Thursday, September 12, 2013

Infertility is not a boob job*

Infertility is not analogous to butt implants, or a nose job, or a tummy tuck either. And yet in our most recent insurance coverage update, our insurance company lists "Infertility" right next to "Cosmetic Surgery" in their list of non-covered procedures. To say this bothers me is an understatement; those who know me best have hear me rant extensively about it.

In fact, I get to a point just about like this when it comes to our insurance company.

At this point, my husband refuses to let me speak to our insurance company at all (or our former doctor's office for that matter).

I've finally figured out why the lack of coverage bothers me so very much. First is the way that it reflects the broader cultural problem where infertility is not considered a "real" medical problem. You would never hear someone facing cancer advised to "just relax" or "go on a cruise." But people facing infertility hear these unhelpful suggestions constantly, which downplay the seriousness of what they are facing. The second reason the lack of coverage bothers me so much relates to the fact that we have "really good" health insurance. As the HR person/company mom told my husband when he added me to their plan, other women have given birth and paid next to nothing. Looking at the coverage document, assuming one stayed in-network, there would no co-pays whatsoever for all prenatal care or labor and delivery. Believe me, I understand that infertility care is expensive,** but giving birth isn't cheap either (in our area $15-20k billed to insurance). Yet here I am, paying ridiculously high premiums for insurance that covers next to nothing I use. It's to the point that I have actively considered being uninsured (realistically self-insured) instead of spending so much on health insurance. The high price I pay is subsidizing those who can get pregnant and have kids; I get very frustrated by the multitudinous ways infertiles end up subsidizing those with children (paying higher taxes, countless government programs to benefit women and children like WIC, SCHIP, etc, not to mention the semi-voluntary gift giving and supporting fund raisers of children of friends and family). Coupled with that is the assumption of many that "oh, you don't have children, so you have all this extra money (sometimes implied: to spend on MY kids)."

I really wish that insurance could be purchased a la carte (same thing with TV channels, but that's a whole nother story). I would love being able to choose what is and isn't covered and whether the cost of coverage was worth the price. Realistically I probably wouldn't forgo maternity and child birth coverage just yet, but I would really like that option. Instead, my options are to continue paying $6,000 a year to be covered under the plan offered by my husband's employer, to forgo health insurance, or to take my chances on the individual market. I don't know about you, but I can think of a lot I could do with $6,000 a year. Others have told me that NaPro docs are better at coding treatments so that they don't end up as "infertility"and actually get covered, but I'm not getting my hopes up too high at this point.

* Alternate title: You bet your sweet bippy I'm bitter

** Please note that I am not remotely suggesting that the government mandate insurance coverage of infertility. I'm also not saying that I think insurance should cover the most expensive treatments, such as IVF, especially since their success rates are low. (Yes, I know and agree with the ethical arguments against IVF, but I don't know too many insurance companies that would consider those arguments.) I'm just saying that it would be awfully nice if insurance covered first line infertility treatments, such as Clomid and Femara and the monitoring required.

1 comment:

  1. Love your titles, lol! Yes, NaPro Drs are better about coding stuff my first surgery we didn't pay a dime and my second we only paid a few hundred buck, but my hubby has really good union insurance so I know it's not the norm. Most of our prescriptions have been covered as well, again I know it's not the norm. The only things insurance doesn't cover is the bio identical hormones so we pay out of pocket for those and claim it on our taxes because it is a medical treatment. It is so frustrating dealing w/ insurance companies on top of dealing w/ IF :(