Insurance Coverage

My agency switched insurance companies this month, so Nicole and I talked about whether it would be worth it for me to switch over to hers. Because of federal discrimination, we would have to pay taxes on whatever my insurance would cost her organization, and we still aren't sure how much that would be and how it would impact this decision. But we DID know that we want family coverage through her insurance after we have a baby, and if hers has better fertility coverage, it would be worth switching now.

I called my provider to ask what the fertility coverage is. The agent read down the list and my heart rejoiced as I heard "artificial insemination, 100% lifetime coverage." But of course I had to go ahead and ask the next question: "Is that automatic, if I were to walk into a fertility clinic, or would I have to meet certain criteria to qualify?" She linked me to the many-paged policy on their website and explained that I would have to show that to my doctor and they would have to show that I qualify based on those criteria. She said to find a fertility doctor, show them this policy and ask their thoughts, ask them the procedure number, call a different number with the procedure number to verify whether it's covered, have the doctor call yet a different number to see if I need pre-certification, and then have the doctor follow through with pre-certification if needed.

Anyone else a little overwhelmed?

The first response had seemed so simple, and was certainly very welcome, and five minutes later I felt so discouraged. Reading the extensive policy discouraged me further, as everything is called INfertility treatment, and requires proving infertility in order to get coverage. So in my case, a woman with no male partner, I would have to show twelve unsuccessful insemination cycles to prove infertility. Then my insurance would cover testing, treatment, and further insemination.

According to one particular fertility clinic that I've been looking into off and on for the past year, one cycle of IUI costs $1200. The sperm itself is another few hundred, including the cost of transporting and storing. If I got pregnant the first time, this isn't so bad - but we certainly can't do this every month. For every unsuccessful attempt, we'd have to save up for a few more months before we can afford to try again.

My insurance company's website has a link to LGBT-affirming providers, and reproductive centers were included in that list. I'm sure they deal with this all the time, and maybe they know how to get around this. I sure hope so. Twelve cycles is a LOT of money to put up front before getting coverage, and if we have twelve failed attempts, the path ahead will be rougher as it is.