Friday, May 8, 2009

Does This Make Even a Modicum of Sense to You??

I have a flex spending account for health care reimbursement that I set up at the beginning of the year due to the anticipated costs of trying to get knocked up. I set aside $1,500 for the adventure. I figured if it worked right away we would use the rest of the money for related medical expenses when the baby came, and if it didn't, oh well cause we would use all the money up then too.

So as you know, if you followed my previous blogging, I did a little acupuncture to try and help things along (I think it helped). But those two months of acupunture was a hit of about $500 to my wallet. Low and behold I discovered that acupuncture when recommended by a doctor as a supplement to a treatment is a reimburseable expense! Yippee!! So off I went and submitted my $500 bill for acupuncture to the flex spending people so they could reimburse me. I even wrote on their that it was to treat infertility and support efforts to become pregnant. Faxed that bad-boy in and got my check about 7-10 business days later. Sweetness! No challenge, no questions, nothing!

Now we completed two rounds of IUI in January and February of this year. I decided at the end of February that I'm going to submit said bills and use up the remainder of the money I had left over (each round =$500) which convininetly covers everything. So I sent them in.
Nothing...
Waiting....
Then I get a letter saying that they need a letter of medical necessity for the procedure.
Huh?
So I called to ask - the lady actually said that the requirement is because apparently it might not be medically necessary for some people. At the time all the pregnancy hormones hadn't kicked in but I may have taken that person's head off if they had.... EXCUSE.ME?? Why would you even think that this might NOT be medically necessary - I was truly a little offended that they even suggested that I chose to do this option rather than gettin' down the good old fashioned way... its not like its fun, pleasant or feels good! And I really could do without having my private parts being seen by waay more people than necessary.

Makes no sense to me. I brought up that they didn't even challenge my acupuncture and those appointments were immeasureably more enjoyable to go to! She didn't really have an answer for that but just reiterated that I needed to get a letter and to ensure that there was a diagnosis on it. And THEN I would be covered for up to a year and they wouldn't challenge anymore infertility stuff until then - Oh goody! I then informed her that I wouldn't be submitting anymore bills for reimbursement since I got off that train from hell (I didn't use those exact words) and plus all my money would be gone for the year.

So I ask... does it make any sense to you that they reimbursed the acupuncture but they are pushing back on me whether the procedures that is actually a medical procedure performed in a real doctor's office are necessary??? Maybe I should submit my massage bills and get the money that way...

1 comment:

  1. I hate insurance companies. More than I can even articulate.

    ReplyDelete