I have to admit, I do not think much about insurance. I am very fortunate to work for a company that offers good benefits. My payment for health insurance comes out of my paycheck before I receive it, so I barely even think about it. Aetna, a large insurance company, is my insurer, so almost any doctor I want to see is “in network”. Before going to the doctor, I don’t really worry about payment at all — I just wait for the bill to come for my little portion of the total amount, and I pay it.
So when I started going to Boston IVF to see Dr. P, my reproductive endocrinologist, I did just that. I showed them my insurance card and didn’t think about it again. Luckily, the first two bills (initial appointment and bloodwork/ultrasound) were paid mostly by the insurance company with no problems. But then at my last appointment (where I was prescribed Clomid), I was told that I had to enroll in Aetna’s Infertility Program before they would cover the medicine, since it is technically a “fertility treatment”. They consider Clomid a fertility treatment just like an intra-uterine insemination (IUI) or in-vitro fertilization (IVF)! And as I have a limited number of IUI’s covered, they have to enroll me in a special infertility program and make sure I qualify. Usually a couple has to be trying to conceive for a year before they “qualify”, but the lovely nurse on the phone said that since I clearly have ovulation issues, that should “help”. Yes, it certainly should, shouldn’t it?
Here I am on the edge of my seat waiting for my miracle drug to come in the mail, and it can’t even be ordered until Aetna confirms that I really am “infertile” enough to need it! Slightly frustrating. Nevertheless, I think I got everything squared away with Aetna yesterday, so as soon as I’m officially enrolled in the infertility program, my Clomid can be ordered. Chop chop, ladies! I’m ready to get going!