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update on blog "I want a re-do"- OT

iamlosingit's picture

for those that didn't read the comments:

I called a Planned Parenthood like someone suggested.  I don't know why I didn't think of them before, I forgot they existed.  They DO provide the services I need done unlike the current free/sliding scale clinic I have been going to for years.  One problem, and this is why insurance companies are crooks:

out of the 50 LOCATIONS in my state alone, only ONE of them is considered "in-network" by my insurance.  Okay, no big deal.  I call to see about appointments and inquire about costs.  The office visit I was told would be on the high-end due to the nature of the visit so that's $230, could be more.  The ultrasound itself? $175.  Planned Parenthood told me they would bill my insurance for it and whatever they didn't cover they would apply to a "sliding fee scale" so I could pay it.  Great!  I call my insurance company with this info to see what is covered.....nothing.   NONE OF IT is covered because (and I quote) "This isn't considered part of the 'family planning', you have to pay for all of it". I asked her to re-iterate, surely I heard wrong.  Nope. "You aren't pregnant, this isn't necessary".  DH is PISSED.  SO my insurance will "help me" if god forbid I bring an unwanted child into this world...but when it comes to the female anatomy NOPE!!  What a crock of crap!!  What is the point of me even having insurance?? Oh that's right, like car insurance that doesn't cover crap it's "for emergencies".  I told them I even had a referral from my clinic requesting I get this done and it doesn't matter, it's not considered necessary.  Seriously?? GTFOH.

I called the clinic back and asked about appointments, they only have ONE doctor that does this testing.  They have ONE opening on the 31st otherwise he is booked until the end of March. (I wish it wasn't a 'he' but nothing I can do about it)  I am seeing this as an omen and made the appointment.  I have an HSA for a reason, and you guys are right.  This has been going on for about 3 years and counting, I need to know wtf is going on with my defective body.  I mean c'mon, it's the only "free" thing I can enjoy with DH and it sucks...J/K J/K

DH is extremely supportive, he says he doesn't care if we are never physically intimate again as long as I am better.  He says "I didn't marry you for that, it's not that important.  I'm with you, for you"  So I guess he is only an a$$hat some of the time lol. Amazing how he can say some of the dumbest stuff or have the most outlandish theories when it involves SS....then says something like this.

Oh and I am not helping DH pay for his insurance deductible.  Update on the hit and run; they found the owner of the vehicle but need to prove they were the one driving, also they can't find the car because it is being hidden.  So the police are trying, there just isn't any progress.  Insurance company thinks nothing will come from it, said driver will probably just get a citation.  When DH asked "isn't a hit and run a felony?" She didn't know.  There is no insurance broker because DH got his policy online.  On the plus side, DH re-configured his insurance starting next month: raised his coverage and made sure the rental care coverage was on it.  Said his policy only went up $6/month.  Sucks it couldn't have been done sooner.  He is also enjoying the bus and is debating using the bus on days when he doesn't have visitation to save on vehicle costs but is unsure.  His bus route only takes 35 minutes home, today is the first time taking the bus to work.... so we'll see if it's still good.  My bus route takes over two hours so not an option for me sadly, would be nice to not have the gas expense.

Lets hope Feb turns out to be better, I vote Feb 1st as a "New Year Re-Do".

Comments

beebeel's picture

Hey, $175 for an ultrasound is a great price. They are $500 a pop at my local hospital where I had to have them weekly during my pregnancy. And yeah, my insurance covered every single one of them because: fetus. My cervical cancer treatments all went toward the deductible. It's such a shitshow. Insurance companies still get to charge me $600 MORE every month just to "cover" me as a woman of child bearing age. But they'll only cover stuff if you're actually carrying a fetus. Let the mother be sick as he'll: save the fetus!

lieutenant_dad's picture

Part of the reason why your insurance company is saying that is because they consider sex and sexual dysfunction non-life threatening. It's similar to fertility treatments, or getting an annual Pap for peace of mind when you don't need it. So long as your doctor codes it as something to help with sexual dysfunction, you're screwed.

Now, if your doctor will code this as DIAGNOSTIC for, say, uterine cysts due to complaints of pain, cramping, and excessive bleeding not during menstruation, your insurance company is likely to cover it. You just have to be careful that PP doesn't charge more for diagnostic versus sexual dysfunction.

It's something to call and talk to them about. Ultimately, while sex is when you experience these problems, something is causing it. Those somethings can be bad and scary (they can also be benign and just a pain in the ass). Those somethings is what they are looking for, not trying to save your sex life (that's just a bonus).

iamlosingit's picture

The referral was because they think it could be cysts or cervical cancer.  Insurance still said no.

justmakingthebest's picture

I have poly-cystic ovarian syndrome. There are time where I experience pain because of it. I have had some of the cysts "zapped" before due to the size and pain I was in because of them. I am also irregular to the extreme. There are times I will go 9 months in between periods and then others maybe 2 weeks. Sometimes I am super light and it is no biggie, sometimes (like last month) a super tampon and overnight pad had a bleed thru in an hour and 1/2 and I had to go home to change. 

I am fighting with doctors right now to have a hysterectomy. My tubes have been tied for 11 years and I have NO intentions of having more children. Even at 36 with major cancer risks on both sides of my family I am arguing over this. It is beyond irritating. 

All I can recommend you do is find a private insurance policy off the marketplace and you guys are going to have to suck up the payments for a year. If you can  get it taken care of, it will be well worth the monthly payments of a low deductible plan! Like, maybe even worth picking up a 2nd job on the weekends to have it taken care of. 

ESMOD's picture

I am guessing that by saying "not covering it"... you mean they are going to make it apply towards your deductible.. as in.. you have to pay out of pocket for your deductible until that minimum is met.  There are certain things that are 100% covered in most plans.. like annual gyn visits.. routine colonoscopies.. basic vaccines and wellness visits.. but when it passes the routine threshold.. you have to pay until your deductible is met. 

I'm glad  you have an HSA with some money in it you can use.  The most important thing to do for yourself is get the test to rule out some of the most dangerous possibilities.