So I got a call from Tanya this morning. Basically it breaks down like this:
Aetna made a boo-boo. Our contract and our benefits paperwork all state that we do not have IVF converage. However, thier computer system verbage and benefits information states otherwise.
Since my question about a bill pointed all of this out, everything has fallen apart.
Initially they intended to make us pay back all the fertility claims that they had already paided and covered since we began working with Dr. Cook (around $10,000)…
After much discussion, they have corrected the verbage in their computers to reflect no IVF coverage at all ever.
They have decided to cover all prior claims up to today and will deny any IVF coverage at all.
Despite the fact that my doctor’s office has, in writting, confirmation of the opposite.
So while we won’t have to cover our past claims, we have before us now 2 choices:
1- Go back to trying IUI’s after my surgery
2- Magically come up with $15,000 to cover IVF
I don’t even know if we have a legitimate legal case and I am still waiting to hear back from my doctor’s office.
My neighbor down the street is a lawyer, and she offered her help. I’m waiting to hear back from her.
I just feel so crushed. Like we took 10 steps forward and got knocked back 20. Every where we turn there are road blocks. I just don’t understand. I don’t see what God’s plan is and I don’t know why this is happening.
I finally let it all out and cried to my mom. I just couldn’t hold it in anymore.
She immediately offered to pay for our IVF. There is just no way…I couldn’t even imagine her doing that. What if it doesn’t work the first time?
I will owe her so much after that…regardless if it works or not. I just can’t. She was still insistant and said it was her money, she would spend it how she wanted to. But I don’t think Barry and I would be comfortable with that option.
Barry suggested going back to the IUI’s, which we really don’t have a choice about. Given the situation, it’s our only option.
I just don’t understand…we want a family so badly. We can’t even have one naturally and all the excitement and fun of the process has become clinical, cold and doctor-controlled. We were willing to do anything, though…but now this?
How can Aetna just go back on what they said and leave us stranded?