Sunday, January 22, 2012

ICLW #5

I'm in a very different place in my process from the last time I actually wrote an ICLW post, two months ago.  At that point, we were waiting for the results of DH's genetic screening, but I didn't really think that it would come back positive.  I figured we would be doing IVF for our first try, but only because we already had the meds and the insurance rep had (falsely) told me we didn't have to do IUI before IVF.

Now, I write this looking back on a month that has left me lucky to still have hair I haven't pulled out.  DH turned out to also be a carrier for spinal muscular atrophy, so we prepared for IVF with PGD, hoping to start our first cycle on 12/31.  On 12/20, the insurance denied the cycle because we didn't count as IF because of having had a miscarriage in the last year.  Funny, since I've never been pg.  Then they denied me because we hadn't tried IUI first.  Never mind that they had approved the PGD and you have to do IVF to get the embryos to test through PGD.

I had to wait 29 days to get the letter of medical necessity that I need for my appeal of the denial.  I got it this past Thursday and mailed the appeal on Friday with signature confirmation.  Tomorrow evening, I'm going to see if it was received yet so I can start counting down the 30 calendar days they have to make a decision.

As far as the PGD, my clinic really wanted to use a lab in California because they don't like the local lab anymore.  The lab in California would have cost us an extra $1000-1500 or so out of pocket and would have taken over 8 weeks to make the probe, so we're insisting that they use the local lab.  My nurse said on Thursday that she's going to put in the referral for that lab, and hopefully that can get going while I wait on the appeal.  The Maryland lab will only take 3 weeks to make the probe once we get whatever samples they need to them. 

I'm really hoping we can start a cycle at the end of March...that would work out nicely timing-wise (if it takes, of course) around stiff that I have going on at different times this year.  I'm still afraid to have hope for actually getting pregnant, but it feels safe to be able to hope for that, since there is a deadline on how long CareFirst has to decide on the appeal and medically there's no reason for the appeal not to work.  Then again, medically, there was no reason for the denial in the first place, so who knows.

2 comments:

  1. As if everything else isn't hard enough...insurance companies can suck!!! Sorry you are having to deal with this!

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  2. Hi, visiting from ICLW!

    I've been told I should do PGD on my next IVF as well. I have poor egg quality, something unusual is going on with my embies, and my FSH is elevated a bit.

    It's so expensive! Good luck! I would love to start cycling in March too for my 2nd, if we can figure out a way to pay for it! :)

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