 66 vials. In the UK, it costs $29 a vial. Of course I didn't trust it. So I checked the pharmacy and their meds out the best I could. The pharmacy is totally legit. The medicines? It is the exact same medicine that I would have gotten from the pharmacy here. I went to the pharmaceutical manufacturers website and discovered that the medicine that I would have received from the USA pharmacy, comes from overseas to begin with. So ladies and gentlemen, that's what we call the American mark-up! Sorry, it really chaps my tiny hiny that the EXACT same medicine is $43 more here. And to make me feel better, my insurance company told me that if Kevin and I were using the medications to try to get pregnant on our own at home (not with IVF), they would cover them and it would have cost the original $500.
So my America, that I truly feel privileged to be a citizen of, just told me that it's my problem, not theirs, that I was sick as a child and as a result can't have babies, the almighty dollar is more important than the hard working people, and we would prefer you to do your business elsewhere. But what is our problem, and therefore your problem as a working person who pays taxes, is paying the rent and grocery bill of people who decide they don't feel like working anymore and doctor shop until they find someone to say they are bi-polar because they lose their temper when they get too drunk everyday. After all, they have a disability.
Well that is interesting, because under the Americans with Disabilities Act (ADA) infertility is a disability. So why is my disability different? Because it costs too much money! After the Supreme Court made up some crap about excluding an entire group of people from insurance benefits doesn't qualify as discrimination, the American insurance companies can legally discriminate against infertiles who need IVF. So because it is too risky and not a guarantee that IVF will result in a pregnancy, insurance companies don't pay.
Now please don't misunderstand me. I don't think that the American government should pay for my procedure and medication, or send me a monthly check for my disability. I don't want that because I am completely capable of working and making my living. And I am not saying that everyone who receives a disability check is not completely deserving of it. But let's be completely honest, most people receiving a disability check are abusing the system. People who really CAN'T (this is different from WON'T) make their living because of their disability are unable to get assistance because we are paying too many people whose "disability" is laziness or stupidity. I am saying that I don't think that insurance companies should be able to pick and choose whose disability is worth giving coverage to and whose isn't. We pay the same premiums as everyone else. I thought the point of insurance was to help with medical costs when you need it. I guess I was wrong. It's for helping with medical costs when someone else thinks it is worth it and as long as it isn't too serious, too risky or costs too much money!!!! Silly me!!!
So instead of putting my money into this dreadful economy and trying to help turn it around, because let's be honest I don't see it being successful anytime soon and it seems too risky to me, I am choosing that America's disability is not my cause today. Because contrary to the belief of the people in charge of this country (which is supposed to be the people, but isn't), I am not made out of money and after contributing to the disability of everyone else with the taxes that they take out of my paycheck, I can't afford my own, here!
Sincerely,
Taking my business elsewhere!
Saturday, August 31, 2013
Saturday, August 3, 2013
All the doctor's nurses, doctors, and sperm analyzing men, may be able to put Hump-D together again.
Hump-D Dump-T sat in an ovary....Well you know the rest of that story. Hump-D fell and broke! Well just like anything else in my life, my Hump-D is special!!! Get your mind out of the gutter, I'm talking about my ovary!!!!! The eggs in my ovaries broke at the thought of falling!
As many of you know, I had a terrible AMH score in September of 2012. When we went to our first RE appointment , we discovered that my AMH was .76. The doctor wanted it to be and really was expecting it to be a 2.0 or higher. Dr. D told us that it was POSSIBLE for the score to go down as much as half in one year. That would have made our chance of a successful pregnancy and live birth almost impossible. So Kevin and I decided that we would wait until July 2013, have my AMH retested, and make a final decision from there.
I went to the doctor's office on July 19 to have my blood drawn so it could be retested. The results of that test will determine the course of action. It will tell us if Hump-D is scrambled or sunny side up with a thumbs up. We had an appointment set for July 31 to get the results. But my phone rang while I was at work on Friday July 26. I saw it was Dr. D's office and literally could not breathe for a minute. Interestingly enough, I debated about whether to answer the phone or let it go to voicemail. Seriously? (Side note: The last time I got the score, I had missed the call and the nurse left a voicemail. I listened to it on the way home from work and was totally unprepared for the .76 that came out of her mouth. Luckily, I was really close to home. That meant I didn't have to auto-pilot for too long. I had started crying uncontrollably and couldn't see as a result.) So I decided that sitting in my office, where I could shut the door and sob safely and privately, was the best option at that time.
