The “Joys” of Insurance…

For the record, I’ve never had a problem with military insurance–even when seeing doctors that are civilians.  The money is taken out of my account automatically every month, I get a referral from my PCP when I need to see a specialist for the first time, and usually can schedule an appointment within a week–two, at the most.  The appointment itself may not be in that time frame, but at least I can get on the schedule.  In the last 10 years of living with Lupus I’ve seen an assortment of cardiologists, gastroenterologists, nephrologists, neurologists, ophthalmologists, and rheumatologists (still with me?).  There have also been appointments with reproductive endocrinologists, but those were surrogacy-related, not for Lupus. 😉 I’ve been poked, prodded, and punctured to be diagnosed and treated, and have honestly lost count of the number of appointments I’ve had with the various specialists and the techs.

My point is this: in dealing with all those specialists and that insurance, never once did they put me through the kind of stress I’m dealing with now.  Seriously, my hair is falling out more than usual, my sleep schedule is jacked, and my appetite is off–all due to the CF this other insurance company has created with my surrogate (for those who don’t know, in this case CF is an abbreviation for Charlie-Fox, or ClusterF*ck).  While most anyone would be stressed, the fact that I have Lupus makes the effects worse, and potentially damaging to my health.

Before I really get going, I have to say that the agency and the coordinator have been awesome through this mess.  They’re the ones that have been dealing with this insurance company (heretofore referred to as Evil HMO) and the OB’s office the whole time.  The phone calls, faxes, and all the other crap have been handled by them, trying to get Evil HMO to do what they’re supposed to–and for that, I’m truly thankful.  I can’t imagine how much more of a wreck I’d be if I were the one trying to get this stuff pushed through, because I have no experience trying to make things work with any insurance company, much less Evil HMO.  As far as I’m concerned, the agency has definitely earned its fee and more.

The agency is the one who writes the check to Evil HMO, and does so for 6 months coverage at a time. The policy was purchased early this year, after our GS’s screening but before contracts.  Apparently some moron with Evil HMO’s billing entered the wrong amount of payment on the account.  It wasn’t like the idiot transposed a pair of numbers, either, which I could totally understand.  No, it (I won’t dignify this individual with a gender pronoun) entered the perfect number of $800 for no obvious reason, instead of the $1958.61 (or something like that) we paid by check to cover 6 months.  Apparently when that amount ran out, Evil HMO cancelled the insurance for non-payment–even though they had cashed the check for more than twice that amount.

The whole issue didn’t come to light until the agency and the coordinator started trying 3-4 weeks ago to schedule an OB appointment for our GS.  The agency coordinator (AC) proved to Evil HMO that the check had been cashed, so they were expected to reinstate the insurance and provide services. Evil HMO claimed to have refunded the money (it didn’t show up until late last week), and demanded another check which AC overnighted to them.  But even after the check was delivered, the billing idiots still hadn’t posted it by the next week, so the OB’s office wouldn’t allow us to be put on the schedule.  After a ton of phone calls with all kinds of people, it was agreed last week that we were allowed to schedule, as long as AC promised that the first appointment would be paid for in cash if the insurance hadn’t been straightened out by then, and that Evil HMO would reimburse us when it was fixed.

Then came the kicker–the OB’s office didn’t have any new patient appointments available until August 1st.  That would put our GS at 19w4d, and the last time she had seen a doctor would have been the RE at our ultrasound 9 weeks earlier.  If she were pregnant with a singleton, I still would have been nervous and trying to find a way to get her in earlier. But with twins? UNACCEPTABLE.  AC agreed with me, and managed to get Evil HMO to admit that maybe another OB’s office might have an appointment in 3 weeks, but a lot more conversations would have to take place before an appointment could be made.

At this point, figuring that wouldn’t go anywhere fast, I changed tactics.  I’d heard about NT scans (though I had forgotten what it was called at the time), and knew that they were generally done between 11w0d and 13w6d. It seems that they’re pretty common with surrogacy, although I know of women who had them even though they were pregnant “naturally” and weren’t of advanced maternal age.  Even though we used PGD, there’s still the possibility that something went undetected–and if there is an issue, I’d rather know about it sooner rather than later.  So I asked AC about the scan usually done around now, and if we could get our GS in for one.  She felt it was worth requesting, and pointed out that if it got approved, the GS would have to be seen this week, as she’ll be 14w0d on Sunday.  And by getting a scan, she’d probably need a follow up appointment after that, which would be sooner than the appointment we might get in 3 weeks.

