#MicroblogMonday: Insurance

Can I just take a moment to comment on the ridiculousness of health insurance in this country?

I’m lucky in many many ways – I’m in a state covered by the infertility mandate and our insurance is quite good. I can’t imagine going through all these treatments and constantly having to check in about the financial status (and hats off to anyone who is doing that!). It’s not perfect and our out of pocket costs are still significant (one of my summer projects is tabulating infertility expenses).  Also our HSA provider has been less than amazing*.

Fundamentally, I find it so strange that, for so many people, infertility isn’t covered. It is an actual medical issue with medical diagnoses. And the resolution and treatments are not exactly something that’s solved without, you know, actual medicine.

Also as a PSA to all those people who think that IVF is a ‘luxury’ fancy treatment: No one wants to go through IVF. The whole process is hell. Why would anyone voluntarily choose this path??!


Why is contraceptive, fertility, maternal and pre-natal health is all considered costs to women and a burden on men? Last I checked, for anyone of those, a man was involved to create a baby. Why isn’t the insurance bill split between the two? It’s always treated as a women’s issue but a lot of it seems joint to me. Isn’t it in both parties interests to ensure a healthy baby and mommy?

Mostly this is a rant to all the (typically white male) politicians who say “why should I pay for someone else to have a baby?” Well, by that logic, why should I pay for your increased risk of heart disease (increased risk for males)? Or prostate exams/cancer? Or sexual dysfunction or skin cancer (light skin -> increased sun burn risk)? Or any X-linked disease? Or any genetic condition that you passed on to your kids ( I don’t have an Alzheimer risk, why should I pay for yours)? It’s a slippery slope (well, less a slope than a cliff) and obviously a ridiculous argument but still somehow is being made.


*Random HSA side story: We’ve been getting requests from our HSA to provide an EOB for the money we’ve spent at the fertility clinic. For starters, I really don’t know more than the basics of insurance and had to look up what an EOB was. Once I did, it made more sense to me that the HSA interface with the insurance company and getting information direction? Isn’t that easier and more efficient than putting the onus on the consumer to do this type of work? Also, the HSA money is quite literally my own money. Anyways, I called them, getting increasing frustrated at the “Ma’am, ask your insurance provider” responses (‘You asked for this damn document, not them. So you give me a response’). Finally I just said, “This is for a fertility clinic. What else do you think it was used for? What non medical expense can possibly exist at a fertility clinic?” And I could totally hear her .. just freeze and not know how to respond. Goes to show that fertility is still totally a topic that people are uncomfortable with — even in the medical field.

 

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14 thoughts on “#MicroblogMonday: Insurance

  1. I work for the state of Pennsylvania. As a state employee, using the (pretty good) insurance by-up plan (because I didn’t want an HMO), I had zero coverage for any infertility treatments. They covered the testing to figure out what was wrong (except for the Clomid, but thankfully that wasn’t expensive)and then we had to stop because we could not afford the IUI or IVF treatments suggested. I will probably never know if I would have been successful in carrying a pregnancy through those medical interventions simply because the cost and lack of insurance coverage pushed it out of reach. It would have been nice to get some coverage, some help, something. I’m sure there are other medical treatments that could be seen as a luxury but aren’t if that’s you needing them – like getting a sex-change operation, for instance. I have no idea if insurance covers that, but it seems to fall into this same category – pricy and perhaps not covered by insurance. I suppose, in a perfect world things would be equitable. Sadly, we don’t live in a perfect world…..

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  2. So in Germany there is universal health care. Everyone has to have it basically. I think it’s about 15% of salary (government supports you if unemployed), so we pay a fair bit each month but then get a lot in return. All health insurance providers legally have to pay 50% towards three rounds of IVF/ICSI. They also pay towards for 3 rounds of IUI I believe. I think it only applies to married hetero couples and they have to be under certain age limits though. Some health insurances will pay more like 75% especially if both partners are insuranced at the same place. I feel very lucky to live in a place where infertility treatments are taken seriously. IVF is definitely not a luxury like you say!

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    1. So in states that mandate health insurance coverage (like mine), it’s similar — you have to show necessity, but they cover IUI (I think unlimited?) and at most 4 IVF rounds. Presumably, coverage levels varies based on your insurance. Interesting point about the hetero couples — I actually am not sure what the restrictions are in the US about that.

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  3. I once had someone with type 2 diabetes caused ENTIRELY by poor lifestyle choices lecture me on why infertility shouldn’t be covered by provincial health insurance. And yet the taxpayer is going to pay for all the associated medical costs resulting from that individual’s wilful negligence of their own health. (Obviously I want those medical costs to be covered but I did find it a bit galling that they didn’t at all seem to see any inequality in their argument.)

    I do see it as a medical issue, and I find it frustrating it’s not covered more widely. I don’t think someone’s ability to have a child should be determined by their financial status.

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  4. We have public health care in Canada (what some people call socialized?) so some of this is foreign to me. Fertility treatments of any sort are not covered in my province however; we pay out of pocket. It can be claimed as a tax deductible and prescription drugs are covered under my employer’s health plan. I’m not sure if I think fertility treatments should be publicly covered or not. Part of me thinks they should be, but then I wonder what the overall cost to everyone would be….because nothing is free. But I do think it’s unfortunate that people might choose not to have a child only because they can’t afford the treatment.

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    1. Oh that’s interesting. I always kinda assumed the Canadian system was perfect 🙂

      So I guess my argument is (a) given that it’s a medical issue, it ought to be covered and (b) otherwise, it decreases access to care based on income. Perhaps we shouldn’t amortize out the cost but then, it seems like any lifestyle issue should fall into this camp too.

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      1. Fertility treatments might be covered in other provinces, I’m not sure. Healthcare is a provincial jurisdiction. I think it’s a good discussion to have; I’ve not thought it through to the point of having a POV I’d defend. I think as more people are diagnosed and need assistance which seems to be the trend it will come up more.

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      2. Tbh, I don’t even see it brought up as a debate much and I’d like to see that happen. I think culturally, fertility treatments are seen as a luxury treatment, meant for only rich movie stars. Maybe I’m wrong about that — I just don’t see much cultural awareness outside of the infertility community and my own friend groups (and that’s mostly because I keep talking about it).

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    1. omg yes! One of these days I’m going to put together a roll call of anti-women’s health things that politicians have said (there’s a gem of one from TN who wanted children born from IUI/IVF to be declared illegitimate. Even when the partner was there giving consent!)

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  5. Oh trust me I had my fair share with battling with insurance in this country and I am in a state that is not mandated. We paid about 20k for all the treatments. Even after I got pregnant, insurance company refused to pay for my blood test. I had to argue with them back and forth. Ridiculous!!!

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