Fighting with Insurance

Not that insurance companies have ever been known to be "easy to work with" but I never thought that this part of the process would bring me such headaches!

At the end of May, Tabitha from NWSC sent me letters that I needed to sign and send to my insurance company, my HR department at work and the compensation and benefits department for work as well. 

Here is a copy of the letter:

Dear Sir or Madam:

I am planning to serve as a gestational surrogate for an infertile couple, working with Northwest Surrogacy Center, LLC in Portland, Oregon. I would not be genetically related to the child, but would instead become pregnant through an in vitro fertilization/embryo transfer medical procedure. I plan to carry and give birth to the child, who will be raised by the intended parents

I have reviewed the Summary Plan Description and do not see anything that would exclude my pregnancy from coverage under these circumstances. I do want to be careful and want to confirm that my insurance will cover my surrogacy pregnancy and delivery.

Please send a letter stating whether my current insurance will cover my pregnancy.

As the letter says, there is nothing in any of my insurance paperwork that says that surrogate pregnancy is not covered. I have always had amazing coverage through my insurance and honestly expected a quick response with a letter stating that they would provide coverage. 

This was a HUGE part of the process as E & S would have to purchase additional health insurance for me if this weren't covered through my personal insurance. This could ultimately delay everything; purchasing a whole new insurance policy could take MONTHS. All sorts of paperwork, etc. 

Near the end of June, I hadn't heard anything back. So, as I tend to do, I took matters into my own hands and called the insurance company. Here's where the fun began. 

I call, wait on hold after choosing the prompt for "coverage related questions" and finally get a representative that tells me, "Oh yes, Samantha, it looks like we received your letter and have sent out a response. The surrogacy will not be covered by your insurance." 

My heart SANK.

Of course, being the type of person I am, I wanted answers. Why exactly wouldn't it be covered? And WHERE does it say that it isn't covered in any of my plan documents? 

While on the phone with this rep, she tells me the page number in my plan document that she's referring to. I pull it up. It says that my insurance will not provide coverage if I were to have a surrogate carry a child for me, due to infertility issues. Not exactly what I am doing here. I'm going to be the pregnant one. I politely explain this to the representative. She puts me on hold for awhile, a LONG while... and comes back and says that she can't find the answer at the moment but would love the opportunity to call me back. Sounds like a plan to me.

Until she never calls. So I call again, get a different representative, and they have a completely DIFFERENT story. She says, absolutely. I repeat, ABSOLUTELY, it would be covered. Her reasoning? "We don't ask you who the father is when you get pregnant on your own, this is basically the same thing." I laughed at this, but is it not so true? When you go to the Dr. and say that you took an EPT that was positive, they don't start asking you questions about who the father is and if it's your baby or not. They schedule your appointment, you see them, and your insurance is billed. No questions asked. I could've lied, not sent them a letter, and just gone in once all the IVF was through and no one would have been the wiser. 

I'm so incredibly happy now that this lady is telling me it's covered. It's a HUGE sigh of relief, and one less thing on the to-do list before getting pregnant. That is, until I ask her to send me a letter saying that it is covered, as it's required for this whole process. She says there isn't a letter they can send for this. Working in the banking business, I understand the legalities of letters we can and can't send to customers, but they had just sent me a letter saying it wouldn't be covered. How was it possible they couldn't retract that letter and send  one saying it would be? Plain and simple. 

After multiple phone calls and holding for what felt like hours, I talked to someone who assured me they would send me a letter saying it was covered, and all would be well. 

Finally, in JULY, I received a letter stating that they would cover me. No more headaches, no more waiting. It seemed like all the T's were crossed and I's dotted. Now to wait for things to fall into place at ORM for us to schedule the embryo transfer.