The Days of Exploration- and some research on the US healthcare regarding IVF

As I sit today for another one of my business trips to US, my mind wanders back to the days when we made the first trip.. We were quite confused, after the discussion with Dr. GHP, on what we should do. Should we cancel the trip and continue with the treatment, or should we go ahead and come back for the treatment?

Our decision was helped by Dr. GHP herself, when she mentioned that we could go and come back whenever we are ready for the procedure. And given that we had already committed for the trip, we decided to take the same. The next day, we were on a flight to US. But our minds, they never rest, do they?

Knowing the health care policies in US, we ended up doing some amount of research in doing this in US. As usual, our research starts with a search in Google. J The first thing to remember and know in US is that, if the Health Insurance firms do not cover the treatment, you probably would have to take multiple loans to cover the cost. ( I have heard stories of how some people had to sell off their properties in India to cover their IVF costs ). Anyways, in this line, there are 14 states who mandate that IVF procedures be covered in their Health Insurance Policy. Here is the page from National Conference of State Legislatures which list these 14 states. 

Here is also another page from fertility life lines.com – which lists 15 states. Louisiana is the state that is missing in the prev URL.

So, if your company is registered in the above 14 or 15 states then, your insurance policy will cover infertility treatments. But hold on before you get the smile on your face.. J - there is some small print: ( which is also listed in the fertility life liens page, but I thought I would add my own stuff )

• 1.       Check if your employer’s plan is “fully insured” or “self funded” . If they are fully insured, the company has to follow state laws, and if they are self funded, they are exempt from the state laws and only need to follow federal regulations.

 The impact? Even if your company is registered in any of the 14 states, but is self funded, then they do not have to cover the IVF costs. So please check this with your company.

• 2.       On a related note, I also heard from people that the employer’s policy should be written in one of the 14 / 15 states for it to cover the IVF costs.. But I couldn’t understand it too well.

• 3.       AS the next step, even if your company covers Assisted Reproduction, please check on what all procedures do they cover. There are multiple ways of getting this done, and IVF is just one way of it.  In addition to this, IVF is done in multiple cycles. You should also check on how many cycles are covered in the insurance.

btw, INCIID provides a list of employers who are infertility and adoption friendly: http://www.inciid.org/article.php?cat=statemandates&id=243

Though our company is registered in New Jersey ( one of the 14/15 states mentioned above ), we realized ours is a self funded policy and hence does not cover IVF costs.  Anyways, since we were residing near Boston, MA, we were consulting with the Boston IVF  – Dr. Alison  Zimon, who not only confirmed the diagnosis, but also put us through the insurance person to get us properly counseled. Since our residency was in MA, ( once again, one of the 14 / 15 states above ), we could apply for a personal insurance from any providers – Blue Cross Blue Shield, MA,  Harvard Pilgrim, MA  and one more provider (I forget name) 

The counselor urged us to speak to each of the co. and get the policy that we felt was applicable to us.  She mentioned that my spouse could decline my employer’s insurance and get a personal insurance.

We first called the Blue Cross Blue Shield Office, and here is where we had a surprise waiting for us. The representative told us that as per the latest health care reforms law passed, if I do have an employer’s insurance, I cannot decline it and take a personal insurance! I couldn’t then ( and still not able to ) get any corroboration from any data sources in the net for this.. If any of you have any data supporting this, please feel free to comment…

Also, about the cost of IVF, we were told that each cycle of IVF would cost around $12,000 - $8,000 for the procedure and $4,000 for the medicines and pharmacy charges. (I am basing this on memory alone, I could be wrong. Request you to please check this up with verified sources). The cost for this treatment in Prashant Clinic was about 1.5 lac for each cycle with about Rs 30,000 for contingency ( that would be approx  $ 4,000 per cycle – with the conv rate of about 45 Rs to 1 $ )

This made our choice quite simple. We decided to do the procedure back in India with Dr. GHP. We started to plan for this – logistically and financially. J

The Days of Anxiety

Every time somebody asks me the question "Do you have any siblings?" - I have always replied back with a smile "Well, my parents saw how i am turning out, and they realized that having one is enough for them!! :)"

I am sure that it is true, but 4 years back, this didn't stop my wife and i from attempting to have our own kid.  The kid turning out to be like me is not enough incentive for us not to add on to an already hopping, jumping population. But then, there seemed to be a problem. This kid was just refusing to be.