I had pretty much decided that it was going to be bad. I had a weird feeling/understanding that whatever this number was it would make a clear cut decision for us. But if you look at the .76 score, along with all of the information that I had learned since September, that pessimistic feeling makes sense. For Dr. D's clinic, there was a 41% success rate for an AMH of .76. Now that isn't broken down for age groups, that is for the clinic as a whole. The average age for an AMH of .80-1.0 is 35.5. So our chances would have been a tick better since I am only 29, but not much. So if my AMH went down, that would have put us in the .20-.70 range where the average age is 37.7 years old and success rates plummet to 14%. Again, my age would have likely cause us to have a little bit of a better success rate percentage, but not much. If it went up, it could keep us in the same success percentage or make it better.
Focus ADD. Sorry, saw something shiny and got distracted. Back to Dr. D's office calling me at work. I decided to answer the phone. It was the nurse saying "I have your AMH results!" I tried to analyze her voice because that's what I do, analyze EVERYTHING!!!!! The best thing she could have done was just spit it out. That's exactly what she did, so fast that I almost missed it. DRUM ROLL PLEASE (imagine the drum roll because I don't know how to spell that). My AMH score went up to 1.04!!!!!!! Wooo Hooooo! Not a huge increase, but it increased! So I asked her what that meant about our success rate. She gave me an age/AMH specific success rate of 55-57%. It may not sound great to you. But if you have mulled over 41% for the past year, 55-57% is AWESOME!!!! So we got off of the phone and I started bawling. SKKKUUURRRR! Crying? Why? That was good news. Is crazy lady back? Why do we cry when we get good news?
So I tried to get a grip and call Kevin. Of course, he didn't answer the phone. He didn't answer the phone when I passed the Bar Exam either. (No, I haven't forgotten) I tried to call my mom, she didn't answer. She didn't answer the phone when I passed the Bar Exam either. So I called one of my co-workers who was just a hallway away. Ironically, she is the one who answered the phone at the DA's office after I found out I passed the Bar Exam. But I digress!!! She came into my office and celebrated the good news with me and helped me stop crying. BTW she is a fellow infertile, so she got it.
Finally (about 10 minutes later), Kevin called me back. (I ended up having to forgive him for not answering the phone when I found out that he physically couldn't answer. He had locked his phone in the car and locked himself out of the car. Poor Punkin.)
So in January of this year, Kevin and I decided that if our score went down by July we would either adopt embryos or adopt an already living child. If the score stayed the same or went up, we would try an IVF cycle. Well this past Wednesday we met with Dr. D and discussed our options. We found out that there was about a 50-60% percent chance for a successful live birth on a fresh cycle and about 50% of the time couples with similar age and AMH have embryos to freeze. We talked about how I was doing emotionally and mentally. Understanding that I was emotionally and mentally "SPECIAL" even before infertility, Dr. D was proud of the progress that I had made in the past few months.
We discussed money, specifically how much an IVF cycle (excluding medications) would cost. Our insurance doesn't cover IVF, so it will all be paid out of pocket. Just for the medical procedures leading up to IVF, the retrieval, fertilization, transfer and ultrasounds after the transfer it is a large 4 digit number that is not quite at 5 digits. Then we found out that he would put me on the highest medication protocol that they have because of my low AMH score. That means that our medication costs will be greater. The number that we heard, without insurance coverage, was $5,000-$6,500! BAHAHAHAHAHA. Can I throw up now. No one can give us a certain number because we won't know how much medication I'll actually need until we are in the cycle and monitoring how my body is responding.
Wrap it up, Katy. So what's the big decision?
KEVIN AND I ARE DOING AN IVF CYCLE STARTING IN OCTOBER!!!!!!!!!!!
We are thinking positive thoughts and trying to keep crazy lady at bay for right now. I will, as always, keep you posted as things happen! So we'll see if we can re-write that old nursery rhyme to say:
All the doctor's nurses, doctors, and sperm analyzing men, may be able to put Hump-D together again.
As many of you know, I had a terrible AMH score in September of 2012. When we went to our first RE appointment , we discovered that my AMH was .76. The doctor wanted it to be and really was expecting it to be a 2.0 or higher. Dr. D told us that it was POSSIBLE for the score to go down as much as half in one year. That would have made our chance of a successful pregnancy and live birth almost impossible. So Kevin and I decided that we would wait until July 2013, have my AMH retested, and make a final decision from there.
