I am in a weird dilemma today. I’m going to preface this with a little bit of explanation of the differences in character between Pea and I.
I am a researcher, planner, and detail-obsessed micromanager. Pea is very nearly the opposite: he’s not detail-oriented, and does not like to have to work to find out specifics. He’s brutal with paperwork and follow-through (I mail everything that comes out of our house, or it languishes on the counter for all time). Pea budgets “by feel”, I know exactly where every cent I own is at all times (partially a product of being very poor for essentially my whole adult life, partially the natural product of the qualities listed above). As a result, I often find myself wanting to know more information about Pea’s side of things than he actually knows to tell me, and it takes some delicate but firm prodding to get him to go and find that information, which sometimes does not succeed.
This has come up a few times as we began navigating the US health care system, as I examined every plan available to me with an eye for infertility (knowing, even months before stopping birth control, that this was going to be a problem). My coverage, as I said yesterday, is quite good. It doesn’t cover IVF at all, or any costs for injectable drugs (including trigger shots), but it’s definitely going to make these next three cycles pretty affordable. Pea signed up for his health care when he started his new job in August, well into our understanding that infertility was very likely to be a significant hurdle, but before I started any treatments. He never shared any of the different plan options with me, and (as far as I could tell) randomly selected a high-coverage EPO, where nearly everything is 100% covered as long as you are within your network of providers, and is 100% NOT covered if you are outside network. I’ve asked him MANY times what his infertility coverage is. MANY times over the past several months, since August when he picked the plan. He’s been his usual fuzzy self about looking into it, saying “they were all about the same for fertility, so I’m sure it’s like the others”. Helpful only where I know what the ‘others’ are.
I haven’t pushed this, because I’M the infertile, so MY insurance is what matters. I’m not on Pea’s insurance, as we’re not married, and we discussed it and decided it wasn’t worth the extra money each month given I have relatively good insurance.
Those were the assumptions I was working under. We need to check this, but I think I’m wrong. If Pea’s only chance to procreate with his chosen partner is through infertility treatments, then we think his insurance will apply.
So. On to yesterday.
I came home to a conversation with Pea where he had finally read his infertility coverage information, because he has to go have his blood work done today.
He is 100% covered for infertility services, including surgeries, IVF, ICSI, and anything else you could think of, up to a lifetime maximum of $20,000.
It has to be in network, or it’s 0% covered. The fertility clinic we are currently working with is not in his network.
I have not yet looked to see if any of the other clinics I researched who are in my network are also in his, because if they are, I’m going to be really mad at Pea.
For now, given the comparatively low cost of the letrozole cycles and my potential extended mat-leave if we conceive SOON, we’re going to stick with our current clinic and our current plan, and not use his coverage. If we successfully conceive, all to the good. If we don’t… well, I still don’t know. IVF is the next step, and this would mean we have what amounts to a free IVF cycle in our back pocket (my current clinic has a $9,900 one-IVF package deal, plus stim drug costs, so I think that should be competitive across clinics).
I don’t know how I feel about IVF at all, but free IVF is at least less insulting. I don’t know how I feel about having to switch clinics, and if I can possibly blame that hassle and delay on Pea given we’re only at a clinic because of me. I’m tired of being the financial and reproductive dead-weight in this relationship, but attempting to compensate for that by taking on more of the cleaning and all of the organizing is just making me angry and contributing to his learned helplessness.
I’m grumpy, and still out of sorts from the glucose tolerance test this morning, and so I would like to say that I do recognize this is good news. Changing clinics will hopefully not be that big a deal, our current tests should carry over, and, more importantly, we’re not there yet.