Fighting for Insurance & Some Surprises | What The IVF | Ep 12



snack – chocolate got a call from the doctor just now it's Saturday thousand 3:30 p.m. and he like did the long wind-up that doctors love to do he goes well and then the the second one that we decided to wave at the yarn I don't know if the lab called you but it did make it to blastocyst and they biopsied him froze it so we did actually get to go to one that one doctor says he's like yeah so got to which is about you know average and yes we would like to get three or four mature threes average and forward a bit great but you know to do this again anyways no we didn't know this we were just lovely would ah you know the riddle a source to accept it is what it was yeah I don't think we just knew we're gonna do it old school grounds no I think this is a gradual coming to deal with it people love it there was a woman who contacted us who is that also part of our clinic that apparently has decided not to proceed with IVF however she already had purchased a lot of the meds she needed and she asked the doctor if there was someone that would be willing to accept some that she could donate them to and he nominated us but she is donating to us a whole bunch of IVF medications which is amazing I mean this is thousands of dollars worth of medications that she's given to us for free and it's I can't believe it I really can't believe it all these myths so amazing just have this minification it's may allow us to do a third round of IVF which has been discussed but financially is extremely difficult and this may be an important component that allows that possibly happen so we realized at this point that we were gonna have to hustle to figure out how to do this financially and it was gonna be incredibly difficult because you could just do the math we got two eggs this time if we get two eggs every time that's gonna be at least another five more cycles so we need insurance to pitch him so this point I go and I've into my insurance I'm sure enough it says no coverage for infertility or infertility treatments which sucks but I realized I'm technically not infertile I could get pregnant naturally we just need to do PGD she's fertile but she has a genetic issue this is a health required health issue issue so I we file for insurance and they deny us but they never technically sent us a denial letter we need to get the letter of denial for our field in order to move on to the next step with a California Board of managed health care and that's one thing you're doing your insurance and you file an appeal make sure you get your denial letter because then you can appeal with your State Board which is not run by the insurance company and they know that I remember actually calling the health insurance and being like okay this isn't covered like I know it's not covered but however it is it there's a unique thing to this I still need you to process it so I can get the denial they're really not covering any weight I was like no you need to process it anyway cause I can actually move to a different Department it's like I filed a claim about them not processing it yes it was an it was an appeal disputing this processing so that process which then forced them to get us the denial which then allowed us to move on to manage healthcare right it was basically a bureaucratic nightmare maze it was really awful and Paul did a ton of telephone work and I did a ton of research and online and writing angry letters work so then I was able to write a very heartfelt appeal to the California Board of managed health care on a medical basis and then we waited and waited about like what 30 days or weeks cuz they have 40 days to 30 days to process your claim and then we get a letter on the 30th day and it says this does not apply for independent this is not qualify for independent medical review we're forwarding it to the complaints department so I phoned them on Monday and she's like no one's complaints department but it's the legal complaints department so we had to write a whole new we basically read susan in our case from a lawyer's perspective effect is it fully wait another 30 days to find out and today I got a call I got a random call and I'm expecting oh we got your thing but it doesn't have this or you know just something annoying about the filing this paperwork and instead the guy you know there's this thing oh okay whoa I just want to let you know we got a notice from anthem and they have agreed to cover everything what what yeah yeah let's see here that everything yeah let's all the procedures have been approved and I take care of it now like really like like really this is a happening like Johnny said like do anything like now I mean you get the letter and then you'll start working with they had to cover my care so gotcha I win and what did I win sort of 50% of coverage cuz turns out my doctor is still out of network it's a second cycle we come in hopeful and energized and we think well now we know what we can browse on the first cycle and that's not gonna happen again this is gonna be even better breathing it wait more eggs we can do this so that's how we managed to get insurance anyway it's be sure to subscribe and hit the bell icon so you're notified about all our future videos and we're on social media on Twitter Instagram and Facebook at WTI VF and next week we move on to the shots and retrieval for round 2 see you next week guys

6 Replies to “Fighting for Insurance & Some Surprises | What The IVF | Ep 12”

  1. Yay!!! Such a good episode. I literally cried when you guys found out that insurance will help cover everything. Happy tears!

  2. My God such a nice one this week. This gave the boost of morale I needed for this weeks finals. Guess good vibes are contagious… I know for you this probably happend a LONG time ago, but still such happy news for those of us who follow weekly. Loved the editing BTW!

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