Cody and I chose the insurance company United. $15 for office visits, $20 for specialty office visits, $1,500 out of pocket max per year (not including office co-pays) with eligible expenses over that covered at 100%. Infertility treatments are covered at 50%. We called, more than once, prior to choosing this company, and were told each time that the treatments for in vitro are eligible expenses. We had our first (now maybe last) appointment today. In fact, we’ve been home all of five minutes. When we were there we found out that for the vast majority of the process, $8,000 worth, United specifically doesn’t contract with any facilities to cover. About $2,300 of it is contracted, but the rest would be up to us.
We feel extremely misled and devastated. From being told 100% over $1,500 is covered to finding out that $2,300 is contracted (we’d pay half, so $1,150, $350 shy of the $1,500OOP) and the rest they don’t contract with anyone for. Is this legal? Is this not a bait and switch? We called more than once to make sure about this! When the first girl, Meghan, said it was, I had her double check, and she said 100% over $1,500. We called the next day to make very sure, and that guy, Adam, said the same thing, and we have him double check, and he said 100% over $1,500. So to find out that insurance will cover $1,150 (half the $2,300) and leave us the remaining $8,000 is like having the rug pulled from under us, the breath knocked out of us. Not only that, they don’t even contract to cover half of those expenses. NOTHING AT ALL.
I don’t know how this can be legal. There were no exclusions, and in vitro SPECIFICALLY is mentioned BY NAME as covered! Can it possibly be legal for a company to have it in writing that 50% of on vitro is covered, with 100% over $1,500, but then to not even actually contract with companies to do the procedures?!
Devastation is really too easy of a word for how we feel right now. IVF is our only chance. We pay taxes to cover the welfare for people who have kids and won’t work (but who can), while we’re trying to find some way to have a family, Cody busted his ass to get into a position with benefits, only to find this out. Something is wrong here.
I feel like an utter fool for thinking something good was going to happen to us, and ashamed that I had hope for this working out.
I’ve got a letter in to an attorney about this. I really feel this is bait and switch, an intentional misleading. Claiming to cover half, and all over a certain amount, only to not contract for it to begin with sounds like it borders on fraud.