insurance

I'm a Double Threat: Infertile AND Uninsurable (Wednesday)

(Start with "Monday" if you can. Unless in addition to infertile and uninsurable you also find me unreadable. Then, frankly, I don't know what to tell you.... But if you find me even the least bit bearable, consider becoming a subscriber to get a weekly blog update and some insider info.) So what were we talking about? Oh right. How I would hate doing the billing for a fertility clinic. It's such a no-win job.

Maybe I could do the billing for a fertility clinic in Beverly Hills though. Unlike other fertility clinics who have clients who are there for treatments even though they can't possibly afford it, maybe the Beverly Hills clinics have clients who are only there because they can afford it. Maybe they're not infertile,  just lazy.

"You know I suppose I could go through all of that sweaty, messy, sex stuff with my husband...Naaa... I may as well just have some children implanted when I go for my tummy tuck. I'll be there anyway. What's another twenty thousand?"

So, in Beverly Hills, I wouldn't mind collecting the money: "You forgot your checkbook? That's okay, I'll take that ring. No, the other one."     

In Kevin Haney's article in the Non-Health Experts department; "Bad Enough I Have To Go Through Fertility Treatments, Now You Want Me to Pay for Them Too?", he brings up an oh so valid and disturbing point about the warm, nurturing, insurance companies.

I had always assumed that insurance companies chose not to insure us, or offered coverage that was so expensive that nobody's job every stuck it into the benefits package, because our treatments were way too pricy. I hate to admit it, but I believed in my heart that the insurance carriers hated the sight of us desperate infertile people and wished we were all dead or would just go take our procreation journey elsewhere.  Those racist bastards.

Not so, I've discovered.

Lo and behold, it turns out to be quite the opposite. Insurance companies, turns out, absolutely adore us: Fallopian tube clogged, endometriosis-ridden, shriveled elderly eggs, ovarian cystic, low sperm counting... Messy as we are, warts and all, or cysts and all, whatever...they just can't get enough of us.

And that's because, sure our treatments are expensive... to us. But according to what I gleaned from  the article, what's a mere twenty thousand dollars a pop for some go 'rounds of IVF compared to the cost of prenatal care, hospital stays, complications that may arise, etc etc, pediatrics, college tuition? (okay, as usual, I may have gone one or two too far,)

So, insurance companies LOVE infertile people. And as long as we stay infertile, we're a cheap date. We're a tuna fish sandwich and a can of beer on a snack tray watching "A Twilight Zone" marathon on the Sci-Fi channel. So, it's not that insurance companies don't want us to have fertility treatments. They just don't want them to work.

And let's then look at the positive: Infertility treatments work. And that's why insurance companies wish we didn't do them... Yeah for us. Here's that article that I mentioned earlier: http://laughingisconceivable.com/?page_id=1623

Listen, I gotta go. It's Ground Hog day and I have this sinking feeling that I've written this exact post before.

I'll talk with ya again tomorrow.

I'm A Double Threat: Infertile AND Uninsurable (Tuesday)

(Start with "Monday" if you can. Mondays are like the GPS of my blog. They head you in the right direction for the rest of the week. Although I know someone who plugged an address into GPS and was directed to make a right turn through a tree....And if you'd like to be led astray by me once more on the weekends with more of my nonsense and some insider blog scoops, please subscribe. I'd love to have you.) So, what were we talking about? Oh right. The best part of infertility treatments.... Paying for them. Exciting no... Important... frankly not to me... but it probably is to the person with the calculator at the doctor's office. You know, the person who works for the doctor who's providing the treatments that might help you have a baby... so I guess making those payments should matter to us afterall.  

There are about a million jobs I would rather not have. And ironically, I've had most of them. So this isn't an uniformed statement. I've had the job and now know I'd rather not have it again.

But there are about ten jobs that I would really hate to have. Collections of any sort is right up there. (I guess it's technically the "Billing" department. It just seems that by the time I get around to making my first paltry payment it's already become the "Collections" department.)

I think that most of the billing people I've dealt with at the fertility clinics have been pretty decent.

I say "I think" because it's hard to hear much of anything that anybody says to you when you're busy crying and begging. And it's almost impossible to hear anything when you're crying and begging into your knees in a crumpled heap on the floor in front of their desk.

If I had to work in billing/collections I would have to collect on something that didn't matter that much. Like winter clothing in the summer. "Hi Mr. Jones. This is Lori from Don's Jacket Farm. You never paid your bill for that ski jacket you bought in January. Here we are in July, it's 87 degrees outside, and there's still an outstanding balance. I'm afraid we're going to have to take the jacket back."

I think I wouldn't mind trying to get money from people who bought "As Seen On TV" products either. 