Having had got tonnes of forwarded emails about how stress affected everything from the growth of finger nails to the  color of the hair, we decided not to wait until the stars align and seek professional help. Today, when we  look back at what we did, it seems glaringly clear to us that this is where we made our first mistake. Anyways,  in all our naivete, we chose to consult a gynecologist. 

"There is no significant problem, ma. Nothing to worry about. It's just two years of your marriage - go ahead and keep trying" was her advice. Probably lulled by the sound of what exactly we wanted to hear, we did that. Months went past, nothing else happened. At one point, we crossed paths with someone who put her hand onto her chin and said "hmmmm.. shouldn't you try another doctor?" And we met a famous new dr - Dr. Kurien. This turned out to be even more interesting :)

It was extremely difficult to get an appointment with Dr. Kurien. You had to book about a month or so ahead if you wanted an appointment. With him, the advice remained the same - what did change was the time frame between two visits to the Dr. We moved on from being "recently married" to "oh yes, we are married" time-lines.

Meanwhile, life at home was becoming more strained and funny at the same time. There were moments of sudden remembrance of the days of the month causing hurried unexplained departures from friends' parties. There were days of "relaxation" and deliberate staying away from fights - marking this fight to be picked up on another day! Now when we look back at that, it's always with a smile.

My work decided to relocate me to the United States, meanwhile. Since "there was nothing significantly wrong with us and we should continue to try", we also thought a change of scene would do us good. I flew in to US a month ahead of when i would take my wife also there. During this one month, my dear wife resigned from her employment and decided to spend one month of vacation at her native place.  During this stay, her parents wanted her to meet their family Doctor -  a certain Dr. Vasanthi. That's when the news broke!

My wife was diagnosed with a situation called Endometriosis. Dr. Vasanthi adviced Laparoscopic surgery which would remove about 70% of the condition and then advised us to go ahead and try. So we went ahead with the laparoscopic surgery.

Few days after this, my friend called me to tell me a good news - his wife was to deliver their kid that night. Completely thrilled, my wife and I went to the hospital to keep him company and welcome the new born to this world. That's when we first saw this hospital called Prashant Clinic - Prashant Fertility Research Center, to be precise. We decided to consult the resident dr Dr. Geetha Hari Priya at the PRashant Clinic just for a second opinion.

If you have never been to Prashant Hospital, what i mention would seem scary, or probably funny. This doctor had about 100 people waiting to see her, at about 10:00 PM. As our visits became more frequent, we realized that was not a one night issue - the crowd exists every day, but Dr GHP, as she is referred to, will consult everyone waiting in the hall, irrespective of the time. Our patience was rewarded after a two hour wait - around midnight.

One look at our file and Dr. GHP simple mentioned "Oh this is stage 4 Endometriosis - the only way you can conceive is through an IVF procedure. "

We looked at each other. We had tickets to travel to US in about 28 hours from them. What should we do? Should we travel or no?
......

Those days Gone and these days going...

Few months back, my wife and I made through a trip through the Western Coast of  USA. A trip that opened our eyes to a lot of the wonder that is nature - there is no other way to describe standing spell bound on the edges of the Grand Canyon, gasping at the world's best preserved meteor crater and lot more adventures.

It also expanded our views on some of the man's advances. From seeing the tribal laws co-exist with federal laws peacefully to the most unbelievable realization of a dream - Viva Las Vegas!
( i hold no copyright to the image, i just used one that came up in Google search :) )


The trip took us through some of the most scenic drives and some very beautiful cities and places...

And i thought, i would go ahead and revitalize my blogs with detailed travelogues. Procrastination, unfortunately took over. And now, there is something that we are going through, which brings in anxiety and information is not that easy to locate. Hence i thought i would start writing again, trying to consolidate the information that i am gathering, so that it might help others in their quest for knowledge in the related field.

Blogging, here i come back again! :)