Tuesday, September 22, 2009

Spoke Too Soon...

I am amazed at the incompetence of people. Remember how I told you how my insurance claim was submitted? It was not. I called this morning to check the status of my application, and I was told that it was still on the desk! WTH???????????? She immediately started telling me that my case is unique and she is unsure of what to do. Again, WTH?????????? She pretty told me in laymans terms that she thinks it would not be approved. (Just imagine me going into hysterics.)

I called the School District's Insurance Representative and stated my plight. She then said she is going to find me someone IN NETWORK, and get back to me. She made mention of this one Dr. in West Palm Beach, Florida that does unusual things (I already researched him and he does the Lap TAC - which I have researched and have found that it does not have a high success rate). I immediately called my hubby and said if Dr. D is no going to do it - I want no part of it!

I called Dr. D. and let him know about the lack of knowledge concerning this matter and he stated that if a date was set, the insurance companies would move faster. He says he cannot fathom why they would deny it after a TVC has been proven to not work for me. So.............. my TAC date is set for Friday, December 18th, 2009!!!!!!!!!!!!!!!
my only concern is that they may only cover 50% and that leaves me with only 2 months to save to cover the balance! AHHHHHHH!!!!!!!!! I discussed it with hubby and we decided that if they cover t partially, then we will put off the surgery until February, which gives us more time to save so we do not overextend ourselves.

I am excited, yet nervous. I am praying and hoping that the Insurance Company works for us and covers the procedure at least partially. Hubby and I are going on a fast about this. I know that with God all things are possible and I am choosing to put my trust in him. Will you pray and believe with us?

I received a wonderful comment from a "lurker" and will respond below. Thanks for supporting, lifting, and praying for us.

Cecilia, Thank you for coming out of "hiding". I was touched by your comment and know that I am now praying for you. It is hard for me to understand why good things happen to bad people, especially after you put your hope and faith in God. I like you have my moments, and find comfort from other blogs. I have to remind myself that I will never understand the mind of God or why he puts us through these heartaches. My faith is the only thing that keeps me going. Just knowing that there is a rainbow at the end of the storm gives me something to look forward to, and I remind myself that my good days outweigh my bad days, Even though I have lost two babies which is beyond what I could ever imagine, I examine my life and thank God for the blessings I do have. I hope today finds you in good spirits, and just know that I am praying for you. {hugs to you}.
BTW ~ I keep telling my hubby for all of us who go through a loss, there must be a win in our future. Shoot! Maybe we will win Power Ball, the Lottery, Publishers Clearing house, etc. :-).

Where is my expected end?


  1. Marie, allow me to chime in. :) I mentioned in another blog I work for an insurance company and I was reviewing our med policies and one of the critiria to have an approved TAC is a failed TVC so for your provider to say its not covered is crazy. Are you on a PPO? HMO? If you have some kind of deductible or out of pocket can I make a suggestion and I apologize if I am out of line, but simply trying to help...if you can schedule the surgery into the new year, it may work better for you in the long run. Helping you hit your out of pocket in the new year when you maybe having other maternity services. If you have the service in December, put money into your out of pocket and have to start your out of pocket all over again in December then you may be spending more money then you have to. I am probably making this sound way complicated. Email me if I am not making sense...I don't know if your plan runs calendar year or plan year...that may make a difference in helping you decide when to do the service, but ultimately its your decision. Prayers being sent your way for success. :) Sorry if I blabbed on. Just trying to help.

  2. Jessica gives some good advice. Though, if you've already met your out of pocket maximum for the year (that's where I'm at), then it wouldn't cost you anything. Fingers crossed for December, Marie.

  3. Jess, I commented on your blog.
    Bree - I have no out of pocket maximum. Keep everything crossed for me please!

  4. Praying, praying, praying! I really hope your ins co gets on the ball and covers this procedure!!! through God all things ARE possible.

  5. Insurance companies just insist on adding insult to injury, don't they? At least mine does! Hope you get this figured out soon, honey. Thinking of you.

  6. Continuing to think of you and pray for you and your DH.

  7. Sorry for the frustration with insurance, and hope things are better now.