Saturday, December 6, 2008

Now what do I do?

Every step forward we take in the TTC journey takes us back 2 steps. It’s like walking on a landmine. Every step forward sets one off! So many people in the world skip and hop along life smoothly. Why not us? Why must we have to fight fate at every step?

I’m tired. Exhausted. Out of steam. I don’t know what else to do now. I’ve kept my chin up through the entire last year, through every disappointment, through every piece of bad news. DH and I have held each other’s hand and plowed forward through every problem that arose.

Most of you know the hoops and loops we’ve gone through in the last year. We are finally at the stage where we are getting set to start our last and final IVF. I did not expect to find out what I found out today. And I’m devastated.

CCRM had called in my prescription to my insurance company’s specialty pharmacy (if I get my fertility medication from anywhere else, they do not cover it). I was calling today to check on the status of my medication, to make sure everything had got approved and we were all set, and to see when they were shipping the meds out. While I was on hold, I logged into their site to make sure I had all the information ready for them when they answered.

I was completely caught unawares by what I saw on the site – “Coverage end date: 12/31/08” WTH?????? I am on COBRA – I pay a hell of a lot of money every month to keep my insurance going so that I have IF coverage. I am eligible to be on COBRA for at least 8 more months. I don’t understand why my coverage is lapsing.

I contacted my ex-employer’s HR department, and found out they are changing insurance service providers wef 1/1/2009, and of course nobody thought it important to inform an ex employee who is on COBRA, and quite frankly, at this point, whose life depends on that COBRA coverage!!

I don’t know what to do now. If I roll on to the new coverage, it will not be effective till Jan 1. And if I am not a member till Jan 1, CCRM can’t even get pre-approvals etc for my IVF. I am supposed to start stims at the end of Dec and ER happens early Jan, ET mid Jan.

Not just is the treatment coverage at stake now, but also the prescriptions – the refills! Per my prescription, and my discussion with CCRM, I am sure I will need to get additional doses of Gonal F, and till I am a member I will not even know how the new insurance company covers fertility drugs. Also my prescription has already been sent to my current insurance. Sending a new prescription after Jan 1 will mean waiting for the entire approval process etc etc etc.

At this point, I cannot afford to pay out of pocket for this IVF either. I'm completely at wit's end about what I can do now.......

How on earth am I going to do this IVF? I feel like the wind just got knocked out of me – entirely deflated! I’m tired, and I really cannot fight any longer. I’m tired of crying, and I’m tired of figuring out how to fight fate any more.

I wanted to go into this IVF with a calm state of mind. How am I supposed to be calm now?

My whole bloody life works on Murphy’s Law : If something can go wrong, it will.


Lisa said...

Crap - that stinks - they should have totally notified you. This may be a stupid question, but can you order a ton of meds now (not sure how long your med cycle is) and let the Jan. 1 effective insurance pick up your procedures if they occur after Jan. 1? I hope it works out.

April said...

arg! is there any way that you can do all that you can with this insurance before the end of the month? like get the meds, try to get a refill even if you don't need it, then cross the other bridge when you get there? i think that you should try to get all that you can out of the cobra before it goes away. also....can't you get cobra without being affiliated with a business? maybe the coverage is just different.

this sucks. take a step back. let's figure it out.....there *has* to be a way.

Linda said...

I'm sorry you're having to deal with the extra stress dealing with insurance. Is there anyway you could get all your meds now, before your insurance expires? Or could you pay first and then get re-imbursed? Or could you let your new insurance company know what you're doing and maybe get pre-approval early? We're 100% out-of-pocket, so I really don't have any other advice. I hope that everything gets resolved in your favor soon! *hugs*

I Believe in Miracles said...

I'm so sorry!! That's so tough. I don't really know what to say. I'm praying for you, that some miraculous solution will work.

Miss Tori said...


First, just breathe. You will get through this.

