Are we parents yet?

The Clements’ IVF Journey

Underlying medical condition? October 23, 2008

Filed under: Financials for IVF — Aria @ 8:41 pm

Are occluded fallopian tubes generally considered to be an “underlying medical condition” for infertility?

Why I ask is infuriating.

Last time I talked to the insurance company, they now claim we DO have out-of-network coverage (saying we didn’t is why we had to stop, and now we magically do??), but they the woman said that IVF and such isn’t family-planning, birth control and abortions are.  I ripped her a new one for that, for trying to claim that preventing a baby is family planning and trying to have a family isn’t, and then she withdrew that statement and said that, okay, if fertility treatments are due to an underlying medical condition, then it’s covered.  I asked if occluded tubes counted, and she said it might not be a medical condition, I’d need to go through treatment AND THEN see what billing says.  She spoke opposites throughout the entire phone call.  I have her name and number.

Cody and I are drafting a letter to Steve Jobs about United.  We found out from one of Apple’s HR reps that we aren’t the only ones having problem (my oldest friend’s husband nearly died and United refused to cover the ambulance because they didn’t get it pre-authorized!!).

So I’m trying to find out if this is generally considered to be an “underlying medical condition” or not.  If it is for other companies and doctors, then they have some explaining to do about why they haven’t covered us so far and why we’re getting billed from the previous doctor, and we can try to figure out from there how to trap them into paying for what they’re supposed to pay for.

Our next appointment is the 30th.


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