Stupid Decisions

 In the most brilliant case of insurance buffoonery I’ve seen yet, when my company started offering fertility benefits this year under a fertility benefit plan, they dropped anyone with an RE designation from their regular medical plan. No big deal, right? Well, the fertility plan only covers IVF, IUI, OI/TI. It doesn’t cover any surgery or procedures outside of those. I want to have my Asherman’s treated by a surgeon who uses microscissors. Every living surgeon in MN who uses microscissors is an RE and therefore is not covered by my insurance. There was one surgeon who was just an OB, and covered, but he died unexpectedly in June.  Two others are both an RE and an OB.  Although my insurance covers every single other doctor at their network (Mayo clinic), it doesn’t cover them, because of the RE designation. I tried an appeal, given that the surgery is not solely for fertility reasons and they are OBs as well as REs. I was denied.

For a while, I started to panic that this was it. I wouldn’t be able to find a covered surgeon, so we’d never be able to transfer our little day 7. That was not the ending to the story I was expecting, honestly. I sent out a desperate plea, which a dear friend forwarded to her RE. And thus I found an OB in St. Louis who uses microscissors, balloon stents, and long estrogen courses (best practice), coupled with a second-look hysteroscopy (also best practice), to treat Asherman’s. He’s in-network. Did a consult this week, and he’s highly knowledgeable, up on the research, and willing to give my uterus a look. So it looks like I’ll be making the nine hour drive, then spending a week in St. Louis while waiting for the stent to be removed, then driving home, and finally flying back six weeks later for the second look. During a pandemic. Because my idiotic insurance won’t cover a skilled OB/RE who is local.

Despite the worry that this entails, the bigger worry that this doctor brought up is actually that the issues with my uterus are not simply Asherman's, but also the result of problems with my c-section scar. Those can only be resolved via lap. As a result, the plan is to book the OR for a hysteroscopy and lap, start with a hysteroscopy, and convert to a lap if the c-section scar is the issue. So I may be recovering from a lap, 9 hours from home, because my insurance won't cover anyone local. Stupid decisions, brought to you by stupid insurance.