My head is spinning...
11 Replies
AnnieO27 - April 23

Hi Everyone,
I'm new to this board after just finding out that my tubes are pretty much blocked. :(
We've been TTC for about 10 months now. I had a HSG last week, and I'm going back to the doctor's in about 3 weeks to talk about my options. It kinda looks like IVF is gonna be the best bet at this point though. I've been reading up on the process...and frankly it's making my head spin a bit...so much information!
My biggest question right now is how we're going to afford all of this! I live in Illinois and had heard that there are laws that require insurance companies to cover infertility problems...yet my husband's insurance clearly states that they do NOT cover any of it. Does anyone know where I can find more information regarding this?

Thanks in advance for any help anyone can offer! :)

 

WantsBaby2 - April 24

Welcome Annie,
I am sorry you have been cursed with this infertility thing. You are in good company. The women on this site are great and feel free to vent anytime you need to.

I live in Illinois and I know they have one of the best mandates for coverage in the country. I have heard of other girls on the site that live here too and don't have good coverage though. I am not sure how that works. Maybe I will try to poke around a bit and find out why some of us have such great coverage and some of us don't.

Good luck to you on your journey. If I can get any info on this I will post back to you. Keep us posted Annie!

Wantsbaby2

 

BabyBound - April 24

Well, Annie, I know all to well how this work. I've worked in Human Resource's Benefits for over 9 years now and know why some companies in IL don't have infertility treatment. As Wantsababy stated, IL mandates the coverage of infertility treament, however it's only mandated for "full insured" insurance policies, not "self-funded" another name is "self-insured." Usually small companies have fully-insured plans because its cost-effective for the company. However, mid to large companies are self-funded...they control what's covered and not covered in their insurance plans and do not have to follow state mandates. Claims are paid by the company and they have a stop-loss clause, which states they stop paying at a certain $ amount and than the insurance company pays. You can see that infertility is a huge cost for companies who are set up this way (especially with a larger population) so this is there way of cutting their cost overall. I know it's a pain and this is the type of insuance my husband's company has...even though they do cover our IUI (we have a $200 copay) and all of the monitoring and bloodwork...but that's it.

My company on the other hand has a fully-insured policy and covers infertility treatment. However, I can't enroll into my plan until October. Hopefully, I want need to.

I just wanted you to know that I feel your pain and wanted to give you information your husband can ask his employer. Good Luck!

 

WantsBaby2 - April 24

Annie,
Looks like Babybound has got it covered. Thanks for the info Babybound. I always wondered how that worked.

Wantsbaby2

 

Shanie2005 - April 24

Hi -

I just found this board today and have almost the same issues...wasn't sure if you re trying for #2 or your first. I just got had an hsg done(last week) and going back to my fertility doc wednesday. We were hoping to try IUI out first since the cost of IVF is so expensive...let me know what you find out! While getting the HSG my Doc asked if I still had both tubes... so THAT concerns me - I did in 2003 so who knows what it will bring.

Chrisy

PS If anyone out there who tried IUI for tubal blockage first please let me know - thanks ;)

 

BabyBound - April 24

Hi Shanie, welcome to the site. You have hit the jackpot on support and understanding. As for your question regarding block tubes...all I know is my RE told me that if my tubes were blocked my best protocol for a pregnancy was IVF. My hsg can back o.k. and I just completed my first iui...I have 3 days before I test. I hope your tubes are fine. Please keep us posted and ask any questions you may have.

Good luck.

 

shanie2005 - April 24

babybound -

good luck!! this is the best site! let me know how your test goes. we are TTC#2 we are 32 & 34 yrs old - never had endometriosis or tubal problems until after I had a c section due to not dialating... I had a lap and had lots of scar tissue etc so we really want to try IUI give it a shot- hope for the best :)

good luck!!!

 

tiggerpounce418 - April 24

I live in PA and there are no laws requiring insurance companies to pay for infertility treatment here. However, just across the river in New Jersey, the do cover it.

So, it does vary by state & by plan. My plan does not cover any type of artificial insemination. Everything else has been covered so far (hsg, s.a., blood tests, meds).

Good luck.

 

paige - April 24

Hi Tigger I noticed you were online right now. I am trying to find someone to ask questions to and share stories. My implantation is in three days and everyon has been so sweet. I just wish I knew a good time to log on so I can peak to you all. You have great questions and stories. Let me know Thanks

 

Fortyfour - April 25

shanie, Welcome to the site and good luck with this crazymaking process. Keep in touch with us.

 

snindy - April 25

Some insurance companies will pay for IVF for only one try in your life time and some don't pay anything like my insurance company, but I know that some offices will accept a payment plan. I think you can make monthly payments if your serious about IVF. I know, it's a hard decision to make but best wishes on your journey and any decision you make.

Good luck,
Cindy

 

AnnieO27 - April 26

Thanks everyone for the responses and encouragement. I know $ shouldn't be a primary issue right now, but unfortunately it's how I think. We're commited to trying everything possible to get pregnant though...beg, borrow or steal! ;) ;D

 

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