Monday, April 25, 2005

Aftermath

There is not much more to say. I have not found any silver lining; I haven't been able to dredge any humor from my heart; I have not found a distraction from the failure, the loss of hope.

The pain is compounded by the unexpected shock of our insurer's refusal to cover the procedure, even after our doctor submitted a letter of medical necessity. We received the official denial upon returning from Yosemite.

Jeff's sperm is not adequately abnormal for them to approve the ICSI; I may or may not have been sufficiently diagnosed as broken in advance to qualify for the IVF at all without three FSH/IUI's. Now that I am designated a poor responder, and the decision to do IVF with ICSI, though unsuccessful, was clearly the right call for our paltry harvest, the insurance company says that it doesn't matter--that the diagnosis can't be made in retrospect. None of their abstruse restrictions were made known to us when calling to verify coverage months ago. There are appeals processes, but it seems hopeless.

I am trying to keep it together, I am trying to stay calm, but I'm failing. Oh, god, how I am failing.

36 Comments:

Blogger Miss W said...

Wanted to let you know that I'm thinking of you and praying for some peace in all of this. I only wish there was more that I could do to help you through this.

12:13 PM  
Blogger Jenn said...

I don't know what to say--I so want to be able to give you a hug right now. Take all that you need right now from everyone in your life in order to get through this in any way you deem necessary.

12:19 PM  
Anonymous amanda said...

Fuck. I'm so sorry. So very sorry.

12:59 PM  
Blogger Jen said...

I'm so sorry, my dear. Seriously, please let me know if you want any help battling the insurance company. If nothing else, I can kick them in the knees for you.

Love to you and Jeff.

1:06 PM  
Blogger JJ said...

I don't know what to say to be helpful, or comforting, or wise. I'm sorry. This sucks so bad.

1:20 PM  
Anonymous Anonymous said...

Bugs -

I am so sorry you are having to go through this hell. It's not fair. None of it is fair.

I am here for you.

You are in my thoughts.

Moogielou

1:28 PM  
Blogger Julie said...

And we are all here to catch you. Insurance companies suck ass. Plain and simple. Please appeal. They told my mom that my dad didn't need to be hospitalized for as long as he was. She pointed out that he had a stroke. They said it didn't matter. She won after a long battle. The hospital was very patient in waiting for their money.

{{{{{HUGS}}}}}}}}}

1:28 PM  
Anonymous Soper said...

Contact a lawyer and mention these words "BAD FAITH REFUSAL TO PAY."

Go kick some ass.

2:00 PM  
Anonymous Dooneybug said...

Oh Dear Bug,

I'm so sorry. Insurance companies have no heart, have no soul. I hope that a positive resloution will be made if you proceed with appeals. Best of luck, I will pray for you!

2:06 PM  
Blogger Suz said...

Sweet bugs, I'm so, so, so sorry. I can't tell you how sorry I am that you have to suffer this one-two punch.

Let me know if there's anything, anything at all that I can do to help.

2:07 PM  
Anonymous jen-again said...

Appeal, Appeal, Appeal. Many insurance companies give an automatic no to first and second attempts...

Hugs to you and Jeff for all you are going through.

2:08 PM  
Anonymous b said...

I'm so sorry, Bugs. Thinking of you.

3:04 PM  
Blogger Anna H. said...

Oh Bug, wish I could make it all go away.

We are all here with you, my dear, and sending you love.

xxoo

3:16 PM  
Blogger Mudbug said...

Others have made this suggestion, but my lawyer is coming out--I can DO something about the insurance company. Appeal. Most definitely. Then, when and if they deny it again, you will (hopefully) be feeling stronger and you can take their ass to the mat. Or all your internet lawyer friends will do it for you.

So sorry sweetie.

3:41 PM  
Anonymous oliviadrab said...

Oh honey! I am so sorry! It's wrong that they should be allowed to dictate this. It is beyond unfair. The fact that they also rely on your being at a stage where it is difficult to fight is evil.

I am so sorry.

3:56 PM  
Blogger Cass said...

What a nasty welcome home gift. Geez. Don't they know flowers or chocolate would have been more appropriate?

I'm thinking of you and sending hugs to you and a big ass-kicking to the insurance company. I have an abundant supply of both, so they'll keep on coming as long as you need them.

4:04 PM  
Anonymous Julie said...

Loving the Bug over here.

5:38 PM  
Blogger Dramalish said...

I just got a very unwelcome BFN, and the suckiness with which it sucks is beyond measure.
I am sorry that you are enduring this, but remember: you ARE enduring. You are here; you are going forward; you are strong.
Your blog is a great help to me when I'm feeling alone in all this.
Blessings,
-D.

6:02 PM  
Blogger penelope said...

You really deserve a break. I am so so sorry they are kicking you while you're down - this is bad.

I hope that in about 3 weeks your righteous rage will come to the surface and you can take the nasty bastards on. Until then you are just too shattered to have to fight - it's not fair.

It's not fair, it's not fair, to the one-hundredth power.

6:11 PM  
Blogger Elle Dee said...

