Fed Insurance & Just starting IF Treatment

[Anonymous]

I'm 33, never been pregnant, been off the Pill for 15 months, and only had 4 periods at completely sporadic times. (For example, no period at all between Feb and July.) Technically we have been TTC but it's been sort of a joke with no cycle. (I used to temp daily but after hitting Day #120, I maxed out my tolerance. I did confirm ovulation twice, however, before quitting.) I have given up on the concept that my body might regulate after a decent amount of time off the Pill.

My OBGYN just referred me to an RE. She thinks that I will "just need some Clomid" to get pregnant. I've had no diagnostics beyond a blood test (not timed with my cycle, of course, and found everything normal) and ultrasound which showed everything normal, including some follicles. But there is obviously no way to know what else we might need down the line.

I'm trying to figure out if I should change my federal employee insurance since we are in open season. I have Aetna HMO right now. I've been trying to do the research on what is covered but my head is spinning. Of course reading the coverage booklets is close to useless, both because it is pretty cryptic but also because I just have little clue about what the mechanics would be of further IF treatment beyond Clomid.

Anyone have any advice for what Fed insurance plan makes most sense? From reading these boards, it looks like BCBS. It covers RE visits, Clomid cycles, and IUI, right? But I don't yet know if I will have to do any IUIs or IVF or how that works (injectibles - is this every day? Really expensive?) I'm really confused and frustrated that I have to stress out planning for the "worst" when a Clomid cycle or two might just do the trick. Thanks for any help you might have.

[Anonymous]

BC/BS does not cover IUI's. Carefirst is your best bet: it covers diagnosis and testing, as well as up to 6 IUI's. Aetna only covers 50% of diagnosis and testing.

[Anonymous]

Switch to Carefirst HMO. Aetna makes you pay 50% of all infertility-related diagnosis/treatment. Carefirst covers both at 100% up through IUI, if necessary. Aetna covers IVF (at 50%) but it's doubtful you would need to go that route within the coming year given your current stage in the process.

Be careful though--Carefirst HMO and BCBS PPO aren't the same thing and the coverage is very different. Don't get them confused.

[Anonymous]

I agree. My understanding is that Carefirst (an HMO) would be your best best, at least for one year. If you end up needing IVF, I think you'll have to wait until next year and then switch to one of the insurances that partially cover IVF.

[Anonymous]

Thanks SO much!

One other question... if my specialist visit is $35 under CareFirst, do I have to pay that for monitoring several times a month? Seems steep!

[Anonymous]

Anonymous wrote:Thanks SO much!

One other question... if my specialist visit is $35 under CareFirst, do I have to pay that for monitoring several times a month? Seems steep!

Unfortunately, yes, but it's still much cheaper than paying for half of each ultrasound as you would with Aetna.

[Anonymous]

Oh that makes sense! Thanks. I guess I better start saving my pennies...

[Anonymous]

But BlueCHoice has a $1,900 maximum so at some point in the year it looks like the co-pays would go away. That would take 54 visits alone but with Rx and other visits it is still helpful. At least I would know that there is a limit for the year.

Thanks so much!

[Anonymous]

Oops it excludes Rx but still...

[Anonymous]

Just a random question, OP, and please don't take offense, but are you a heavy exerciser or dieter? I ask because I was on the pills for years, and then when I got off, I didn't get my period regularly for about 2 years (the second of which we were TTC, with the same frustrations you have). I wasn't a super avid exerciser or dieter (although I used to be) but fairly regular, with a pretty low fat diet, which I thought was pretty healthy. But at a certain point I had an injury, stopped working out and even cooking much, which meant that DH, who lvoes butter, cheese pasta, was cooking.. in about 2 months I put on about 5 lbs and started getting my period on the dot (and now we're actually able to predict ovulation, though still TTC, 5 months so far--but I'm also 38). Coincidence? Maybe. but figure I'd put it out there (seems totally obvious, but my OB never considered it, since according to BMI, etc, I was not underweight).

[Anonymous]

OP here, no offense taken at all. I am 5'2" and about 118 pounds. So my BMI is in the middle of the healthy range. I try to run 3-4 miles, 3x a week but unfortunately I rarely meet that goal. Especially this last year+ since I've been off the Pill. I've run less than 100 miles all year and that has been my only exercise. Some weeks I get all 3 runs in but it's really rare. So, I'm guessing it's not exercise.

I do eat fairly healthy - lean proteins and lots of fruits and veggies. But I'm certainly not shy of dessert or 1-2 beers here and there. And I have red meat usually 1-2 times per week.

Finally, this has been the case since I was a teenager. Didn't get a normal period until 16.5 years old and it never came back. They put me on the Pill to "regulate" me (seems silly now). In the interim I went off the pill a few times in my 20s and every time I failed to get a period. The current experience is interesting b/c I am actually getting periods here and there!

But if treatment doesn't help, I am certainly willing to try a butter, pasta, and cheese diet.