Thursday, May 15, 2014

Access Denied!

Dear Patient,
We're writing to inform you of a coverage denial. 
This request is denied as not medically necessary because: there is no available documentation of a current problem you or your partner have that indicates you meet criteria for needing intracytoplasmic sperm injection (ICSI), which is generally required if there has already been a problem with fertilization during in vitro (IVF).  Your partner's only recent semen analysis is normal.  Therefore we cannot approve ICSI for you at this time.

.. my insurance company wrote that in a letter to me this week.  Bast**ds!

So, remember in 2012, we discovered a Crohn's Disease maintenance drug produced toxic antibodies in his semen?  Well, we ditched that drug and he went for a biologic that not only kept the disease at bay (remission) but has no effects on reproduction (that we know of).  Latest semen analysis is normal.  POOOOF!!! goes the male factor!

But, there's still the question of the quality of my eggs....since I had aggressive chemotherapy treatments at 25 years of age.

Since it's 'unexplained' infertility....the lovely insurance company won't cover the ICSI portion of the procedure.

Luckily, we're in a research hospital so get the benefit of most of their cutting edge science without additional costs.  Nurse responded back to my text about the coverage denial saying "we'll eat the cost, because we feel you're a perfect candidate for this".

Now we just have to decide if it's worth it.... is it?


No comments:

Post a Comment