Infertility Insurance ~ Listening to Stories
Listening has never been my strong suit. It's not what I lead with. Another of the many advantages to aging is that I've learned some new tricks. And you've helped me learn them. All of you. And especially my PathtoFertility readers, Ladies Night In women, and Fertile Yoga students. You all need to talk more than you need to listen, especially to each other and I need to listen more than I talk.
It's a perfect combination. You talk and I listen.
In listening, I heard the story out loud that is below. It's written by one of our now former patients. When I mentioned that it might be helpful to other men and women experiencing infertility treatment and dealing with infertility insurance coverage, she was quick to offer to help by agreeing to write the following blog for PathtoFertility. Sharing her experiences so that someone else might have an easier time.
What a lovely gift that I accepted with gratitude.
If you have a story, experience or other words of wisdom that you think could help someone else, please email me at FertileYoga@gmail.com ~ All emails and communications will be kept confidential.
Enjoy ~Lisa Rosenthal
Delaying Fertility Treatment Because of Insurance: A Patient Perspective
Lisa (Rosenthal) asked me to share my story because she thought it might be helpful to others. I was referred to RMACT (Reproductive Medicine Associates of Connecticut), because of problems in conceiving, in 2012. I did not come to the practice at that time because my insurance had a high deductible and, to me, that was an insurmountable obstacle. You may have something similar, with a high deductible plan or a plan offered by your employer that does not cover the procedures you need in order to embark on or continue your fertility journey.
I felt defeated. I basically knew what our issue was, fertility-wise. And it was something that should have “easily” been treated, if only I could get to the Reproductive Endocrinologist’s office. But I knew that fertility treatments were not inexpensive, and I knew that deductible would have to be met before my insurance would kick in. I felt like I was stuck for the rest of 2012 and 2013. Hubby and I tried everything we could on our own and became more and more frustrated every month.
Late in 2013, when we heard about our insurance options for 2014, I felt even more defeated. Our employer’s plan was becoming more expensive monthly, and the deductibles were going up even higher. I felt my biological clock ticking and knew I had to do something, and do it soon! But how? Luckily, there was a misunderstanding at work. Our rep who gave us our insurance options accidentally told us about a website where one could look for other plans that might be better than the company plan. His mistake was that he said our employer would contribute to these plans. They would not, but the cat was out of the bag. Someone far smarter than me looked at the options, and found that they weren’t so bad, even without the employer contribution. When she mentioned this to me, I looked for myself.
For $100 more per month, I could get my own plan, and instead of thousands of dollars for my deductible, it would be hundreds. I did my due diligence. I did the math for 12 month times this premium, plus the deductible vs 12 months with my employers’ plan’s premium plus deductible. Obamacare came along for 2014 enrollment, so I looked at my options there too. It didn’t have any plans that were helpful to me (the prices I saw were very high), but your experience could be different.
And full disclosure, that extra $100 a month was not easy for me to come by. Heck, even just the increase in premium for my employer’s plan was going to be hard to swing. I got a second job to help pay for the premium, deductibles and copays that went along with my journey. I mention this because I realize it’s not that easy for everyone. It wasn’t that easy for me either.
The reason I share this is that I was very unhappy and couldn’t see a way to get what I wanted, no, needed, from the insurance offered by my company. I won’t pretend that I love this insurance plan that I ended up choosing, because if anyone reading this is saying “I know who this anonymous person is!” they will tell you I shed a LOT of tears and had a lot of stress caused by this very same company. My insurance is far from perfect, but it is good enough that it I have been able to proceed with fertility treatment.
All of that said, if I had not done this research for myself, I would not have been able to embark on this fertility treatment journey. I am sharing my story because I know there are others who, like me, haven’t yet been able to find a way to get over an insurmountable hurdle with their insurance plan.
