This morning was Andy's appointment with the Urologist. And because we really needed more drama in our lives, they gave us crap about how our appointment had been rescheduled (funny... we never got a call! One would think they would notify you when you drive 40 minutes to an appointment that has been changed!). We convinced them to let us see the doctor.
We got some good news and some not-so-good news. Andy's prolactin is back to normal! Yay! but the doctor wants to put him on self-injectables to regulate some other things. Getting insurance to approve the medication is very difficult though. Dr. Fenig is awesome, and doesn't code anything as fertility, but my insurance company doesn't have the medicine listed as anything BUT fertility. Seriously? Has NO ONE ever had this issue before? And they also won't cover injectible medications except for IVF (Andy is not getting IVF. If anyone did, it would be me and I'm not either yet.). This doesn't make any sense since guys don't get put on injectibles for IVF. The girl I was talking to didn't read it right either, because people with PCOS ARE covered for injectibles. But anyway, they're giving me the runaround about this medication which Andy NEEDS to have, fertility issues or not. So I'm trying to have the doctor submit a pre-determination explaining that it's not for fertility so it's covered. I'm also re-applying for the fertility program now that we know about the tumor so that if it can only go under fertility, we can still get a discount. My doctor thinks they'll approve me because even though we haven't been trying 2 years, there's absolutely no way for us to get pregnant without medical intervention, so I will make sure they know that, and Dr. Fenig agreed to submit forms to them explaining it all. He also said that he'll tell the insurance company that if they will only code it under fertility that it's just as expensive to use other drugs for the same thing. GO DR. FENIG!
We'll see what happens over the next week or so, but there's just no reason we shouldn't get SOME coverage for this since it's medically necessary. We may have to fight for it though. I did already call the Dr. so he knows to submit a pre-determination like they asked for. I think he may have put one on there anyway, but either way, we'll get it worked out in the next week.
One really good piece of information came out of it though. I told him that My RE, Dr. Timmreck, had been very negative and told us that even if we get Andy's testosterone up that we'd probably still need IVF. He said he disagrees. He said "We're going to get you fixed". He said that the first appointment and he's still saying it, and I don't know what it is about him but I believe him. Of course I'm still worried about me and whether or not I ovulate, but if I do, and these shots do their job, we'll be REALLY leveling the playing field!
I dunno.. I'm still sort of frustrated, and sad for Andy. He kept making the cutest but saddest pouty face. I wish he didn't have to deal with all this, but I'm just going to have to be there for him like he's been there for me with my kidneys. He keeps saying he'll do whatever he has to.
I really wish this process was easier for us, but I know when we're smiling down at our new little one it'll all be worth it. I just hope it's soon!
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