Wednesday, August 8, 2018

More Insurance Fun:

I'm sure you all are bored to tears reading about all of our insurance woes but here we are again. It has been back and forth for weeks now trying to find a provider that does the surgery I want/need but at the same time is contracted with Tricare. I have now been assigned a case manager from base to help with this whole mess.  My case manager from Utilization Management has put me in contact with Tricare several times, doing three-way calls, to help sort this all out. Basically, all the doctors I have suggested either are no longer contracted with Tricare, or flat out will not accept any insurance at all (which I have mad respect for by the way), or have a 6 month+ wait list.  I was told point blank by a Tricare rep that excision surgery is not medically necessary (!?!?!?!?!?) and that if I want to go to the endo care clinic in Atlanta or see a specialist in NY, they will not pay a dime towards my care.  Even if I change from Tricare Select vs. Prime, they will not help me in any way.

FINALLY just yesterday, after being on the phone with Tricare for over a half hour, it was recommended that my case manager put in for my old doc in AZ that did my first endo surgery and second IVF, which ultimately helped us conceive Skittle.  The problem?  He no longer is in network for Tricare as of Jan 1, 2018.  BUT, because we've been trying to locate someone to do that surgery for quite a while now and there are no providers within 100 miles of me that do this surgery, they are still pushing the referral since I was his patient in the past.  I'll take it!  Coordinating my care between four doctors is close to a nightmare but I am determined to see this through.  Surgery in AZ will be difficult logistically, but it can be done. Dr. B has given his blessing (not that I need that) for surgery in AZ and is requesting to speak to the surgeon about my case.

The endo care clinic has been lobbying in DC for quite a while now trying to bring awareness to this disease and pushing for better insurance coverage for excisional surgery.  I hope they keep up the good fight as I now see everything they warned me about!

If this blog can help just one other person with the difficulties and struggles of infertility, I think it's all been worth it to show my vulnerability and pain.

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I have been back and forth with ReproSource (the lab that works for Dr. B), trying to figure out all the testing I need. DH's first of two semen analysis kits have arrived and of course he's TDY.  Sigh. It's taken weeks to be able to schedule the first of my blood draws but it's finally happening tomorrow. Pray for me?  It's a 17 vial blood draw in the morning. Hydrate, hydrate, hydrate time!

Here's a pic of Skittle cause she's cute :)

Love you all!


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