Monday, November 2, 2009

The Witch Has Arrived

Well, she arrived in full force on Saturday.  Lucky me.  I'll be picking up my femara tonight in conjunction with some much-needed grocery shopping.  I feel terrible, because I just don't feel like it's going to work, but third time's the charm, right? *eye roll*  Nick maintains his ever-optimistic point of view, though.  I suppose one of us should.

Speaking of Nick, he called the insurance company today to inquire about a few things:

  • Why are our bills from office visits with no procedures costing us more than $200 out of pocket?
  • Why did a single tube of blood and it's subsequent lab-running cost nearly $300?
  • What will we need to do when we go back to do our HSG/IUI/any procedure?
  • Why do we have to spend thousands of dollars to do something that lots of women get to do for free? (He didn't really ask them this, but their answer would have been something like, "To keep us in business!")
I was on the edge of my seat...er...couch...to hear what they had to say.  I was envisioning an "Oh! We've made a mistake! Let us send you a bunch of money!" kind of conversation.  No.Such.Luck.

Basically, after we hit our deductible (it gets fuzzy after this because I literally understand nothing about insurance), they pay 90% until we've paid $1200 out of pocket for the year, then they pay 100%.  They said I've hit my deductible (yay), so they're paying 90% at this point.  This begs the question: Where, in the name of all that is holy, do they get off charging $2000 for 30 minutes in a doctor's office?!?  Unless I'm doing the math wrong, the fact that I've paid $200 for office visits, and Cigna is paying 90%, says to me that the office visits cost $2000!  Please tell me I'm wrong!  Nick forgot to ask them about the lab work, so he'll call them back soon to talk about that.

As for the procedures, we have to get pre-authorization on a procedure by procedure basis.  Is this normal?  I guess I was thinking/hoping/assuming that it would just be an umbrella pre-auth.  What I want to know is how long they're going to take to do the authorization once we tell them we are doing a procedure.  I mean, if I'm only given a week or two of warning beforehand, will that be enough time, or will I be paying out of pocket for the joy of someone shooting dye up my fallopian tubes?  I just don't know.  I mean, I guess I should be happy that we even HAVE infertility coverage, but it's such a pain in the butt, know what I mean?  They DO cover AI, IUI, and certain types of IVF (I've been putting off doing any overt research on IVF in the hopes that I won't ever need it).  However, we have MedCo for prescriptions and I hate them.  They're all about 30 day supplies of stuff, even though we keep trying to explain to them that I only need 10 pills or a week's worth of antibiotics or whatever.  ugh  It makes me wish I drank!

Anyway, this post is getting longer than I was expecting it to, and I'm sure it's bored you to death.  I'm very sorry.  Hopefully soon, my hormones will make me be in a better mood and all my posts won't be whiny.  One can only hope.

5 comments:

Marla.z November 3, 2009 at 12:04 AM  

Hmmmmm. Gotta love insurance questions. My insurance sux a**. Every time we call them about an inquiry, someone tells us something different. We can never get a straight answer.

Here are my thoughts for your $200 dr's visit: Perhaps, you reached your deductible with that visit, meaning from this point forward, you pay 10% and they pay 90%. That's my best guess, because no appt cost 2 grand. Hell, my RE was entirely out of pocket, and she's an expensive biotch, but she was less than 1/4 of that.

I have no opinions about the time needed for the pre-auth. I don't have Cigna, so I can't help you there. Sorry. Good luck with your insurance issues. I'm in the same boat.

Elizabeth November 3, 2009 at 7:38 AM  

I used to have Cigna, and I have to tell you there is a lot worse out there (like the one I have now). That being said, I still think ALL insurance SUCKS! So sorry you're going through all this crap! Our insurance covers NOTHING related to treating infertility, but would pick up the cost (minus co-pay) after we reach our $1500 deductable for diagnosing the cause of infertility.
When I had my HSG they covered the cost past my $1500, and now have a medical line of credit that I signed up for so I can keep from being sent to collections because I can't write a check for $1500 like it's pocket change.
Hope that you can find some answers and not have to pay so much in the future!

Heather November 15, 2009 at 8:58 PM  
This comment has been removed by the author.
heathermohr November 15, 2009 at 9:00 PM  

Good luck with everything!

Skye November 27, 2009 at 9:25 PM  

$2000?! So it isn't just the doctor there who drives a BMW, it's the nurses too? Yikes!