Insurance Companies....
So DH and I find out yesterday that as of July 1st we will no longer have any fertility coverage. Not that our carrier covered the treatment we really need (IVF), but the idea that we had something felt good. It covered everything up to but excluding IVF. I know exactly how lucky we were. The cost of my meds alone each cycle was $5000+. Even though we are doing our next two IVFs self pay (thank God our clinic does a 2 for 1 special) we will be draining DH's retirement account and taking out a year long loan through the clinic which is probably more than we can afford each month, but who needs to buy food right? Our insurance however would have picked up the little bits like pre and post IVF consultation and some of the blood work and ultrasound expenses. CDPHP is what Hartwick College is switching to and let me tell you of what I have read about it... IT SUCKS! I can't even go to the local urgent care clinic affiliated with the hospital that I work for.... Um excuse me? Nor can I use my hospital's lab... they are the only lab that has analyzers that can block out my body's stupid interfering antibodies.
This brings me to what gets me the most about infertility and insurance coverage. Only 12 states have any mandates on coverage for infertility and most of those even suck. We pay $5000 each year for insurance (the college picks up the rest) and in that $5000 I pay for coverage for heart disease, cancer, obesity, and kidney disease... None of which I have. The insurance companies try to scare people into not taking up coverage by saying how much it will raise policies. Well tell me how paying an extra $.50 per policy (because on average only 1 in 8 couples will ever even use the benefits) for a disease that *I* have is any less important than paying for all the disease I *dont* have?
Women like octomom give all women going through infertility treatments a bad name. Notice I didn't say anything about Jon and Kate? As much as they give themselves a bad name they only wound up with 6 babies because they did a lesser treatment IUI (intrauterine insemination aka artificial insemination). That is where they give your ovaries a mega dose of stimulating hormone, trigger the release of the eggs, and then let the sperm do the work. Other than canceling a cycle due to too many potential eggs (not all follicles will produce an egg let alone a mature egg) there is no way to control how many eggs will fertilize and how many embryos will implant. Oh and counting follicles via ultrasound is not an exact science. They can't always see all of the follicles. That treatment is somewhat cost prohibitive because the meds are so much, but still doable for most and more often covered by insurance. So I can't blame Jon and Kate for trying for one more baby... they probably had great IUI coverage. My doctor said at our initial consult that he prefers IVF (not because he wants to make money either) because he can see the best embryos and control the number he puts back significantly reducing the risk of high order multiple birth (HOMB). HOMB runs an extremely dangerous risk for both mother and fetuses. Most women have tried so hard to get pregnant and will not consider reduction for that reason or for religion or personal reasons. So if you get 6 embryos that implant with an IUI it's a high risk pregnancy all the way. You'd think that insurance companies would see this risk and opt for a procedure that albeit costs more money in the long run has a higher rate of success and a lesser chance of high risk pregnancy. That chance of an IVF working for an average infertile couple is 35%-50%, IUI only runs about a 15%-20% chance. For a woman like me with endometriosis IUI only gives an 11% chance and IVF gives a 35% chance.
Other countries that have national health coverage include a certain number of infertility procedures that are included in the health plan. Some states like Massachusetts and Connecticut require insurance companies to cover procedures including IVF. Here in good old New York State... we have a infertility grant which is nice, but seeing as they can not get the budget to pass I don't think anyone will be getting assistance in that way anytime soon. They don't call it the "Empire" state for nothing :::hums the Darth Vader theme:::
This brings me to what gets me the most about infertility and insurance coverage. Only 12 states have any mandates on coverage for infertility and most of those even suck. We pay $5000 each year for insurance (the college picks up the rest) and in that $5000 I pay for coverage for heart disease, cancer, obesity, and kidney disease... None of which I have. The insurance companies try to scare people into not taking up coverage by saying how much it will raise policies. Well tell me how paying an extra $.50 per policy (because on average only 1 in 8 couples will ever even use the benefits) for a disease that *I* have is any less important than paying for all the disease I *dont* have?
Women like octomom give all women going through infertility treatments a bad name. Notice I didn't say anything about Jon and Kate? As much as they give themselves a bad name they only wound up with 6 babies because they did a lesser treatment IUI (intrauterine insemination aka artificial insemination). That is where they give your ovaries a mega dose of stimulating hormone, trigger the release of the eggs, and then let the sperm do the work. Other than canceling a cycle due to too many potential eggs (not all follicles will produce an egg let alone a mature egg) there is no way to control how many eggs will fertilize and how many embryos will implant. Oh and counting follicles via ultrasound is not an exact science. They can't always see all of the follicles. That treatment is somewhat cost prohibitive because the meds are so much, but still doable for most and more often covered by insurance. So I can't blame Jon and Kate for trying for one more baby... they probably had great IUI coverage. My doctor said at our initial consult that he prefers IVF (not because he wants to make money either) because he can see the best embryos and control the number he puts back significantly reducing the risk of high order multiple birth (HOMB). HOMB runs an extremely dangerous risk for both mother and fetuses. Most women have tried so hard to get pregnant and will not consider reduction for that reason or for religion or personal reasons. So if you get 6 embryos that implant with an IUI it's a high risk pregnancy all the way. You'd think that insurance companies would see this risk and opt for a procedure that albeit costs more money in the long run has a higher rate of success and a lesser chance of high risk pregnancy. That chance of an IVF working for an average infertile couple is 35%-50%, IUI only runs about a 15%-20% chance. For a woman like me with endometriosis IUI only gives an 11% chance and IVF gives a 35% chance.
Other countries that have national health coverage include a certain number of infertility procedures that are included in the health plan. Some states like Massachusetts and Connecticut require insurance companies to cover procedures including IVF. Here in good old New York State... we have a infertility grant which is nice, but seeing as they can not get the budget to pass I don't think anyone will be getting assistance in that way anytime soon. They don't call it the "Empire" state for nothing :::hums the Darth Vader theme:::