Are you stupid, or just an @sshole?

When we first started TTC, we were told that our insurance covered fertility services.  Then, in the time between the clinic required testing (STD screening, HSG, psych eval.) and our first IUI, our insurance company stopped covering our fertility services.  We were not told about the change until I was leaving the clinic after my first IUI.  Our insurance company had decided that I did not meet the criteria for infertility, so we would have to pay for everything out of pocket.  

The eligibility requirements  for infertility, as stated by the insurance company are as follows:

Infertility services are covered for any abnormal function of the reproductive systems such that you are not able to:

*Impregnate another person

*Conceive after 2 years if the female partner is under 35 years old, or one year if the female partner is 35 years or older, or if one partner is considered medically sterile.

*Carry a pregnancy to live birth

Excellent, we thought.  We'll just write to the insurance company and appeal their decision not to cover us.  After all, their policy seems to indicate that infertility is based on whether or not a COUPLE can conceive together.  If I were with a man, I would automatically be covered if my husband was sterile.  Since Elizabeth can't produce sperm, these eligibility requirements should apply to us.  

We wrote to the insurance company, and about a week later they said that our case would be reviewed by the board, and we could make our case via phone during the meeting if we wanted to.  So we did the teleconferenced meeting, and made a good case.  Unfortunately the insurance company upheld their decision not to cover our IUIs, but told us we could do a second level appeal.  We did a second level appeal to the insurance company, and a few weeks later got a letter back stating that our request to have coverage for IVF was denied.  

Ummm, IVF?  Where the hell did that come from?  We were only asking for coverage for IUI, which costs a fraction of IVF.  Of course we wouldn't expect IVF coverage at this stage of the game.  So we did a third level of appeal, which required us to write to the State Department of Pensions and Benefits. We re-stated our original argument, but added the fact that the insurance company didn't even know what procedure we were going for, indicating that they weren't taking our claim seriously.  The state wrote back a few days later, and told us that they were making the insurance company complete an expedited final review of our case.  Apparently, expedited means tremendously slow, because it took 3 1/2 months for the insurance company to give their final decision.  And guess what they said...

YOUR REQUEST FOR IVF COVERAGE HAS BEEN DENIED!

The insurance company should know that IVF and IUI are NOT interchangeable terms.  So I've come to the conclusion that they're either really stupid, or else they're very intelligent, calculating @ssholes.  It wouldn't surprise me to find out that somewhere along the line, an insurance company employee had "accidentally" changed IUI to IVF just so that the insurance company could deny our appeal.  Why else would they continue to write about IVF, even after we'd made a point of correcting them on that?  Maybe I've just seen one too many M.ichael M.oore movies, but I'm convinced that they're doing everything in their power to waste our time, string us along, and make us give up on the appeal.