Sara and Chip found that the doctors, tests and insurers meant to help them overcome infertility were more like obstacles.
My husband and I were married in May 2015. I was in my late thirties, while my husband Chip was already forty. We knew we wanted to start trying to get pregnant right away. We had no idea how heartbreaking the journey from infertility to parenthood would be.
After a year of trying without success, we decided to find out why we weren’t getting pregnant. As an elementary school teacher I put off seeing the doctor until closer to the end of the school year. But there was a nagging feeling that time was slipping away from us. I was already 39 and feeling like it was getting to be “too late.”
I went to my OBGYN and got bloods done. Nothing out of the ordinary. ($40 copay + $85.42 out-of-pocket for bloods).
My OBGYN sent me for an internal x-ray to look at my uterus, fallopian tubes and ovaries. We weren’t able to get that scheduled until the end of July. It was EXTREMELY uncomfortable (and cost $700.00). Results? Normal. My doctor said Chip needed to get checked also. At this time Chip was traveling regularly for work, almost every month, so he wasn’t able to get to the urologist right away. School began for me in August and the time was ticking away. We were four months in and hadn’t really even started yet.
Chip went to the urologist, had an exam and gave a sperm sample – the results? “Inconclusive.” He repeated it (costing a total of $198.44). Finally, in the end of November, we got an answer! It was only then, seven months into addressing our infertility, that we were ready to go to a fertility specialist. But by then it was the holidays and we needed a break from all of it.
We decided to continue “trying on our own”, taking a break from doctors, appointments and the stress. We spent quality time with our families and let our wallets recover a little.
Then, again, school was in full swing and Chip was traveling a lot for work. We finally got into the fertility specialist in May 2017 – one year after we started.
After discussing options with the doctor, we decided to try an intrauterine insemination (IUI). This required an initial exam, an ultrasound, some testing at home, then another doctor visit for both of us for the procedure to be performed.
The next month, we went through the entire procedure all over again. The two IUI’s ended up costing us $1455 and I was still not pregnant. This journey had cost us $2478.86 so far, with nothing to show for it.
Summer was over. We decided, for our own mental and physical (and financial) health, to take a break from specialists. We went back to trying on our own, again. School began and we continued with our lives and the heartache of knowing we still didn’t have a child.
When December of 2017 came we doubled our determination to get pregnant. We met with our fertility doctor again, this time to discuss IVF. It would be our best hope of having our own biological baby.
One of Chip’s co-workers who had been through the fertility process as well, said that Blue Cross Blue Shield of Illinois (their employer based insurance) covered infertility treatments. We tried to get some of the visits and tests covered retroactively but because I was not on his insurance (I was still on Cigna from before we were married) Blue Cross Blue Shield of Illinois (BCBSIL) denied any of our claims.
Meanwhile, my insurance, Cigna, didn’t cover anything having to do with infertility.
The IVF procedure costs $8400. That didn’t include the medicines, equipment and appointments. Sadly, without insurance coverage we simply couldn’t afford that.
To solve that, Chip added me to his policy in January 2018. Our doctor is an in-network provider, but, it turned out the facility where he performs IVF is not. I called BCBSIL (customer service was terrible) and was told all I needed to do was “apply for a PPO waiver”. Supposedly I could do this over the phone, so I did, and it would take 15 days to be approved.
We scheduled an appointment with the doctor for February – plenty of time for the PPO waiver. I called 15 days later and they claimed there was NO RECORD OF OUR WAIVER! What?! I re-applied for the waiver. This time I made sure to get a name and confirmation number. We waited, yet another 15 days.
There are many steps leading up the implantation of the fertilized egg so despite the “lost waiver” we went to our February appointment anyway.
We had two consultations and some bloodwork ($436.66). The next appointment was to do more bloodwork, an ultrasound, learn how to do the hormone injections, order the medicine and discuss costs.
We finally got a letter in the mail from BCBSIL: WAIVER DENIED. They claimed there was another in-network facility in our city where the procedure could be performed. We filed an appeal. The appeal would supposedly take 30 days. I called one week after the 30 days was up and they claimed there was NO RECORD OF THE APPEAL!
I demanded to speak to a supervisor at BCBSIL.
They treated me rudely, condescendingly.
Ultimately, I filed a complaint with a supervisor.
It’s a back and forth, constant waiting game. After my complaint BCBSIL “magically” found the appeal but denied it, AGAIN. I got on the phone. BCBSIL could/would not tell me where this “in-network facility” was. I emailed – no response. I was finally given an address of a facility. We searched but the facility no longer existed. I filed another appeal and waited another 30 days. Our doctor called BCBSIL and did a peer-to-peer review: Denied.
In May, two years after we began our hopeful journey towards having a child, I was fed up. I turned to sharing our experience on social media. My social media campaign got BCBSIL to pay attention. I’ll show you how next time.
Sara C. Tate is an educator, writer, blogger and working on a children’s book. She is a beloved daughter, sister, auntie, wife, friend and amazing teacher whom her students adore! Sara and her husband, Chip, live in Midlothian, VA with their two cats, Fozzy and Lulu. Twitter @saratate3blog