Amazingly enough Evil HMO agreed–maybe because they were sick of hearing from us.  Yesterday we got approval, and were allowed to schedule the scan for today.  So I hopped on a plane to San Diego last night, and will drive up to the scan today.  I’m missing spending our 8th anniversary with my husband, but we agreed that it was more important for me to attend the appointment.  We’ll just celebrate this weekend. 🙂

The tl;dr version:  As the Marine Corps teaches everyone who makes it through boot camp, Persistence beats Resistance.  And if one is pursuing surrogacy (either as an Intended Parent or Surrogate), persistence is mandatory.


10 years

I remember it like it was yesterday.

Sitting in the doctor’s office, waiting for him to come in and give me the news.  Wanting a diagnosis, but scared of what it would be.  Wondering what my life would be like in the years to come, hoping that I could still achieve my dreams—and at 22, I had a lot of them.  Looking at all the models and diagrams of healthy and not-so-healthy body parts, curious as to what mine looked like.

The door opened, and in he walked.  He sat in the chair, took a quick glance at the folder he was carrying, and then set it aside.  Without inquiries as to how I was feeling or any other preamble, he issued a statement:

“You absolutely, unquestionably, without a doubt, have Lupus.”

I sat there and blinked for a moment, letting the words sink in.

Lupus.  Finally, a name to go along with the symptoms I had been experiencing for the previous 3 months.  Hair loss, such that every time I ran my fingers through it, I ended up with a small handful of hair tangled in my fingers.  Fatigue, to the point where if I had 30 minutes of spare time, I was napping—even though I was already sleeping 10 hours a night.  And above all, PAIN. In my fingers, wrists, and elbows. In my hips, knees, and feet–so much so I was taking 2 Tylenol and 3 Advil every 5 hours just to walk.

The doctor was already describing the treatment protocol. Prednisone (a corticosteroid), to reduce the inflammation.  Plaquenil, to suppress the immune system in overdrive that was causing some of the symptoms. Celebrex, to help with the pain.  Daily doses, it was hoped, would ease the symptoms over a 2 month period.

“And then?” I asked.  “After 2 months, will I be able to go off them and get back to my normal life?” (oh, the naïveté of such a question makes me laugh now)

I could see him holding back a chuckle as he said, “This is your normal life, now.  Lupus is a chronic illness; it won’t go away.  If 2 months on these doses doesn’t result in an improvement, then we’ll have to increase them, and maybe add another medication or two. They should ease your symptoms, but I don’t know for sure.  Only time will tell.”

“What about my job? I’m a Marine, learning Arabic. I have 6 months until I graduate. Will I be able to stay in, or will this get me kicked out?” I’ve finally found a place where I feel like I fit in.  What will I do if I have to leave…

“I don’t know.  But stress is bad for you, as are long hours. You might want to see if they can make accommodations for you.”  Now I was holding in the chuckles; obviously this guy had never served in the military.

“Will I still be able to have kids?”  (Even then, I knew that I wanted to be a mother some day.  Not soon, but some day.)

“I don’t see why not.  It’ll depend on certain factors, and the timing will have to be right, but women with Lupus get pregnant and have children all the time”.  (If only he could see me now, needing a gestational surrogate to become a mother, because of Lupus.  If only he knew that I spent 2 years trying to get stable, then 2 weeks trying to conceive, and then 2 more years trying to recover from the “safe for pregnancy meds” that messed up my system in the 2 weeks I was on them.  If only he saw the Rituxan infusions that didn’t work, the last ditch effort to put me in remission, that I might be able to try again.)

And with that, my time was up.  He handed me the prescriptions, some informational pamphlets, and walked me to the front desk.

10 years have passed since that day.  I generally don’t dwell on it, but since May 10 is both World Lupus Day and my sick-a-versary, I felt that I should recognize it somehow.  Writing it here seemed fitting, as it was the start of my surrogacy journey–even though I didn’t know it at the time.