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smooney
Hidey Ho!
Member since 2/10 1669 total posts
Name:
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Re: Wow! Just Wow! Just when you thought things couldn't get worse.
ive never heard of such a crap py insurance policy!!!!  
but does this mean that you are tapped out now for life? what about if you DO get pregnant?? will they not cover a hospital stay and delivery costs??
in thinking positive for you*** maybe you should seriously consider another medical insurance company for when you HOPEFULLY become pregnant!!! 
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Posted 9/7/10 6:01 PM  |
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Long Island Weddings
Long Island's Largest Bridal Resource |
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Re: Wow! Just Wow! Just when you thought things couldn't get worse.
oh I'm so sorry to hear that. . that's so awful. . but I think there is still hope there even if it seems dim right now. . hopefully the IUI will work and if not, if there is ever a chance for your DH to switch insurance would that work? does he have any choices at work or is there just one? like I know we can switch once a year if we want a different plan.
ahhh I know those are probably all cr*' solutions but I will send some  your way that something works out. . what crap on top of crap! 
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| Posted 9/7/10 6:09 PM |
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Re: Wow! Just Wow! Just when you thought things couldn't get worse.
I'm sorry you are going through this!
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| Posted 9/7/10 6:24 PM |
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curiousO
he is here.. thank you God
Member since 10/07 2344 total posts
Name:
Me
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Re: Wow! Just Wow! Just when you thought things couldn't get worse.
Posted by smooney
ive never heard of such a crap py insurance policy!!!!
but does this mean that you are tapped out now for life? what about if you DO get pregnant?? will they not cover a hospital stay and delivery costs??
in thinking positive for you*** maybe you should seriously consider another medical insurance company for when you HOPEFULLY become pregnant!!!
no, she was talking about Infertility cap for $10K. Pregnancy and labor are totally separate, thank God.
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| Posted 9/7/10 8:20 PM |
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Jenn1621
<3
Member since 5/05 1728 total posts
Name:
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Re: Wow! Just Wow! Just when you thought things couldn't get worse.
I am so sorry. Insurance is such a pain in the ***. There shouldn't be a cap for this!
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| Posted 9/7/10 8:52 PM |
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FlowerWife
Positive Vibrations...
Member since 1/08 8423 total posts
Name:
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Re: Wow! Just Wow! Just when you thought things couldn't get worse.
Posted by smooney
ive never heard of such a crap py insurance policy!!!!
but does this mean that you are tapped out now for life? what about if you DO get pregnant?? will they not cover a hospital stay and delivery costs??
in thinking positive for you*** maybe you should seriously consider another medical insurance company for when you HOPEFULLY become pregnant!!!
this is actually really common, its really not that cra ppy (i mean it stinks that its used up but as far as plans go) considering many plans dont cover infertility AT ALL. my policy has the same type of thing but its $30k "lifetime". at my request my RE filed everything under the code for PCOS, so i still have my entire $30k available for my IVF cycle.
pregnancy has nothing to do with it. the cap is on all things filed under the code for infertility. some places can file most things under other codes, but things like IUIs and IVF procedures can't really be filed any other way so they eat away at the cap.
Kristen - can your husband possibly changes plans within the same carrier?? i would inquire if that would start the cap over again. i know for mine it is lifetime that you have the PLAN so if i changed plans within the carrier i believe all of my caps would reset. im not 100% sure about it but its def worth looking in to.
good luck!!!!
Message edited 9/7/2010 8:56:14 PM.
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| Posted 9/7/10 8:55 PM |
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rosalie
LIF Infant
Member since 5/10 309 total posts
Name:
rosalie
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Re: Wow! Just Wow! Just when you thought things couldn't get worse.
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| Posted 9/7/10 9:07 PM |
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BeachGal
LIF Adult
Member since 2/10 2827 total posts
Name:
J
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Re: Wow! Just Wow! Just when you thought things couldn't get worse.
I am very sorry this is happening, it seems so unfair. Maybe you could borrow from your 401k and repay the loan with your tax refund next year so you wont have the loan for too long? Hopefully you can figure something out.
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| Posted 9/7/10 9:21 PM |
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WhitneyL
LIF Adolescent
Member since 10/07 645 total posts
Name:
Whitney
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Re: Wow! Just Wow! Just when you thought things couldn't get worse.
I'm so, so sorry you have to go through this.
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| Posted 9/7/10 10:25 PM |
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Hofstra26
Love to Bake!
Member since 7/06 27915 total posts
Name:
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Re: Wow! Just Wow! Just when you thought things couldn't get worse.
Posted by FlowerWife
Posted by smooney
ive never heard of such a crap py insurance policy!!!!
but does this mean that you are tapped out now for life? what about if you DO get pregnant?? will they not cover a hospital stay and delivery costs??
in thinking positive for you*** maybe you should seriously consider another medical insurance company for when you HOPEFULLY become pregnant!!!
this is actually really common, its really not that cra ppy (i mean it stinks that its used up but as far as plans go) considering many plans dont cover infertility AT ALL. my policy has the same type of thing but its $30k "lifetime". at my request my RE filed everything under the code for PCOS, so i still have my entire $30k available for my IVF cycle.
pregnancy has nothing to do with it. the cap is on all things filed under the code for infertility. some places can file most things under other codes, but things like IUIs and IVF procedures can't really be filed any other way so they eat away at the cap.
