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Old 03-13-2008, 10:02 AM
CryingInside's Avatar
CryingInside CryingInside is offline
Senior Member
 
Join Date: May 2006
Posts: 2,067
Exclamation I need your help ladies!!!!

I just found out that my insurance is only going to approve my lap procedure on the infertility level instead of the medical level. If it was approved for medical reasons it would be covered 100% with a $250 deductible. Instead it is under infertility and is approved at 80/20% with a $2000 max. In other words, instead of costing us $250 it is probably going to cost us $2000! Crap, crap, crap! My doctor is appealing their decision, but is there anything at all I can do? Do you think I can write a letter of appeal or something. I wouldn't even know what to say! Have any of you had to do that before?

On top of that, my silly washing machine stopped working a couple of days ago....we don't have enough room in the laundry room for the new, much larger machines! They are all a good 3 inches too big for the space we have available. Things are just not going well right now. And I am falling deeper into a depressive state. Darn it!
__________________


Stephanie 26
DH 26
TTC-actively 3 years, not-not trying (hehe) 5 years before that.
HSG-10/05 normal.
LAP-10/05 endo (Stage III or IV), fibroids & polyps in uterus, and a cyst on left ovary-all removed.
Pacemaker-08/06
LAP/Hysteroscopy-03/08 endo removed, tubes flushed, D & C. No fibroids, polyps, or cysts!
  • 4 clomid cycles (2 w/ IUI)
  • 4 injectible cycles (Femara 5mg & Follistim 75IU 2 times, 100IU 2 times, all w/ IUI)
Currently-
Not thinking, talking, or doing anything related to babies. Dh wants a baby-break.

09/08 Started taking Bee Pollen, Royal Jelly, and Propolis-just for fun.

www.myspace.com/stephaniehorst

http://stephaniehorst.blogspot.com/
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  #2 (permalink)  
Old 03-13-2008, 10:20 AM
MaggieMoo's Avatar
MaggieMoo MaggieMoo is offline
Senior Member
 
Join Date: Aug 2006
Posts: 2,227
Awww Steph!! Big 'ol hugs to you!
There has to be somthing that can be done as far as the coding for the surgery??? Why don't they say you are complaining of menstrual issues. That has to be considered medical rather than IF. I hate insurances!!! They suck sometimes!!
__________________






Tricia: 33
DH: 34

DS: 7 years Old
DS: 1 year old

M/C: 9.14.05
ttc: 2.5 years
**7 cycles of clomid (2005-2006) & Progesterone

**2 Laps (9.04 & 3.06)
**HSG 9.06: Clear -No problems
**DH SA is PERFECT!!!
**FSH elevated & Estrogen low
10.2.06 NATURAL CYCLE (NO MEDS)!!!
10.3.06 Beta #1: 1,897 Prog: 29.44
10.5.06 Beta #2: 3,953 Prog: 21.59.
10.7.06 Beta #3 7,897 Prog: 43.95
10.25.06 Beta#4 166,438 Prog: 35.56
10.12.06 **Saw the sac, baby & heartbeat!!!
EDD: June 5th, 2007

U/S: 10.16.06 **Everything fine & looks good!!
U/S: 10.26.06 **Heard heart beat, Everything looks GREAT Graduated to my OB!!
11.3.06 Everything is fine! Heartbeat is 154 bpm
11.30.06 Perfect! Heartbeat 153 bpm
12.22.06 Perfect! Heartbeat 156 bpm **Active baby!
It's a Boy! Alexander Christopher - May 5th, 2007. 6lbs, 9oz, 18.5"



[
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  #3 (permalink)  
Old 03-13-2008, 10:32 AM
mdbrum16's Avatar
mdbrum16 mdbrum16 is offline
Senior Member
 
Join Date: Mar 2007
Posts: 536
My RE couldn't get mine covered either, so my OBGYN did the surgery and took lots of pics for my RE and it was covered 100%. Otherwise we were going to have to pay $1800. I'm not sure if that is an option, but figured I would throw it out there. Things will get better
__________________