I am so so sorry. I keep trying to prepare myself for the worst case scenarios, but there are always ones we don't think about in advance - like the smack in the face from your insurance company - like salt in your wound. I'm so sorry. I wish I could send peace straight into your heart. I'm thinking of you.

6:13 PM  
Blogger penelope said...

I reread your post - I'm enraged for you.

What the hell is "adequately abnormal" - that makes no sense whatsoever. PLUS every single time they analyze sperm the numbers are different so how can there be a concrete measure of abnormality.

damn actuaries!

6:19 PM  
Anonymous Anonymous said...

I'm so sorry for the outcome.

Years ago when I had to fight with an insurance company my surgeon told me to write them and say I would contact my state's insurance commission and file a charge of acting in bad faith against the insurance company. He said this would strongly motivate them to pay and he was right! It was 11 years ago and things may well have changed but you can't do yourself any harm by contacting your state's insurance commission and ombudsman (if you have same). good luck!

Leslie

6:26 PM  
Blogger Cricket said...

The insurance companies are depending on patients being down/tired/sick so they can rip people off. Allow that to give you interest in fighting the good fight.

6:36 PM  
Blogger amyesq said...

Oh that sucks so so much. And who says you have to keep it all together? Geez, forget that, let it all hang out - you need it.

I am very much praying that the insurance company sees some reason and agrees to pay. I am with everyone else - appeal!

6:44 PM  
Anonymous akeeyu said...

Oh Bugs, I'm so sorry. I really wanted this to work for you.

I'm with Soper. Raise hell, legal if need be. My insurance company refused to pay a (admittedly much smaller) bill for over a year until I got a third party involved on my behalf.

6:52 PM  
Anonymous Anonymous said...

Yeah, what Soper said. I'm sorry Bugs. There is a special place in hell for insurance companies.

Emily

6:59 PM  
Blogger Zarqa said...

Damn it. That sucks majorly. I'm sorry and mad for you.

7:17 PM  
Anonymous Menita said...

Oh no that sucks.
I'm with the appeal and fight brigade. I fought my insurance company for a year on non-IF related stuff and finally got them to pay and yes, as someone said before, the hospital was very patient about waiting for their money (in fact they got into the appeal act big time).
I am so sorry you are having to deal with this now on top of everything, it just sucks.

7:50 PM  
Blogger Ova Girl said...

I keep coming back and reading your post wishing I had the right words to respond to all this terrible pain. It's so unfair and I am so sorry.
Can I just say - I happened to read via your profile, your post about "Choice" and i was deeply moved. At a time of great danger to yourself, physically and emotionally, you had the courage to move on, to get out and to find safety and happiness with your lovely partner. You've taken a hell of a lot of blows just recently, but you are a great fighter and a survivor.
Thinking of you with all hope.

11:32 PM  
Blogger Kristin said...

I am so sorry Bugs. It sucks beyond belief that this didn't work for you and it sucks even more that you're having to fight with your insurance. {{{{Hugs}}}}

7:06 AM  
Blogger Floyd said...

I wish I had some words that could comfort you during this time but it all seems so inadequate. Please know you're in my heart.

However, this insurance crap I do know about. CONTACT AN ATTORNEY. I am attorney and I'm telling you to contact one. I'm not saying sue but sometimes involving an attorney can get them to pay - it's a cost analysis issue. You want to threaten a "declaratory action" - it may help.

7:31 AM  
Anonymous Molly said...

Oh God. Just wanted to stop by and tell you how sorry I am. And to agree with Soper -- speak with a lawyer and make sure that all avenues are exhausted.

9:06 AM  
Anonymous Jenn said...

As a former appeals nurse for a HUGE insurance company...APPEAL, APPEAL, APPEAL! If you want any help with the appeal, what it should include, etc., e-mail me, I'll be more than happy to help.

9:23 AM  
Blogger Internal Spring said...

I have to agree with all the encouragement to appeal and/or contact a lawyer. I believe insurance companies pull stunts like this because they know people won't appeal, it's a cruel cost savings measure.

I hope you find some peace soon, that's what we all wish most of all for you.

1:24 PM  
Blogger Sandy said...

Bugs....I don't normally swear but for you in this situation, I swore out loud at my screen! Thinking about you and sending you thoughts of strength.

2:18 PM  
Anonymous j said...

I know it seems hopeless on the insurance front, but you really should appeal. My friend had a somewhat similar situation. Her insuranced company comfirmed that she had coverage for IVF, and in reliance on that, she went ahead and did her IVF cycle. They even reimbursed her for part of the cost, and then sought it back from her when they realized it wasn't covered after all. The insurance company was actually right that it shouldn't have been covered. She appealed, and had to go through two levels of appeal, but finally they let her keep the money, and paid her the rest. Even though technically it wasn't covered, they decided that since she was told that it was, and relied on that in going ahead, it wasn't right to go back on that. By the way, I'm a lawyer, and I sue insurance companies for a living. Unfortunately, I don't deal with health insurance, so can't be much help on this, except to say that insurance companies count on people giving up and not pursuing their rights. If you have the tenacity to appeal and pursue it, there is a good chance you will get something from them. The last thing you want right now, I'm sure, but it can really be worth it.

4:32 PM  

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