Saturday, February 7, 2009

Just catching up...

Many of you were interested in where I got the story about the moratorium in Kyrgyzstan...well, it came in an email to me from one of the agencies. Not MY agency, mind you...but one I wish I was with and is very reputable! I tried to click on the link that was attached to it and symbols that made absolutely no sense to me came up, so...if you are still interested, here it is... http://www.kenesh.kg/press/news/2009/02/03/Parlamentarii_vystupili_za_ujestochenie_mejstranovogo_usynovleniya_v_Kyrgyzstane

I have no doubt that as follow-up info comes, this wonderful agency and adoption worker will let people know. Thank goodness. My translation skills STINK.

In other news (IVF stuff, so if you don't care, no worries if you want to move on to the next blog!), I start the Lupron on Thursday. I have to say that my primary care nurse is absolutely WONDERFUL. I'm basically with the military's version of welfare medicine, aka Tricare Prime. Now, before you go firing off the emails about how lucky I am that I get *free* medical care through the military, just don't bother. My medical care is NOT *free*. It is paid for through the brave and dedicated work of every military member that has or will be. It is part of my husband's paycheck for being on call 24 hours a day to protect you and your rights. And, MY tax-dollars pay for it. So, forgive me if I expect it to be even halfway close to government-subsidized health care programs. Through Prime, I have little-to-no choice in doctor, appointment access, specialized care, you name it. The pay-off for that is the co-share cost, which is minimal. If I wanted to have more choice and access, I do have the option of going Standard, but will probably pay more in co-pays and other services. So, anyway, I'm with Prime. And, I can honestly say in 12 years of being a military spouse, I have had average to above average care about 90% of the time. Not too terrible, if you ask me. Lately, though, I have had exceptional care with my primary care staff, specifically my nurse. You see, the program we are enrolled in is through Shady Grove and is called Shared-Risk. Basically, you plunk down $20-$27K and have 6 tries (fresh) at pregnancy through IVF. If, at any time, you decide you don't want to do it, you quit and get your money back. The ONLY way they collect their fee is if you end up with a live birth. Not pregnancy, but LIVE BIRTH. If you are successful the 1st time, you've paid them a TON of money extra, but at that point, who cares? That's your risk (and your new baby!) in the contract. If you are successful the 2nd time, you have paid about what you would pay regularly for 2 IVF cycles and it's about break even for the clinic...maybe they make a small portion. Any time after that, well...they are basically losing money on you. So, their agreement to accept you into their program basically says that they are pretty confident they will be successful the 1st or 2nd time, or else, they wouldn't really take you. They lose money and they have to report all those numbers to the Society of Assisted Reproductive Technology, and they don't want to have anything but stellar statistics.

So...that's the program we are in. This program includes mostly everything. Save pre-screening and diagnostics (which the military partially covered and we out-of-pocketed the rest-OUCH!) and medicine. Ahhhh...the MEDICINE. The drugs needed for each cycle are going to cost about $3200. Does my insurance cover any of that, you ask? Well, funny story. Between the unbelievable diligent work on the part of my primary care nurse on base and my IVF nurse at Shady Grove, they got some stuff covered. After all, Tricare Prime DOES have pharmacy benefits like any other insurance program. What didn't they get covered? Just the most expensive drugs...the gonadotropins, otherwise known as the follicle stimulation drugs. Why?

Well, Congress, in its infinite wisdom, has declared that those drugs ARE covered if you are NOT using them with assisted reproductive technology (i.e...up your chances when you do the Hokie Pokie naughty-style). If you do this, there is NO monitoring, and one could VERY easily overstimulate and be very sick (or even DIE!) as a result. These are pretty strong drugs, and they work very quickly. It is just NOT healthy or safe to be making yourself produce boatloads of more eggs than you usually do just to up your pregnancy chances and NOT be monitored while doing so. But, put yourself in a program to do the SAME thing but be safe and monitored, and Congress (who is in charge of our plan) says nothing doing. Now, let's be clear...if John had "issues", shall we say, you better believe that Vi*gra WOULD be covered. So, sleep safely knowing that drugs to help infertility, a medical condition that affects over 7.3 million women, will NOT be covered with taxpayer dollars but no man will have to suffer the humiliation of not being able to put on the party hat, so to speak, because that IS covered. Ridiculous.

Anyway, the purpose of this rant was to really proclaim how very blessed I am with the people who are in charge of my care. They have truly gone above and beyond the call of duty, even for exceptional service, and I just can't say enough about them. And to say that I am thankful for what IS covered through our pharmacy benefits, because every bit helps. AND to say that I, as a taxpayer, find Congressional policy hypocritical, ridiculous and insulting. Then again, it IS Congress of whom I'm speaking, so....

3 comments:

  1. I am just FASCINATED with the IVF information. I've just never known anything about it and you are just a font of knowledge now. :-) Plus, you make it funny. Thanks for the link. I'll send it on to the person who asked for it. My fingers are crossed for TRY #1 -- who cares if they make money, right???? The adoption folks make money, why shouldn't a clinic?

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  2. Best wishes... I'm really excited for you too!!!

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