How to deal with health insurance anxiety

How to deal with health insurance anxiety? The short answer is: I have no idea. The longer answer is: you call it a friend (they’re helping me more than they’re hurting me, etc.) instead of an enemy and realize that, no matter what, everything really IS going to be okay. But getting to that point is very very very very very difficult for me. Did I mention that it is difficult for me? Very.

Not too long ago, I was in the midst of a love affair with HIG (my pseudonym for my insurance co.) for giving me access to unlimited psychotherapy at a $0 copay, and certain medications at very low co-pays. Yes, I had to spend an entire afternoon on the phone with them to figure out how to order my fertility medications, but I wrote out their instructions step-by-step and felt secure that they were all covered, as long as my nurse went through their pre-authorization process. Because I don’t want to bore you to tears, I will leave out the tedious details of what happened and just say that after my nurse and I followed all of their instructions to a T,  we were given the serious runaround. My poor nurse was transferred to a gazillion departments, at certain points they were saying my account was blocked, at others they were saying those medications weren’t covered, and along the way we were both given approximately 8 billion phone numbers and fax numbers to call and fax prescriptions to.

But even as I type this, I realize that what happened today, while bad, isn’t nearly as bad I experienced it. Any snag whatsoever with insurance taps into one of my deep-down-deep triggers, and I go zero to sixty in half a second. I try to calm myself, but the reaction is one of the strongest beasts I have to tame. My reaction makes every bit of the annoying experience so much worse than it actually is.

But I have to cut myself some slack. I have now had to deal with FOUR different insurance plans since I began this journey three years ago. HIG, student plan; M.caid; PIH plan; and now HIG federal plan. That’s a lot of phone calls, and lot of frustration, particularly with the first of these, which had me and my doctors fill out a preexisting condition questionnaire for every single doctor’s appointment I went to, and I went to A LOT. This WAS while I was trying IUIs (three of them) and having natural pregnancies and miscarriages. Can you imagine how difficult it was for me to manage that, especially getting that boatload of doctors to fill out the questionnaires in a timely fashion? I got to the point at which I filled out the questionnaires they sent to me using a red Sharpie, in all block letters with exclamation points. I was truly losing my mind. Also: They often “lost” these questionnaires and tried to deny coverage. I had homicidal dreams around that point, I won’t lie.

Anyway! Fun, fun. Those days are gone…but they live in my very cells.

So yesterday, when I went to the drug store for the second time to try to pick up my Zolo, and for the second time the drugstore told me there was a problem but we’re confused as to what it was, I got on the phone with my insurance, the drug store, did, too, and at the end of the whole fiasco, I’d probably suffered for around four hours, replete with phone-gripping and teeth-gritting, to get it all straightened out. (Suddenly, without warning, they wanted me to use mail-order. And they wouldn’t do an emergency override for this month until my fifth call, when a kind woman took care of it for me.)

So today, when I got the call from my nurse, and I heard in her voice that things were not going well with ordering the fertility medications, I went zero to sixty inside but breathed, breathed, and was kind to her, and tried to put it out of my mind. The plan, at that point, was for us to wait until tomorrow, for me to call the insurance back tomorrow to see what was going on. But I couldn’t get it out of my mind. I started to get that sweaty-palmed, upset-stomach feeling. I was unable to concentrate on the things that make me happy. I decided to go to they gym to get the anxiety out of my system, and during the drive there, I started to cry. Nooooo. Not okay. I breathed some more and started telling myself: Everything is for you, even this. Everything is going to be okay. I imagined the worst case scenario, that the medications would not be covered. Would that be so bad? Couldn’t we put it on the credit card if we absolutely had to? Yes, we could. And we would pay it off. End of story. So even the worst outcome is not so bad. 

I almost caved and went to star.bucks to get a caffeinated coffee (right now I am drinking french-press coffee at home, 2 scoops caf to 4 scoops decaf). But I forced myself to turn left and not right on a certain street, so that I would wind up at the gym and not at the cafe. I took my new phone with me everywhere in case my nurse or my insurance called. I got on the elliptical machine and ran hard. “Don’t mess with me,” I said under my breath, directing my words to the faceless, formless corporation that manages my health care in the messiest, least efficient way possible. “Leave me alone!”

I felt damn good after the run. But I could still feel it. That small nagging anxious feeling. I tried to work some more magic on myself: Okay, this anxiety really sucks, but it’s not debilitating. Just accept that you’re going to have it for the next day or so until you know the final outcome. No big deal.

But unfortunately another part of me thinks it is a big deal. My reaction is a reaction to much more than this relatively minor series of incidents, obviously. My reaction is a reaction to ALL of it. The lack of control. The feeling that I am trapped, somehow, inside this labyrinth of Western medicine. But more powerful than that are the memories, the countless memories I now have of myself feeling frustrated to the point of tears while on the phone with some customer service rep who lucked out and picked up the line that happened to have the frazzled recurrent miscarrier on the other end.

I am no longer that frazzled woman. I am stronger, healthier, and my relationship is thriving. But I remember her. Poor, sweet girl. At the Columbia fertility clinic, they take your photo on your first day there, and it appears on the top left-hand corner of all of your receipts and documents. That photo haunted me. At the time the picture was taken, I was growing out a short pixie cut, and my hair was still very short and swooping wing-like every which way. My eyes–oh! God. In that photo, they are eyes filled with pure terror. With bruised dark circles beneath them. I was so, so tired and anxious and in despair.