I went to the doctor's office on July 19 to have my blood drawn so it could be retested. The results of that test will determine the course of action. It will tell us if Hump-D is scrambled or sunny side up with a thumbs up. We had an appointment set for July 31 to get the results. But my phone rang while I was at work on Friday July 26. I saw it was Dr. D's office and literally could not breathe for a minute. Interestingly enough, I debated about whether to answer the phone or let it go to voicemail. Seriously? (Side note: The last time I got the score, I had missed the call and the nurse left a voicemail. I listened to it on the way home from work and was totally unprepared for the .76 that came out of her mouth. Luckily, I was really close to home. That meant I didn't have to auto-pilot for too long. I had started crying uncontrollably and couldn't see as a result.) So I decided that sitting in my office, where I could shut the door and sob safely and privately, was the best option at that time.
I had pretty much decided that it was going to be bad. I had a weird feeling/understanding that whatever this number was it would make a clear cut decision for us. But if you look at the .76 score, along with all of the information that I had learned since September, that pessimistic feeling makes sense. For Dr. D's clinic, there was a 41% success rate for an AMH of .76. Now that isn't broken down for age groups, that is for the clinic as a whole. The average age for an AMH of .80-1.0 is 35.5. So our chances would have been a tick better since I am only 29, but not much. So if my AMH went down, that would have put us in the .20-.70 range where the average age is 37.7 years old and success rates plummet to 14%. Again, my age would have likely cause us to have a little bit of a better success rate percentage, but not much. If it went up, it could keep us in the same success percentage or make it better.
Focus ADD. Sorry, saw something shiny and got distracted. Back to Dr. D's office calling me at work. I decided to answer the phone. It was the nurse saying "I have your AMH results!" I tried to analyze her voice because that's what I do, analyze EVERYTHING!!!!! The best thing she could have done was just spit it out. That's exactly what she did, so fast that I almost missed it. DRUM ROLL PLEASE (imagine the drum roll because I don't know how to spell that). My AMH score went up to 1.04!!!!!!! Wooo Hooooo! Not a huge increase, but it increased! So I asked her what that meant about our success rate. She gave me an age/AMH specific success rate of 55-57%. It may not sound great to you. But if you have mulled over 41% for the past year, 55-57% is AWESOME!!!! So we got off of the phone and I started bawling. SKKKUUURRRR! Crying? Why? That was good news. Is crazy lady back? Why do we cry when we get good news?
So I tried to get a grip and call Kevin. Of course, he didn't answer the phone. He didn't answer the phone when I passed the Bar Exam either. (No, I haven't forgotten) I tried to call my mom, she didn't answer. She didn't answer the phone when I passed the Bar Exam either. So I called one of my co-workers who was just a hallway away. Ironically, she is the one who answered the phone at the DA's office after I found out I passed the Bar Exam. But I digress!!! She came into my office and celebrated the good news with me and helped me stop crying. BTW she is a fellow infertile, so she got it.
Finally (about 10 minutes later), Kevin called me back. (I ended up having to forgive him for not answering the phone when I found out that he physically couldn't answer. He had locked his phone in the car and locked himself out of the car. Poor Punkin.)
So in January of this year, Kevin and I decided that if our score went down by July we would either adopt embryos or adopt an already living child. If the score stayed the same or went up, we would try an IVF cycle. Well this past Wednesday we met with Dr. D and discussed our options. We found out that there was about a 50-60% percent chance for a successful live birth on a fresh cycle and about 50% of the time couples with similar age and AMH have embryos to freeze. We talked about how I was doing emotionally and mentally. Understanding that I was emotionally and mentally "SPECIAL" even before infertility, Dr. D was proud of the progress that I had made in the past few months.
We discussed money, specifically how much an IVF cycle (excluding medications) would cost. Our insurance doesn't cover IVF, so it will all be paid out of pocket. Just for the medical procedures leading up to IVF, the retrieval, fertilization, transfer and ultrasounds after the transfer it is a large 4 digit number that is not quite at 5 digits. Then we found out that he would put me on the highest medication protocol that they have because of my low AMH score. That means that our medication costs will be greater. The number that we heard, without insurance coverage, was $5,000-$6,500! BAHAHAHAHAHA. Can I throw up now. No one can give us a certain number because we won't know how much medication I'll actually need until we are in the cycle and monitoring how my body is responding.
Wrap it up, Katy. So what's the big decision?
KEVIN AND I ARE DOING AN IVF CYCLE STARTING IN OCTOBER!!!!!!!!!!!
We are thinking positive thoughts and trying to keep crazy lady at bay for right now. I will, as always, keep you posted as things happen! So we'll see if we can re-write that old nursery rhyme to say:
All the doctor's nurses, doctors, and sperm analyzing men, may be able to put Hump-D together again.
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