"Good afternoon Ms. Williams. I'm calling about your Bacon Genie.... Our records show that we've never received your payment on this exclusive offer of $19.95.... No ma'am you are not on a 'six easy payments of $3.32 a month' plan. We ask that you kindly send us the payment within three business days or return the Bacon Genie. And... please, Ms. Williams...Keep the rubber spatula and the 'Artery De-Clog-O-Matic' as our free gifts to you just for trying the Bacon Genie."     

But I don't think I'd be comfortable collecting funds for an infertility clinic. Even though they don't have to be mean or ruthless. And some can be extremely helpful. There might be solutions or at least suggestions that they can offer. I did get a discount on one of my go-rounds. I mean, gee, I was so pathetic-looking, sitting there boo-hooing. Who could say "no" to that face?

On the one hand the decent billing people...and I truly believe most of them are... feel for your situation and will help in anyway they can.... On the other hand, if she doesn't get the money from you, the people who pay her don't get paid. Then they in turn have no money to put into the account from which her bi-weekly check is paid and then her check bounces around town faster than the free rubber spatula.

So even though I would like the opportunity to help people going through treatments to explore payment options and less expensive treatment options, I still don't think I have the heart or at least the stomach to work in Billing at a fertility clinic... unless, of course, it involved commission.

"Look! You people owe us 15,000 simoleons. 1500 of that is mine!  Tut tut, none of your whiny excuses! Yeah I feel sorry for ya. But sympathy don't put gas in the Jag. Now fork it over or there  are a couple of guys in Jersey who will come and unblock your tubes for ya.... Whether or not they're blocked."

Listen, I gotta go.  I have to be on the midnight train to Georgia. I'd rather live in his world, than live without him in mine.... This, by the way is the first sign of senility: You can't remember what you went into the hall closet for, but you remember the words to songs from when you were five...okay...nine.... Maybe I can go on "Don't Forget the Lyrics" Seniors Edition. No songs from after 1970.

I'll talk with ya again tomorrow. Check out Kevin Haney's post about this very topic (infertility finances, not Gladys Knight hits) at:  http://laughingisconceivable.com/?page_id=1623. And if I haven't lost you already, you have a strong constitution and might enjoy being a subscriber. So please consider it.

I'm A Double Threat: Infertile AND Uninsurable (Monday)

A couple of weeks ago I posted a wonderful article by an insurance agent named Kevin Haney. I should say that I posted a wonderful half of an article. After I posted that part, Kevin had the audacity to run off. He claims he ran off to get married. Whatever.  So anyway, I decided to not print the rest of the article and threw it back in his face, miffed that he chose his fiancee over my blog... Well, that's how Star magazine reported it anyway. What really happened is: Kevin did get married a week or so ago. That part is true. But I'm pretty sure he didn't do it just to spite my blog. In fact, his nuptials had nothing to do with me only printing half of this fantastic article.  There was so much great information about infertility and taxes, and infertility and insurance, and infertility and everything else financial... I thought I'd let everyone digest the first half for a week and return this week and post the rest. 

Some of us have never dealt with these topics before and are understandably a little, shall we say, turned off, if not totally freaked out by them. In my house growing up, like car troubles and weekly allowance... insurance was my father's domain.

My mother was in charge of meals, boyfriend problems, wardrobe problems, extracurricular activities problems, school problems,  college application problems, fight with the best friend problems,  and sibling problems.

My father was in charge of the car and the cash.

Sexist, yes. Old fashioned, yes. But it was the '70's-'80's and there it was.  

So in case any of you have had similar familial experiences, I didn't want to overwhelm everyone and send all of you running, crying to your father: "Daddy she's talking about investments and insurance. What does it all mean? Please make it stop!"

So this week, we're going to chat about the stuff that Kevin is discussing in his article. I'm not going to explain what he's saying. Who the hell am I, the UN? He does a great job of laying it out there in plain English.

(Geez I keep praising this guy over and over. There are only two reasons anyone  kisses up like that: 1) They're being paid handsomely to do so or  2) They want to touch the person in an inappropriate manner. Well, I'm the third category: An idiot who's just really excited about the article and the valuable information it provides.)

As for my part in all this: What I will attempt to do this week is to get into some of the crazy rules, regulations and red tape that Kevin so eloquently brings to light.  Geez, I complimented him again. Maybe we were related in a previous life... I must have had decent relatives in one of my lives. 

Listen I gotta go. My biweekly direct-deposit disappointment just went into my account and I have to start making the round of sincere phone calls to my adoring creditors.

I'll talk with ya again tomorrow. Check out Kevin Haney's article under "Non-Health Experts" at:  http://laughingisconceivable.com/?page_id=1623

Rest Assured: You've Got (Infertility) Insurance (Thursday)

(Start with "Monday" if you can.  You can slack off today anyway. Nobody really expects anyone to do any work the week before a holiday. Or the week after. Or between Thanksgiving and New Year's... Or those last two weeks in July... Or whenever else we just can't be bothered....And hey, if you'd like some more insider info etc about Laughing Is Conceivable please become a subscriber...please...please) So, what were we talking about? Oh right. The great medical coverage my company's insurance carrier offered for my fertility treatments. Okay, it wasn't really great. It was more like: "Get out of our office before we throw you off the insurance altogether, you infertile fool."