At the gym, I did some yoga after my run, and I saw myself in the mirror. I was pleased with the pinkness of my cheeks and the perkiness of my behind. My hair now reaches past my shoulder blades. I realized that I wasn’t feeling all that anxious, even though my mind was running through the possibilities: The insurance is going to make me go to a hematologist to get the blood-thinner script. The blood-thinner won’t be covered because it’s for infertility. They’re going to find out I’m doing DE at RBA and not cover anything because these meds are tied to a treatment at a not-covered clinic. And so on.

But while I was doing a downward dog, my nurse called. I dropped to my knees, scrambled to my phone, and answered it, trying to sound like I wasn’t standing on a tightrope, wondering if I was going to fall to the net or be allowed to keep walking to the other side. “It’s all good,” my nurse said. “You’re covered, and they’re working on it.” I thanked her profusely. We chatted and laughed about how disorganized HIG is. We compared on-hold times. The relief we were both feeling was palpable.

And although I’d sort of convinced myself that I was not feeling that awful ache of anxiety anymore, when I got off the phone, I exclaimed: “Yes! Yes yes yes!” Because I’d won. I hadn’t cried (much). I hadn’t buried my head in the couch. I’d gone the gym and told the trigger to f*ck the hell off.

Guys, I really want this to be the last time I have to deal with insurance + fertility hell. I’m done. It’s time to move on.

And one more thing: I found out that my new insurance actually covers 3 IVFs. Oh dear. I’ve never had IVF coverage before. It’s so bizarre to have it, to know it is right there, waiting for us. “Maybe we should try IVF with your eggs and donor sperm,” DH said the other day. I just opened my mouth and stared at him for a bit. “Does not compute, does not compute,” I said. “System overload, help, help.”

I would rather try DS with DE in our current program, or move on to adoption. I think. But thanks, Universe, for keeping things interestingly not easy!

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17 Comments

  1. That’s so great! I think, if it is available to you, go for it!

    Reply
    • Hmm, not so sure that’s the path for me right now. The idea of going through IVF…uuugh. Sounds like torture. Once in one liftetime may be enough for this girl. Especially since I’m 40 and have an AMH of .3.

      Reply
      • I guess that’s a good point. I’m not too keen on it either. Nice to know you have the option, though.

        Reply
  2. Yay for coverage! Congrats! Btw most insurance will cover ivf only if the husband and wife are involved, not donor eggs or sperm, so just incase that was in the back of your mind you should follow up with them and ask ☺️ otherwise I’m so happy you’re one step closer in the right direction!

    Reply
    • Well, I’m not exactly thinking of the coverage as a good thing actually—it would have been great a couple of years ago, but now it just adds a possibility I’d rather not have to consider. Ironic, isn’t it. I’m 40 and my AMH is .3. My chances would be very low, and I hated going through IVF even the one time I did it. And we don’t even know if DH’s sperm is a problem or not. So, in short, I wish I could give my coverage to those who need it and want it!

      Reply
      • Oh, I’m so sorry for misunderstanding it! Sometimes, the things we need just come at bad times. Ivf is extremely difficult and challenging, and I completely understand your feelings about it! Infertility just puts us in such an emotional roller coaster! Hang in there xo

        Reply
  3. OMG–this has been my experience with CVS Caremark lately! They denied my appeal for my UC meds. Then, I went 10 rounds with them trying to get my fertility meds! I only wish I had skipped the Starbucks and gone to the gym–but hey, we just joined a new gym today so “next time”! Oh, and the IVF coverage–is there such a thing as “to much of a good thing”? Perhaps. Love ya. XO

    Reply
    • Indeed! Yes, too much of a good thing…and at the wrong time. I wish I could give my coverage to you MLACS. CVS Caremark sounds so horribly annoying. Boo to all of ’em!

      Reply
  4. Good grief! I applaud you for making it to the gym (I’d have skipped the coffee and gone straight for a glass of wine). I would give up a kidney to have IVF coverage. But you’re not going to need it. I’m sharing your hope that this is the last time for the insurance and fertility hell. You’re so close… I can feel it!

    Reply
    • Amen to that! Okay, then I’m just not gonna worry about it. (: No more. I decide—no more. I decide—this is it! Damn, if I could I would give you and MLACS my IVF coverage. Or if I could jump in a time machine and give it to myself two years ago…sigh. That ship has sailed. On to new waters.

      Reply
  5. Sometimes I think about how difficult it is for intelligent, educated people to navigate the insurance world and then get even more upset that there are probably many others who get even more swindled. I also get upset in dealing with my insurance company purely on principle, because they cover just about everything else imaginable EXCEPT for infertility treatments.

    Reply
    • I know what you mean! I used to work with the elderly population—they are just completely lost, in general, and have to rely on others to help them figure out the ridiculous complicated systems.

      Reply
  6. Tess

     /  February 8, 2014

    yes – I hear you. After paying for 3 failed IVFs ourselves, we suddenly have IVF coverage. We briefly considered DS and another IVF. But I was “does not compute!” Next plan is DE or DD/DE.

    Good job skipping the cafe and going to the gym and beating that trigger!

    Reply
  7. Love your re-framing of the health insurance situation; it’s much easier to get caught up in all the details and difficulties of dealing with them and think of them as enemies.

    What a decision with the new IVF coverage…yes, it’s wonderful that they’re covering that, but it does change the equation as you point out. Good luck and thinking of you.

    Reply
    • Thanks! I must sheepishly admit that I yelled at a poor customer service rep this morning (the battle continues, why o why) and apologized but still feel like I sent some bad karma out!

      Reply

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