Next, first thing Monday morning, call your ex-HR people and ask if the new carrier has a form such as "Continuation of Care" or "Continuity of Care" which you can fill out and get to the new carrier prior to 1/1/09, so that they know that you are in the middle of a treatment program and that you can get any pre-certs and pre-auths done prior to the start of the new coverage. There should be no reason why you can't do this now.

Obviously, I'm not familiar with California insurance laws, but I would imagine that the carriers there have the same type of forms we use here in Colorado. If your HR person isn't familiar with this form, ask him/her to ask the agent or carrier rep that they are working with for the form.

If you need the name of an insurance agent who is familiar with things there, let me know and I can put you in touch with one, that way he/she will know exactly what you need to do to make sure you aren't hit with a road block for the care you need after 1/1/09.

E-mail me (my blog has my address) and I can give you additional information or talk with you to answer any questions.

Also, there is no reason that you shouldn't be able to order additional meds through your current carrier. I was able to order additional meds the day after I got my first shipment. So that should help put your mind to ease a little there.

I hope this helps a little. You'll make it through this. I promise!


Lorraine said...

Noooo! After everything it takes to get geared up for a new cycle, some administrative glitch is such a crappy reason for things to fall apart...

I hope you can find somebody at the other end of an 800 number who can coordinate the transition. Insurance is regulated by the state, so it may be worth looking into exactly how much leeway they have in terms of interrupting a process that is already underway?

Loads of good luck on this one!

Jackie. said...

LOVE that Miss Tori. She has some specific and actionable feedback that you can put into play on Monday. I know that you can make it through this.

My family underwent some similar challenges with my grandmother's care a few years ago. I know that there was no interruption in her care because her daughters were diligent about asking questions and doing follow-up. This is exactly your expertise! You said that you are deflated, and I understand that. Please try your best to relax this weekend because you will need all of your strength to DO WHAT YOU DO BEST on Monday.

This is not over.

((((((((((hugs hugs hugs)))))))))))

the Babychaser: said...

I think Ms Tori is right. I was told when I was thinking about changing carriers--which would have hit mid-cycle--that if you're in the middle of a treatment cycle the old carrier stays on the hook for it.

God, I know how this shit can come up and smack you around, just when you thought you'd come to terms with the truckload of shit you already were dealing with. This is why I keep xanax in my purse, seriously.

But I think this one can be worked out. Yes, your employer blew it. But hopefully you can just mad abstractly, rather than have your cycle messed up.

Hang in there and keep us posted.

Anonymous said...

Oh my god, this is unbelievable. I am so sorry. It sounds like Miss Tori has some great advice for you. In the meantime, just try to take things one day a at a time, and breathe. I really hope this works out and it sounds like there is a way to do it. My fingers are crossed for you.

margelina said...

Ugh, I am so, so sorry Nikki. I completely understand how you always seems like when things go wrong, they go really wrong, all at once. I do not know why each step has to be so difficult for you, but you don't deserve that.
I hope you are able to find a solution to this soon. Miss Tori had alot of excellent ideas to give you a starting point, so hopefully there is something there that will work for you. I pray that you get the strength to soldier on and work this out. You so deserve this, very much. (((hugs)))

Lisa said...

Oh gosh Nikki. I'm so sorry you are having to deal with all this B*LLSH*T! Especially right now, when you are so close and everything is going so well. It's NOT FAIR!!! But maybe you can order all the meds now, and then prepay the entire IVF cycle upfront. They require you to pay for everything upfront anyway, so can you just pay it all now? I don't know, I'm sure it's more commplicated than that, and I'm so sorry that you are having to deal with all this!

Take a deep breath. I'm sure there is a way to work this out. But it probably won't be easy and I know you are so tired and just trying to gear yourself up for a peaceful and calm couple of weeks before the cycle starts. Try your best to stay calm while you sort this out. You can't let this little (okay big!) glitch stop you. 2009 is going to be your year, I can feel it! You've come too far to give up now.