So, I took the matter up with our company's Human Resources: "Do you think we could get a health plan that would cover some of my infertility treatments?: Drugs, tests, ice for my butt injections, anything?" 

To which they responded: 

"No, but if you have some annual leave time, you can go to your doctors' appointments without getting fired."

I often wonder why someone came up with the name: "Human Resources".  It certainly didn't fit this group of broads at all. I guess "The Humane Society" was already taken.

I find it interesting that only fifteen states in the U.S. require insurance carriers to cover at least some infertility-related costs. And even with those states... You could drive a truck-load of us through the loopholes.

 A lot of states, like California for instance, have a clause that goes  something like this:  

  • Requires group insurers to offer coverage of infertility treatment... Employers may choose whether or not to include infertility coverage as part of their employee health benefit package.
  • Okay, well that doesn't sound too hard for your employer to get out of. I'm sure my lovely HR ladies meeting with the prospective insurance carrier went something like this: 

    "Ladies, if you want the basic package it will cost your company eight dollars a year per employee. If you'd like to add coverage for infertility treatments then the rate goes up slightly to $9700 a year per employee."

    I could see the HR women contemplating this:

    "Well, that seems like a sexual issue and none of us has had any interest in sex since the '80's... and we were hired to save the company money... yeah I think we'll just go for the eight dollar one where you only get an ambulance if you're unconscious or have lost more than half of your bodily fluids." I could see them equipping the ambulance driver with a dipstick to verify the latter. 

    And, incidentally, California (at least as of the report I read from 2009) doesn't require IVF coverage at all.

    Hawaii, like many states, does require coverage of one IVF cycle if cheaper forms of ART have been tried.  But, get this, (loophole alert!) you have to have had at least a five year history of infertility to get treatments covered.

    I consider myself to be a fairly honest person, but, honestly, I would lie my ovaries off on that one. We were each nearly forty when we got married. So, we're supposed to touch touch kiss kiss and sit around until I'm like pushing forty-five before we hula off to the fertility clinic?

    Several states like Louisiana allow you to get diagnosed and receive medical treatment for things that may be affecting your fertility, but once a doctor says the actual word "infertility"...the next words you'll hear will be: "And by the way, we take cash, checks, and most major credit cards."

    So if the surgeon is mid-surgery cutting a few feet off my colon: "Clamp. Scissors, Neosporin. Oh wait, this looks like it could result in infertility. Okay, gang--Roll it up and shove it back in."

    Listen, I gotta go. I'm almost done making my insurance picks for next year. Should I get the optical coverage and have the freedom of picking out one of the three approved frames or should I just go it alone?

    I'll talk with ya again tomorrw.

    Rest Assured: You've Got (Infertility) Insurance (Wednesday)

    (Start with "Monday" if you can. You won't be able to fully appreciate how screwed we are-insurance-wise- unless you start with Monday and read about places in the world who are less screwed.) So, what were we talking about? Oh right. How treatments in Denmark are free but won't be come the new year.

    I don't think my treatments here were ever free. No, I think I'd remember that. No, I do seem to recall my fertility treatments costing me thousands of dollars, my car, my credit rating, and my house in Aspen (that I never had and now never will.) Maybe someone reading this in Denmark can mail me a few kroner. 

    When I was about to undergo fertility treatments, I checked out the benefits my company offered. And the benefit to having these benefits was? Okay, there was no benefit.

    I opened up the booklet where it said: "Benefit Highlights". I misunderstood. "Highlights" to me usually meant something good. Like football highlights. A great pass, a fantastic interception, a three linebacker collison. Something exciting happened. But no. Here apparently "Highlights" meant:

    "Sucky things we need to bring to your attention now so you we can get all of your whining out of the way at this meeting and we can pretend we're listening to it and then ignore you starting January 1st when it takes effect."

    So I looked for my category in the booklet: First I had to sift through the maternity care services:  For natural child birth, only the first push was covered so you'd better make it a good one. 

    I could tell already my company went all out on their benefits package.

    Then Family Planning Services: A bag of condoms and a "just say no" video, followed by a lecture called: "Zip It or Snip It...You Decide"

    Then I got to "Fertility Treatments" which was defined as "getting pregnant by any artificial means."

    Artificial means? Any of you ever inject yourself with Nutrasweet? Me neither.

    The definition was then followed by three columns. The first read, from top to bottom: IUI, IVF, Surrogacy,Egg Donor, and Shoving a chicken egg up your whoo whoo and waiting for it to hatch.

