Saturday, September 6, 2008

State Mandates... and an Appointment

I made an appointment with the local repro endocrinology clinic! I am proud of myself.

I had a good talk with my OB/GYN, who seemed as if she was expecting this call from me (or at least that's how she played it--I appreciated it).

So I started to look into my insurance seriously, made a few calls. And it turns out that the situation is even worse than I expected. My insurance is actually willing to cover treatments for infertility (i.e. insemination); but my LOVELY LITTLE NORTHEASTERN STATE imposes mandates that completely void my insurance. Firstly (and the only one that really matters here), is that I must be married to receive this coverage. The 2nd mandate (I love this) is that a married couple must have been trying for a year--unsuccessfully--in order to receive insurance coverage for infertility. I'm assuming doctors all over just fudge that one. I mean how many couples notify their doctor the day they start trying? Give me a break.

So, yea. There will be no insurance coverage for me. None.

Not sure what these mandates are supposed to be doing, but my suspicions are that in my very Catholic, very tiny state, our very conservative governor is worried about unmarried females (read: gay females?) trying to have children without a living breathing male in the room. Forget unmarried straight females--that's just wrong.

I'm very curious if this is only the case in my state, because I would seriously consider moving. I live close enough to a border that it wouldn't be a big deal. I would love to see this issue in the media...but really, what politician is going to want to broach THIS subject? I don't see it happening.

I'm going to see how things go at the clinic and go from there. I think all this information is just going to be helpful to me as I consider my best path...

4 comments:

Meg said...

Wow, you move fast! Good for you making those calls!

That just stinks about the insurance. Not all states are like yours. In MA coverage is mandated and it doesn't matter if you're married or single. Insurance kicks in once you have an infertility diagnosis or after 1 year of trying - 6 months of trying if you are over a certain age (35?). Exactly what is covered or how many tries will vary by insurance plan. If you are on the border it wouldn't hurt to investigate how it's handled in your neighboring states. You're also right about doctors having some leeway in defining what counts as a try. It's all in what code they use to bill the insurance.

I'm sure you already googled it but here is a list I found:

http://www.fertilitylifelines.com/paying/insurance/statemandate.jsp

Dora said...

Holy crap! That's complete discrimination. You might want to think about contacting the ACLU. I believe they are looking for cases like this. I had issues with my state regarding using a known donor. I think I have a strong legal case, but I don't have the time at my age. So I switched doctors, and my donor became my "boyfriend."

Care said...

In OK, doctor's can't even provide fertility treatment of any kind (IUI, IVF, etc) unless you are married with written consent of both spouses. So even if you have insurance coverage, you are SOL because no doctor can provide services. Like you, I suspect that the laws were written that way to prevent gays from becoming parents (they can't adopt here either). Regardless of the motive, it sucks to live in such a backwards place.

Is it possible to travel out of state? If you have insurace coverage, can it be used in a neighboring state? Rather a pain to coordinate, but it might be a possibility.

Randi Skaggs said...

Hey -- I found your blog from Hip Slope Mama.

Wow -- that just boils my blood about your insurance company. It's so indicative of the judgmental tone our country is taking in regards to families that you have to be married for the procedure. Fits quite well with insurance companies that cover Viagra but not birth control.

Anyway, I wish you the best of luck. Once the desire to become a mom hits you, you can't really let it go, and I hope your dreams come true -- soon!