Misti 27/ had stage 2 endometriosis/PCOS
DH 29/ Great
ttc 5 years
2 furbabies
Both Bassett Hounds
Lloyd and Daisy
7 double IUI's
used mixtures of Clomid and Gonal
IVF#1
Started Lupron 5/21
6/16 29 follies!!!
6/17 moved up target date!!!!from 6/19 13 eggs
6/20 ET only 1 to transfer!!!
7/2 BETA 12/11
Saw new RE Went on low amylose diet
2nd lap stage 3 endo!
6/12 BETA
Starting Embryo Adoption process
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Old 03-13-2008, 10:44 AM
mia23's Avatar
mia23 mia23 is offline
mia23
 
Join Date: Oct 2007
Posts: 1,092
Oh Stephanie I have no help my insurance only covered my lap 80/20 too. Maybe you could see like it was suggested if your OBGYN could do it. I hope the appeal goes well and they will cover it. As far as the stinking washing machine, Dh and I bought our last set at a used appliance store. They were older models but in very nice condition and clean. That could always be an option if only an older model will fit, and I also know that they have those special stackable ones for apartments maybe that would work. I am sorry this lap is causing you so many issues. Have you had one before? Was it covered then? Call me if you need to talk. And keep us updated about the appeal. everything works out for you!
__________________
Me- 24 PCOS & Endometriosis Stage II (Lap 1/2007 removed endo and everything else looked good!)
Dh- 34 Fine
BUTTONS (our kitty who thinks she is human)

9/06-11/06 3 Clomid w/ IUI all BFN

9/2007 Follistim Cycle #1 (75 IU) + timed B/D (1 follie)
BFN
10/2007 Follistim Cycle #2 (150IU) + 1 IUI (3 follies)
BFN - Had OHSS and cysts had to go on BCP
11/2007 Follistim Cycle #3 (150IU) + timed B/D (3 follies)
BFN- BCP due to cysts yet again
12/2007 Follistim Cycle #4 (150IU) + B2B IUI's (3 follies)
BFN (well possible chemical pregnancy)-
OHSS & cysts back to BCP

2/2008 Follistim Cycle #5 (150IU) + timed B/D (4 follies)
BFN


Natural Cycles
Cycle #1-46 Day Cycle, Cycle #2-38 Day Cycle, Cycle #3- 33 Day Cycle, Cycle #4- 37 Day, Cycle #5- 35 Day Cycle Cycle #6 -33 Day Cycle


Taking a break from trying to become a momma to focus on myself and my marriage. Working hard in therapy .
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Old 03-13-2008, 03:54 PM
sarah16's Avatar
sarah16 sarah16 is offline
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Join Date: Nov 2006
Posts: 4,111
I don't have any advice but I wanted to say good luck and I'm praying for you!!
__________________
ME: 29
DH: 29
Beautiful daughter born 4-23-03
TTC since Feb 2005 - didn't ovulate
Started treatment Aug 2006
6 rounds of clomid
tubes are open
bloodwork is good
3 rounds of femara/follistim/HCG
2 IUIs
6 months of acupuncture
Moving on to infant domestic adoption!

Officially waiting to be matched!! -- June '08
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  #6 (permalink)  
Old 03-13-2008, 04:27 PM
mnm000 mnm000 is offline
Senior Member
 
Join Date: Aug 2007
Posts: 477
Oh man, Stephanie, that just stinks. I know how long and hard you have been waiting for the surgery to be done so that you can move on to another cycle. I hope and pray that your doctor will get it figured out with your insurance.
__________________
Me- Unexplained
DH- slight morphology issues.
Married for 3 years
3 failed cycles of Clomid
3 failed cycles of follistim
May 08 - Lap
August IVF
July 11th - start Lupron
July 26th - start stims-follistim and menopur
August 6th - ER
August 11th - ET (2 blasts!!)
August 25th - BETA is in at 2700!!!
8/27 - Beta #2 is 7000
9/8 - 1st US - It's twins!!!
12/1 - Gender Scan


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