Thursday, February 24, 2011

I have a point at the end, I promise

I have a secret. A secret I fear minimizes the pain I feel on this journey, so I don't mention it. Sure you’ve had a failed IUI, two failed cycles of clomid, a painful HSG, a laparoscopy and will have to use all your vacation time to travel 3 hours one way to the RE you’ve been referred to but…at least you don’t have to PAY for it!

That’s right: my insurance coverage is stellar. Top-notch, really, you can’t compete with it. I am incredibly lucky and have no right to complain about the little bit that we do pay.*

There are many reasons I have this incredible insurance:
  1. My job. My company offers great medical benefits. I chose this job primarily for this reason. Before I got hired on here, I worked as a temp in the same position and had horrible insurance. I went to the emergency room once during that time and racked up $6000 worth of bills, of which my insurance company paid $50. Before that, I worked for a small non-profit that didn’t offer benefits, and I paid out-of-pocket for private insurance that denied all OBGYN claims, even my yearly exam, because I have had abnormal pap smears in the past (a “pre-existing condition”). I have been through the ringer with private insurance and “group plans” that actually really blow.
  2. My premiums are through the roof. I pay $343.16 a month for insurance for me and A, which is pretty reasonable for what we get. My company pays $676.70 per month. So if someone bought this policy on their own, they’d pay $1,019.86 a month – and no one but the healthiest of the healthy would ever make it through underwriting and qualify.
  3. My policy is awesome. $500 deductible, after that everything in network is covered at 90%. Including mental health and all medical procedures. $1000 out of pocket max after the deductible.
  4. My state kicks ass. By sheer luck, I was born and chose to stay in the state that is literally the best in the union at covering infertility. I am thankful EVERY DAY that I live here** and that I don’t work for a Catholic school.
Definition of Fertility/Patient Requirements
Infertility means the inability to conceive after one year of unprotected sexual intercourse or the inability to sustain a successful pregnancy.
o        Group insurers and HMOs that provide pregnancy related coverage must provide infertility treatment including, but not limited to: diagnosis of infertility; IVF; uterine embryo lavage; embryo transfer; artificial insemination; GIFT; ZIFT; low tubal ovum transfer.
o        Coverage for IVF, GIFT and ZIFT is provided if the patient has been unable to attain or sustain a successful pregnancy through reasonable, less costly, infertility treatments covered by insurance.
o        Each patient is covered for up to 4 egg retrievals. However, if a live birth occurs, two additional egg retrievals will be covered, with a lifetime maximum of six retrievals covered.
o        Employers with fewer than 25 employees do not have to provide coverage.
o        Does not require religious employers to cover infertility treatment.
o        Employers who self-insure are exempt from the requirements of the law.

So if you do the math, you see that hypothetically if I did three IVFs in one calendar year, I'd pay a total of $1,500. I cannot tell you how much relief this provides me. I do NOT take my coverage for granted. I know that without it, we probably could not even scrape together enough for one IVF. 

I am truly grateful.

But, after a bunch rambling, I arrive at my point: Why can’t ALL OF YOU have this coverage? It’s 90% luck on my part that I’m in this boat. What can we do to get your legislators to improve your state’s (and country’s) coverage mandates? Why can’t everyone take the affordability out of the equation? I am irate on your behalf.

The only thing we can do is to speak up. To answer honestly when someone asks us when we’re going to start a family. To bring up infertility in conversations it belongs in. To work hard to find that line between respecting our own privacy and speaking up for families we don’t even know. To write our legislators. To explain to the people who make the laws that infertility is a disease, and requires treatment just like breast cancer. IVF should not be a luxury, affordable only to celebrities and those who make enormous sacrifices.

The best tool we can use to change things is our voices.*** 


*This is the same reason that I don't say how old I am, because I am young, and I’m tired of people telling me “but you’re so young!” I understand that gives me an advantage and I’m glad. I don’t take that for granted. But when people say “you’re so young” it sounds more like “You can’t possibly be experiencing the biological yearning for a child that I do at 32” or “what do you know about wanting a baby, you should be bar-hopping” and I find those insinuations extremely offensive. (Wow, tangent much?)

**For a full overview of state-by-state insurance mandates for infertility, check out this page. And now you have all figured out where I live and are probably going to stalk me.


Still A Guest Room said...

It's so great that you have if we could only get it to spread!

Marissa said...

Don't feel guilty about having coverage!!! Yes, I'm a bit jealous and yes, I've talked to my husband about moving to IL, NJ, or MA or something, but seriously. Don't feel guilty for it. IF still sucks!

Drevas said...

Yay for AWESOME coverage! That is really, really great, my friend. :)

Alex said...

This is awesome!!!