Saturday, October 13, 2007

Insurance is a bunch of crap!

I spent a lot of the day yesterday on the phone with our insurance provider. They are evil people. It's just plain wrong what they are doing.

They are going to deny my preapproval for IVF that they issued on September 12th. Even though it says on the letter that any preapproval gained before benefits change stands, it also says "with provisions" because of that, they will NOT allow me to do IVF. The letter I have says the preapproval stands for one year, but in actuality, it means absolutely nothing!

I have yelled, cried and been as persistant as I can.

What is even worse is that if I WERE IN THE MIDDLE OF A CYCLE right now, they would have still cut the benefits off on November first. What that means is that if I had actually started a cycle when the preaproval was gained, I'd be beginning stimming this week and in the middle of treatment they would have cut off benefits.

Thier reasoning is that a preapproval doesn't actually approve you for anything. They say that what a preapproval does is say that you medically need the proceedure, NOT that they approve it to be done!

I am not done fighting...we are actually going to talk to the CEO of Jeff's company to let him know that this not only affects us but that (and here's the kicker!)

THEY KNEW ABOUT THE BENEFIT CHANGE AT LABOR DAY! If they had sent a letter to us then, we'd have opted to do regular IVF at a MUCH higher success rate rather than do the study! They need to KNOW how much they have screwed us!


LJ said...

Awful, just awful. I am so sorry they are just ripping the rug right out from under you.

Adrienne said...

Call your state insurance commissioner. This doesn't sound legal. Kick their asses as hard as you can.

Starfish said...

I work for an HMO (not a commercial plan so it's slightly different) so call the Department of Insurance and complain, especially if it is truly medically necessary. Also write a personal letter addressed to their Medical Director. Unfortunately it is legal, but you can try and pull some heart strings. Good luck!

SaraS-P said...

Just plain wrong.

Ulema said...

People should read this.