Monday, November 24, 2008

My insurance is absurd

So I made an acupuncture appointment today at the strong recommendation of my doula. Apparently acupuncture can be an effective way to induce labor 'naturally' but only if you've given the acupuncturist a chance to work on your body before. Makes sense, although I'll admit to being rather a huge skeptic given the claims on the (very highly recommended) acupuncturist's webpage that they can 'cure' certain types of infertility. 'Nuff said, I'll leave that be.

But, the first appointment is over $200 and each appointment thereafter is about $150 and they want to see you every week until your due date and then daily until you go into labor. Well beyond our means. So I called up my lovely insurance (Aetna, mind you, possibly the largest insurer in the U.S.) and the woman on the phone read the conditions for which acupuncture is covered, starting with Fibromyalgia (a rather vague clinical diagnosis) to chemo (no underlying causes needed apparently) and including only one pregnancy condition: severe nausea during pregnancy. So I just left the poor office a message to ask if they would consider billing this as 'nausea during pregnancy' rather than 'GD.' After all, I sometimes get so hungry as to feel nauseous - I'm not sure that's what the insurance is looking for, but it might just count ... Not that the insurance minds $605 per GD office visit at a GD clinic, even if they see me for less than 10 minutes and seem to be a bit baffled why I'm there in the first place ...

The good insurance news is that I got the PKU/Pediatrician visit insurance worked out. If the baby is born during the 10-day gap in her insurance, I can pay a pro-rated amount through my insurance from her birth until mid-January, at the fine rate of $6.61 per day. It doesn't sound too bad until we calculated it'll be a bit over $300 to cover those 10 days, after which she will be double or possibly triple insured and we won't file anymore with this insurance. But if necessary, it's another $300 we'll spend. Should my poor little girl ever get around to asking why she doesn't have a sibling, we'll have a ready and easy answer: we had a pile of money set aside for future RE/IVF expenses and it all got spent on 'normal' medical costs even though both of your parents are very well insured.

2 comments:

Io said...

I'm feeling some severe nausea in your future...
It's amazing to me how convoluted all this insurance stuff can be. If people with advanced degrees are having to run around to circumvent their stupid ways, what hope is there for everyone else?

Ms. J said...

So glad to hear you got ONE insurance thing resolved in your favor!

I remember being super pissed that my insurance wouldn't cover, nor even discount, the recommnded Hep A and Hep B vaccines for traveling to China to pick up our baby. BUT, if we came down with Hep A or Hep B, they'd pay hundreds of thousands of dollars in treating the disease! Grrrrr.