Thursday, December 5, 2013

Land Of Fruitfulness VI

I am beyond frustrated mainly because in my opinion there really is no reason for this frustration as everything could have easily been organized and avoided.

Needless to say I am at the very beginning of this journey despite the fact that it has already been occuring for 6 months and I fully understand that this has the potential to go on for years and many people have done what I am doing for a long time.

I have done everything everyone has asked, I have done what my oncologist has told me which was basically just to jump through the hoops. I had an echocardiogram done which I knew I didn't need, I have faciliated commincation between multiple doctors offices when they really should have been able to do it themselves considering they are not only with the same hospital but in the same building and use the same medical record system. Now when I finally think I am all set there come yet another bump in the road but it appears to have the possiblity of being an even bigger obstacle deoending on the outcome.

Since I completed the preliminary testing months ago the plan has been to move forward trying artifical inseamination because I am so young and it seems as though everything should respond well to fertility drugs, etc. If that didn't work then of course there would be the plan B of invetro. but that would be later on down the road.

After I had the echo and got everyone all connected to be cleared to start fertility treatsments we then just began the waiting game of a new cycle. Which for me is always an unknown so that was fun. I was elated Wednesday when I discovered I had started a new cycle (or in laymens terms my period arrived) I called as soon as I had a second and tried to get things moving. There was a minor miscommunication that resulted in my speaking to the on call doctor that night around 6pm because I thought I need to start the shots that night. Only to discover that doesn't happen until day 3. Whoops, hopefully I am not being noted as a diffiicult patient cause I am not trying to be.

So then Thursday I awaited another phone call to get evrything setup. The nurse called and told me I needed be in Fridat at 8:30am for all the baseline testing and then I would get a call mid afternoon to start the shots. I would also be getting a call from the pharmacy about arranging the shots. I was so excited thinking maybe this was actually happening FINALLY!

Then I got another phone call from MGH I can't for the life of me remember her name but she is the one submitting the authorization to my insurance company for all of this. She informed me that based on my medical record I didn't meet the criteria for this to be covered by BCBS because of one hormone level being at 12 and their cutoff is 10. She proceeded to tell me that there was a very good chance they would deny me. So I needed to decided if I wanted to go ahead knowing I could be denied in which case I would have to pay for everything which would be a couple thousand dollars. For some people that might not be an issue but for me I don't have a couple thousand dollars laying around if we did need to pay. So basically the only option was for me was to wait until they get the approval or denial back next week and then hopefully try again for my next cycle (whenever that will be). 

I of course asked if I was denied then does that mean I could never get any kind of fertility treatment without having to pay for it? She said there would a good chance I would approved for invetro. I explained how that didn't make sense to me because inseamination was pretty much entry level to all this therefore it is less invasive, less expensive, etc. so why would I be denied for that but approved for invetro which highly invasive and very expensive? Her only response was that because with the slightly elevated hormone level the success rate of inseamination was lower but invetro would have a higher success rate. I would say I could agree with that if they tried it once and it didn't work but otherwise I don't get it at all.

The part that brings about my frustration is this has been the plan for months and even if they were waiting to get clearance from the echo and such, all that was done at least two weeks ago so why didn't they submit an authorization before today? They have my medical record, they know the qualifying criteria for the insurance company. If there was even a question that it might not be covered (which would seem to be a concern for most people) they should have been organized enough to have this all set. I feel like I have been jumping through all their hoops and getting nothing in return. 
I feel lost as though I am supposed to just know all of this. It's not like there is an orientation to this process we are basically flying by the seat of our pants.

So I am frustrated in having to postpone even longer with high possibility of not begin able to proceed as planned which in my opinion would be like starting from the beginning.

If there is anyone out there who would like to be our fertility sponsor please let me know. I really wish there were more resources for fertility post cancer treatment!

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