The post on the Geriatric Pregnancy caused a bit of a stir, huh?

Here’s a quick update on the insurance coverage issue I mentioned in previous posts - that my “copay counts towards my Out-of-Pocket (OOP) Maximum”.

I finally pinned down United Health Care on not paying (even) any copay for my chiropractic treatments since I have met my OOP for the year. So now, I don’t have to pay anything…zero….zilch…nada… woo hoo!!! Well, at least for the rest of year 2008 since I have 20 sessions allowed. 18 more to go…

UHC is “wise” though… they want the chiropractic service provider to re-file and re-assess the case (moi!) after every 7 sessions. I guess to make sure that I’m not just there for the massage… which I am there for mainly

Anyhow, it took a total of 2 calls from me and 2 calls from the service provider to establish this - the last call being at the chiropractor’s office where both the office person and I had to speak to the insurance’s 1-800 folks. For some reason, those 1-800 folks somehow end up reading the family OOP… every time … instead of my individual OOP. I’m not sure if those were honest mistakes or if they are trying to avoid paying.

Well, you just have to “know your rights”…

I went to see the Chiropractor - only the 2nd in the last 12 months of my 40 year-life. It was my first time to see her and she is good! She massaged my back, eased my very knotted shoulders and adjusted a lot of my bones! Crack and pop! Whoa, I feel much better!

Guess what? After NOT trying for 11 years, she had an unplanned pregnancy early this year but miscarried. She is 35 years old, 3 months pregnant again and still cracking bones.

I asked her until when she will be able to do that (as I like her already even if it is just our first appointment and I don’t want to be passed on to the other practitioners). She said she does not know yet and will just have to wait and see…

Anyway, her doctor called her a case of “geriatric pregnancy”. Hu-wat??? Say it again… GERIATRIC PREGNANCY. If she, a 35-year old woman , is considered a geriatric pregnancy case, that means I, 40-years old, fall in that same category also (I am not pregnant though, I just wish though…)

Wow, I never thought of my case being “geriatric”. Somehow, I reserve that term to the really, really old people - all wrinkled, gray hair, slow-moving and stooping. Yes, we all go that way in the future…but meanwhile, I just never thought of myself in that way at this time.

Hmmm… the Reproductive Endocrinologists do call our cases “Advanced Maternal Age” - are they just being nice??? Or does the terminology change once they turn us over to the OB/GYNEs???

…..

When she learned that I was trying to get pregnant too, she mentioned that she had a couple of friends who had difficulty conceiving and were able to get pregnant after going through acupuncture. She specifically mentioned one who was getting periods 2x a year only and got pregnant!

I’m not easily affected by such statements but hmmm…. I’m just wondering if acupuncture is the new “just relax and you’ll get pregnant” or “if you adopt, you’ll get pregnant” statements?

…..

Now, I mentioned in my previous post that the insurance’s 1-800 number said that since I have met my Out-of -Pocket max expense for the year, that I do not have to have co-pay. Well, the Chiropractor office asked me for a co-pay since their system showed that I still need to have co-pay. I’m disappointed but I’d like to go back and continue my “therapy”, so I paid the co-pay.

I called the insurance 1-800 number again and they did confirm my original understanding. I called the Chiropractor’s office and they said they will look into it. I told them that I would like to have that settled before my next appointment because I do not want to keep paying if I do not need to (even if they will refund it).

After I confirm that my insurance does take over 100% and no copay after meeting my Out-Of-Pocket, Acupuncture is next!!!

…..

Ohhhh… all the blogging ideas coming to me when I am laying on my tummy and getting my back massaged!

Infertility treatments not covered by your insurance? There are many ways to get back at them.

No, this post does not tell you how you can fund your Infertility Treatment. What it does tell you is how you can maximize the use of your insurance!

A Little Background…
Our health insurance provider is United Health Care (UHC) from DH’s job. It does have Infertility DIAGNOSIS coverage but does NOT have Infertility TREATMENT coverage.

UHC also offers discounted services through their Extra Benefits programs such as Parent Steps for Infertility Clinics. The good news is that CCRM is one of the included providers. The bad news DH’s big company has not availed of Parent Steps as an Extra Benefit.

Well, I was not going to stop there… I’ve spent almost $6K on medical expenses already this year, there must be something that the insurance company can do for me…

I have met my Deductible ($250) and Out-of-Pocket (OOP, $1500) max expenses for the year since as early as February. So, I called the insurance’s 1-800 number and found out that my co-pays count towards my OOP for the Chiropractor and for Acupuncture.

So that meant that once I have reached my OOP, I do not need to do co-pay anymore. That meant that for the rest of the year, I can go to the Chiropractor and the Acupuncturist for FREE!!! Woo hoo!

Well, at most 20 visits per year. But there is just about 10 more weeks until yearend, so I think the rest of the year is covered.

So, if you have met your Deductible and Out-of-Pocket expenses, go get yourself a Chiropractor and an Acupuncturist!