I know you’re wondering two things, if you are in the same situation I was in. 1. What was that website, and 2. What’s this awesome insurance plan? I’d share that with you, however, it's information you can get from any independent insurance agent. You might even be able to pull aside your insurance representative or your Human Resource person and ask about the agent your employer uses. The agent can look at all of the plans available to you. They don’t charge any extra than if you went to the insurance company directly. They actually cannot by law, from what I was told while I was exploring my options. As for the particular insurance company and plan, I know we all have different circumstances and it does affect the prices and plans available to us. When you’ve found some plans that look promising, ask to see the benefits documents, so you can be sure that what you assume will be covered, actually is. Don’t be afraid to ask questions and if you get an answer that is unclear, ask another question.
Lots of love on your journey!
~A fellow RMACT patient, now graduated to a healthy and strong pregnancy
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Here's the question you don't want to ask: How can I be sure/do I know that these embryos are mine?
This question is asked of me not infrequently and don't worry, I don't take offense to it. I can assure you at RMACT we have multiple, double, triple and even quadruple checks at every stage in our laboratory process. We pride ourselves on going well beyond the standard of care when handling eggs, sperm and embryos.
In fact frequently, the lab staff pay closer attention to patient details than the patients themselves. We ask that you verify and initial a sticker with details of you and your partner's names, last 4 digits of social security number and date of birth. Women are asked to initial a label right before their egg retrieval and men are asked to initial an identical label at the time they produce a fresh semen sample. Occasionally there may be typos or clerical data entry errors in our computer system when you first register with our program. This may be due to errors communicated from your referring physician or inconsistencies in information on your care card and drivers license. It is however, very important for the lab to verify and correct your data before we receive your eggs and sperm.
We have double checks at every step of the way....
- 1) The woman verifies and initials a label with both her name and partner's name, last 4 digits of SSN and date of birth at time of egg retrieval.
- 2) The partner verifies and initials an identical label when producing a fresh semen sample.
- 3) When the sperm is washed, a second embryologist verifies the sample.
- 4) When the eggs are inseminated, a second embryologist witnesses, verifies and signs off on the eggs and sperm.
- 5) When embryos are frozen, a second embryologist witnesses the culture dish and cryovials, verifies and signs off on the paperwork.
- 6) When embryos are thawed, a second embryologist verifies the cryo vials or straws. The vials are kept until the embryo transfer so that the physician and patient may also verify.
- 7) At the embryo transfer, the patient is asked by the embryologist to identify themselves. The couple can then see the culture dish through a live video link to the microscope in the embryology lab. They verify the label on the culture dish and they can see the embryos being loaded in to the embryo transfer catheter.
Occasionally we do catch a clerical error at the time of the embryo transfer when we ask the patient to state their name, last 4 digits of social security number and date of birth. That means that one or both partners did not properly verify their information at the beginning of the cycle. When we ask you to verify your information, please check it carefully as it ensures that no mistake is made. Rest assured though, even if there is a clerical mistake, it can and is caught and you will not receive the incorrect embryos. That is why we have so many checks in the system, not to be repetitive, but to be completely thorough.
We need a patient who is using donor sperm to know her donor sperm number. We understand that this is all a lot to remember, but again it ensures complete safety. Believe me, when you can't or don't verify completely, the laboratory staff does stress out about it and lose sleep.
If you have questions, we are available to answer them. Standard protocol demands that the lab identify the patient before egg retrieval and embryo transfer. At RMACT, we choose to go beyond and through live video link to the lab, you will identify your name and information on the embryo culture dish and we will give you a close-up look at your actual embryo(s) for transfer. You will see your embryo(s) being loaded into the catheter for your transfer and we will provide you with a photograph of the embryo(s) that we transfer. What else would you like to know about the lab? Are there concerns that you have that have not been addressed here? Feel free to ask and we will do our best to explain and clarify.
Dawn Kelk, PhD
Reproductive Medicine Associates of Connecticut
Reproductive Medicine Associates of CT have the following credentials:
Licensed as a Surgery Center by the State of Connecticut
CLIA (Clinical Laboratory Improvements Amendments) accredited
CAP (College of American Pathologists) accredited
AAAHC (Accreditation Association of Ambulatory Healthcare) accredited
AIUM (American Institute for Ultrasound in Medicine)
We are members of SART (Society for Assisted Reproductive Technology), and also submit data to SART and the CDC (Centers for Disease Control)