Monday, May 7, 2012
Insurance Drama
Way back in February when I decided that I was going to have TAC surgery I got all my medical records and the paperwork sent to my insurance for them to pre authorize me to have the surgery. Well about 1 week later we got a letter from them saying that they would cover the surgery, but only if I was 10 weeks pregnant. That is not what we wanted and not what my doctor wanted so I called my insurance company. I was then told that only part of my medical records were not reviewed, so the nice lady said she would resubmit everything to see if that would change the outcome and they would say yes to covering my surgery. Well we waited and waited and waited and finally about 8 weeks later I called to check on the status of their decision. This time I was told that my records were never resubmitted and that the decision still stands they will cover my surgery if I am 10 weeks pregnant. Seriously, we wasted 8 weeks waiting for something that was never going to come in the mail. I called my doctor right away and I was told to send him and email and that we would appeal the decision and it was not a big deal. Ok so I sent my doctor an email that day and then I waited. This was on a Thursday and I didn't want to be annoying so I waited for another week to call back and see if he sent it. I was told that someone would call me back after they talked to the doctor because usually he will send an email back to you when he gets everything sent out. Well again I waited, and no one called so I called back on Monday and was told the same thing, someone will call you back blah blah blah. No one called me. So on Wednesday I called back AGAIN, and this time I didn't even tell the lady my name I just told her why I was calling and she said "is this Natasha?" I was near tears because I have no idea what is happening my surgery is in a month and I still don't know what is going to happen, so frustrating. She assured me that she would talk to the doctor and get on him to send the letter, and she apoligized and said that they have been really busy and my email got lost in the shuffle, of course it would! On Thursday night I finally got an email from my doctor with the attached letter he sent my insurance company along with a note from him saying that unfortunately he doesn't have very good luck with insurance companies approving appeals, most have a standard no policy. So of course I cried again, I just can't believe that this would happen like this. Haven't I been through enough? Apparently not because if I have lost 3 or 4 babies they would approve it with no problem. That is not even an option for me, I will not survive another loss, I can't do it. I don't know how women do it that have lost multiple babies, I honestly don't know. So now I just sit here waiting for a bunch of doctors that now nothing about my condition and my situation decide whether I get to have my surgery or not, it just seems so unfair. I was approved to have the surgery when I am 10 weeks pregnant but there are a lot of risk that go along with that. My doctor has never actually had a woman lose a pregnancy after a surgery, but witht the way my life has gone in the last 4 months I feel that I will be the one that something bad will happen to. It feels like a frickin nightmare that I am living, just when things seem to get better BOOM it all blows up in my face. I keep praying that everything will work out the way it is supposed to but I really feel like I am starting to lose hope, and I know that is not a good thing. There has to be another baby in my future but I am not willing to take any risk, I don't know what is worse, deciding to just not have another baby or take the risk and get pregnant and have the surgery at 10 weeks. I don't know what scares me more.....
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Oh Nathasha what a mess I am so sorry. It must be really difficult and scary. I am scared to get pregnant and i have many children with fairly uncomplicated pregnancy's. I know that I will have more children but the thought of another loss seems to overwhelm me also. I am saying a prayer that you would indeed get the surgery! Hugs and prayers to you.
ReplyDeleteI'm visiting from Tesha's link up. I am so sorry for all of the insurance drama. I know you must be so stressed and scared. Praying for peace and wisdom for you!
ReplyDeleteThank you Kacie! I am trying really hard to trust in God and that whatever happens is meant to be. Somedays I am better at this then others, right now I seem to have a good outlook on it. Thank you for the prayers, I truely appreciate them!
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