…or the lack thereof.
This morning as I was nursing Stella before heading to town for her one month checkup, I received a phone call from my health insurance agent.
First off, I am NOT happy with this guy. Throughout my pregnancy with Stella, I was on a state insurance program that would cover my “pre-existing condition” of pregnancy (read: they got to charge me a super high premium for maternity coverage), and Charlie was on Assurant. Once Stella arrived, we wanted to save money and simplify things by all being on one plan, because according to my agent, once I had a healthy delivery, the infertility diagnosis would no longer apply and cause issues with pre-existing condition b.s.
He had us cancel our existing policies effective 12/31/11 because he was “certain” we’d have “no problems” getting on the new plan through Cigna (a high deductible HSA plan that covered well-child routine visits and immunizations 100%). I, like a complete and absolute moron, believed him and followed directions.
Well, this morning, one hour before Stella’s doctor appointment, I got a call from him that they fucking denied us health coverage.
So much for a sure thing.
I just requested the “why” letter from Cigna, and BOTH my husband I were declined. He is 30, I am 29. We are both in PERFECT FREAKIN HEALTH.
You get one guess why we were BOTH denied.
Health information provided from your application and phone interview indicates history of infertility treatments by spouse in March 2011. This condition and treatment does not meet the approval criteria of our medical underwriting guidelines.
How awesome-sauce is that? So now, not only do I get denied, but SO DOES CHARLIE since he’s married to me and I have problems getting knocked up – EVEN THOUGH we have paid for every penny of the IF diagnosis and treatments out of pocket.
We had to pay out of pocket (OOP) for her appointment this morning, which thankfully was just a routine well-child visit that didn’t include any shots. It was still a $160 visit ($120 since we paid right there), but this obviously has to get resolved asap. Between a gazillion well child visits and immunization shots over the next year, the OOP expense would get ridiculous quick, plus I am obviously not comfortable with NONE of us being insured right now, not even with major medical. This is the first time in my life I’ve even gone one day without insurance, and it’s all my insurance guy’s fault.
*tip toeing around and chugging airborne trying not to get sick in the meantime*
ETA 3/7/12 – For those of you coming across this post down the road, we had to switch to a different company that would cover us (Assurant) – though we had to sign an exception acknowledging that they would not even cover diagnostic work related to fertility for AT LEAST 3 YEARS – after which time we could apply to have a waiver granted and have that covered again…though they wouldn’t have to grant that exception if they don’t want to. Such b.s., but at least we have coverage again. I just don’t understand why CIGNA couldn’t have done something similar to that waiver. Weird.