Kristen - can your husband possibly changes plans within the same carrier?? i would inquire if that would start the cap over again. i know for mine it is lifetime that you have the PLAN so if i changed plans within the carrier i believe all of my caps would reset. im not 100% sure about it but its def worth looking in to.
good luck!!!!
I think it's total BS though that they take from the $10K cap for everything else fertility related and I will tell you why. It turns out that Cigna, cr@p company that they are, requires a minimum of SIX IUI cycles before they will start paying for ANY IVF treatment. Well, guess what??...............I've had 6 IUI cycles this year and evidently it ate up all of the $10K that was available so now that I *technically* am "allowed" to try IVF there is no money left to do so. That is a bunch of cr@p IMO. That money should be exclusive of other IF treatments. What's the point of offering IVF coverage if you're going to require six IUI's first that will eat up any money to be used towards IVF? It's nonsense.
On top of that, we've had to pay $4500 out-of-pocket this year for medical expenses because of deductibles and co-insurance and now we'll be paying a ton more for any future RE visits since we've used up out $10K. It's garbage insurance. DH's company was trying to reduce costs and switched over from Oxford to Cigna and it's been a nightmare for everyone. The whole company HATES the insurance right now and they are all hoping they change carriers again after this year which I sorta think is unlikely but I guess there is a possibility.
To answer everyone's question, there are no other insurance options for us within my DH's company. My DH's company chooses one insurance carrier and the only thing you can really "choose" as far as a plan is concerned is the out-of-network or in-network plan. There are no real choices other than that. We're stuck with whatever policy and carrier his company chooses to go with.
It's crazy but my DH said if need be he will find another job because he won't let a job cost him a family. I was shocked because it's a big deal for him to look for another job. He's a digital design engineer so it would be a big move to leave his company as he makes a great salary and because there aren't a ton of engineering companies on the island but we'll do what we need to. He is going to speak with the HR dept. as well and express our issues with the insurance if for no other reason then the hope they will take into consideration everyone's complaints and weigh that when they make future decisions regarding our coverage.
Only time will tell how this will play out. I plan on at least another Clomid/IUI cycle for now and in the meantime I've scheduled a consult with Dr. Braverman and LI IVF. LI IVF has a grant program which I am hoping we qualify for. Guess we'll have to see what happens. Thank you everyone for all the support and kinds words. It's appreciated. 
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| Posted 9/7/10 11:29 PM |
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curiousO
he is here.. thank you God
Member since 10/07 2344 total posts
Name:
Me
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Re: Wow! Just Wow! Just when you thought things couldn't get worse.
Posted by Hofstra26
Posted by FlowerWife
Posted by smooney
ive never heard of such a crap py insurance policy!!!!
but does this mean that you are tapped out now for life? what about if you DO get pregnant?? will they not cover a hospital stay and delivery costs??
in thinking positive for you*** maybe you should seriously consider another medical insurance company for when you HOPEFULLY become pregnant!!!
this is actually really common, its really not that cra ppy (i mean it stinks that its used up but as far as plans go) considering many plans dont cover infertility AT ALL. my policy has the same type of thing but its $30k "lifetime". at my request my RE filed everything under the code for PCOS, so i still have my entire $30k available for my IVF cycle.
pregnancy has nothing to do with it. the cap is on all things filed under the code for infertility. some places can file most things under other codes, but things like IUIs and IVF procedures can't really be filed any other way so they eat away at the cap.
Kristen - can your husband possibly changes plans within the same carrier?? i would inquire if that would start the cap over again. i know for mine it is lifetime that you have the PLAN so if i changed plans within the carrier i believe all of my caps would reset. im not 100% sure about it but its def worth looking in to.
good luck!!!!
I think it's total BS though that they take from the $10K cap for everything else fertility related and I will tell you why. It turns out that Cigna, cr@p company that they are, requires a minimum of SIX IUI cycles before they will start paying for ANY IVF treatment. Well, guess what??...............I've had 6 IUI cycles this year and evidently it ate up all of the $10K that was available so now that I *technically* am "allowed" to try IVF there is no money left to do so. That is a bunch of cr@p IMO. That money should be exclusive of other IF treatments. What's the point of offering IVF coverage if you're going to require six IUI's first that will eat up any money to be used towards IVF? It's nonsense.
On top of that, we've had to pay $4500 out-of-pocket this year for medical expenses because of deductibles and co-insurance and now we'll be paying a ton more for any future RE visits since we've used up out $10K. It's garbage insurance. DH's company was trying to reduce costs and switched over from Oxford to Cigna and it's been a nightmare for everyone. The whole company HATES the insurance right now and they are all hoping they change carriers again after this year which I sorta think is unlikely but I guess there is a possibility.