    The second column listed what you would get "In-Network". I don't have the paper in front of me right this second. I'll try to remember what it said: To the best of my recollection, it went something like: 

    "Not Covered", "Not Covered", "Not Covered", "Not Covered" and "May be covered in rural areas. Please consult your sales representative for details." 

    The third column listed what the insurance would pay if you went to a doctor not in-network.

    "Not Covered", "Not Covered", "Not Even Remotely Close To Being Covered", "Not Even Remotely Close to Being Considered To Being Covered",  "May be covered in rural areas. Please consult your sales representative for details."  

    After the big group insurance briefing, where the rep talked in circles and answered questions with questions (Is there a statistic on how many former insurance sales reps have become political candidates?) Anyway.. after our hour of enlightenment in the company break room... I actually did consult/corner our company's insurance sales representative about all of this infertility non-coverage. I wanted to be sure I was reading this right. Boy was that a productive pow-wow.

    I'm not sure he knew what a fertility treatment was. He just looked extremely uncomfortable (embarrassed) like I'd just asked: "That Flexible Spending Account: Can you buy sex toys with that?"

    He flipped through the booklet for twenty minutes. He reminded me of a twelve year old looking for his homework that he knows he didn't do, while the teacher hovers over his desk waiting to collect either the homework or an explanation.

    I guess he figured by his third time through the booklet on his diligent search, I would just walk away. But I didn't. I'm not big on hints. 

    He pretended to look at the booklet forwards and backwards. Front to back, back to front. Maybe his copy was written in English and Hebrew. By about the sixth go round, I don't know what he was doing with that booklet but it resembled fanning himself more than reading. 

    He finally just mumbled that he wasn't sure and handed me an 800 number to customer service. I thought: "Great. He just outsourced my question to a fifteen year old in Tibet."

    Listen, I gotta go. Still pondering my open enrollment choices for next year's company insurance. I'm not sure if I should take the basic plan or the bells and whistles plan. I mean, I'm in pretty good condition for someone my age. Then again, at my age, that's like saying I'm an extremely sturdy sand castle.  

    I'll talk with ya again tomorrow.

    Rest Assured: You've Got (Infertility) Insurance (Monday)

    People in Denmark are apparently tripping over each other in a mad rush to get to fertility clinics. At the moment, fertility treatments are free of charge: Part of the Danish healthcare system. In January, goodbye and good luck. No more free. That unfortunate beautiful country must look like a one day sale at Macy's on December 23rd... or even worse.  Now that we're heavily into November and the "Buy one IVF get the second one... and the first one... free" deal  is about to expire in Denmark in a mere month and a half  (Merry Christmas and a Happy New year), I'm envisioning the one and only consignment sale I ever attended. Shoot me. Never again.

    My husband and I walked in holding in our hands nothing but each other's hand. How naive we were.

    People (mostly women I must say) came rushing in with boxes, containers, tubs... anything that could hold and transport  massive quantitites of other people's crap.  The doors opened at seven. And they're off!

    These people came crashing through as though they were running into a burning building to corral their children and pets, cram them into the tub and whisk them away to safety.

    One woman pushed past me. She had just cleared off an entire rack, sight unseen, and was hurriedly transporting the entire mess to a safe haven: A private spot on the hallway floor nestled between a water fountain and the toilets. Here she could scrutinize each item to see whether she actually wanted to purchase it or generously leave it in a heap on the floor under the dripping fountain for someone else to sift through.

    As I strolled over to the water fountain, I turned it on, took a sip, letting it run over as I spoke to the hoarder on the floor below: "I'm from New York. Believe me. If I wanted that MF shirt. I'd have that MF shirt."

     (Feel free to think "MF" is a rap star turned shirt designer if you like".) 

    Anyway, all I'm saying is: I hope Denmark, because of a change in law and the urgency of the infertile, isn't turning into one big, obnoxious, desperate mess of a consignment sale. Their biggest fertility center usually has to turn away about twenty percent of its prospective patients because they can't handle the demand. Now it's up to forty-five percent. Anybody who applies now will probably be out of luck for the free care. 

    I was outraged to hear that the treatments, come January, will start at two thousand Kroner. Until I did the exchange rate and realized it was $367.87  in U.S. dollars. But of course the prices only go up from there.

    Still, I can't think of anything during my fertility treatments that cost $367.87. Maybe the consultation.

    So this week we're going to take a look at insurance coverage here in the U.S. as it affects infertility diagnosis and treatments. Only fifteen states presently require any coverage... and you might be surprised at the vague and sometimes peculiar criteria. We'll discuss...

    Listen, I gotta go. It's open enrollment time for the company health insurance and I have to decide whether I should have dental coverage or  pay my mortgage. At least if I decide on the dental coverage, I won't be the stereotypical homeless person with no teeth.

    I'll talk with ya again tomorrow.