To answer everyone's question, there are no other insurance options for us within my DH's company. My DH's company chooses one insurance carrier and the only thing you can really "choose" as far as a plan is concerned is the out-of-network or in-network plan. There are no real choices other than that. We're stuck with whatever policy and carrier his company chooses to go with.
It's crazy but my DH said if need be he will find another job because he won't let a job cost him a family. I was shocked because it's a big deal for him to look for another job. He's a digital design engineer so it would be a big move to leave his company as he makes a great salary and because there aren't a ton of engineering companies on the island but we'll do what we need to. He is going to speak with the HR dept. as well and express our issues with the insurance if for no other reason then the hope they will take into consideration everyone's complaints and weigh that when they make future decisions regarding our coverage.
Only time will tell how this will play out. I plan on at least another Clomid/IUI cycle for now and in the meantime I've scheduled a consult with Dr. Braverman and LI IVF. LI IVF has a grant program which I am hoping we qualify for. Guess we'll have to see what happens. Thank you everyone for all the support and kinds words. It's appreciated.
did you think about trying femara this time instead of clomid?
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| Posted 9/8/10 9:50 AM |
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hunnybunnyxoxo
this is what it's all about
Member since 11/07 3321 total posts
Name:
Lisa
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Re: Wow! Just Wow! Just when you thought things couldn't get worse.
oh no!!i am so sorry!!!
miracles happen... some women are told they cant have babies and just when they think they are without a pray, they conceive naturally with no help.. boggles my mind how that happens, but i it does happen.
just continue with iui, and hopefully you will have your miracle!!!!
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| Posted 9/8/10 11:12 AM |
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AngnShaun
Sisters
Member since 1/10 21015 total posts
Name:
Ang
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Re: (Mini UPDATE in First Post) Wow! Just Wow! Just when you thought things couldn't get worse.
Thats really promising... I hope it works out for you and you get to give your DD a brother or sister!!!    
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| Posted 9/8/10 11:27 AM |
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JackiePags
They're the love of my life
Member since 8/10 1299 total posts
Name:
Jackie
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Re: (Mini UPDATE in First Post) Wow! Just Wow! Just when you thought things couldn't get worse.
That is great news....best of luck to you and your husband!
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| Posted 9/8/10 12:40 PM |
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hunnybunnyxoxo
this is what it's all about
Member since 11/07 3321 total posts
Name:
Lisa
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Re: (Mini UPDATE in First Post) Wow! Just Wow! Just when you thought things couldn't get worse.
yaaaaaaaaaaaay!!!! light at the end of the tunnel!!!!!!
praying for you!! after all this , i hope you are doubly blessed with twins!!
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| Posted 9/8/10 2:17 PM |
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My4GirlsMyLife
My 4 girlies
Member since 2/08 9702 total posts
Name:
Valerie
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Re: (Mini UPDATE in First Post) Wow! Just Wow! Just when you thought things couldn't get worse.
I am praying this works for you !!
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| Posted 9/8/10 2:53 PM |
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HeatherRose
Life is Good :)
Member since 11/07 6605 total posts
Name:
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Re: (Mini UPDATE in First Post) Wow! Just Wow! Just when you thought things couldn't get worse.
I'm so sorry you are going through all of this. If the grant doesn't work out, maybe you could enroll in another insurance company through yours or DH's job
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| Posted 9/8/10 3:07 PM |
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Hofstra26
Love to Bake!
Member since 7/06 27915 total posts
Name:
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Re: (Mini UPDATE in First Post) Wow! Just Wow! Just when you thought things couldn't get worse.
Posted by HeatherRose
I'm so sorry you are going through all of this. If the grant doesn't work out, maybe you could enroll in another insurance company through yours or DH's job
Thank you. As far as insurance is concerned, I am a SAHM mom to my DD so there is no insurance options on my end but my DH's company doesn't offer any other options for health insurance except for the one we have. You're only option is the insurance they offer or no insurance at all. Our hands are tied which is why we're praying we get this grant. It would be a lifesaver.
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| Posted 9/8/10 3:13 PM |
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HeatherRose
Life is Good :)
Member since 11/07 6605 total posts
Name:
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Re: (Mini UPDATE in First Post) Wow! Just Wow! Just when you thought things couldn't get worse.
Posted by Hofstra26
Posted by HeatherRose
I'm so sorry you are going through all of this. If the grant doesn't work out, maybe you could enroll in another insurance company through yours or DH's job
Thank you. As far as insurance is concerned, I am a SAHM mom to my DD so there is no insurance options on my end but my DH's company doesn't offer any other options for health insurance except for the one we have. You're only option is the insurance they offer or no insurance at all. Our hands are tied which is why we're praying we get this grant. It would be a lifesaver.
lots of prayers you get it!!!
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| Posted 9/8/10 7:14 PM |
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Jenn1621
<3
Member since 5/05 1728 total posts
Name:
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Re: (Mini UPDATE in First Post) Wow! Just Wow! Just when you thought things couldn't get worse.
That's great news! Dr K was/is my doctor. I really liked him. Wishing you lots of luck that the grant works out for you!!
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| Posted 9/8/10 9:48 PM |
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