Health care portability

I'm lucky to have always had good employer-sponsored health insurance, so I don't (yet) need a public option. But one of the big lessons of infertility for me has been the value of insurance choice and portability. Massachusetts requires insurance coverage of infertility, one of the things that has made universal health care in MA so expensive. So our two cycles of meds, two inseminations, and a multitude of doctor visits and tests cost us only my co-pay (and those ultrasounds in the basement didn't cost anything). Actual cost: at least $3200. Our cost: less than $100, plus my regular insurance premiums. Insurance: priceless.

My current employer, like most, does not cover infertility treatment. No problem, I thought, I'll just take advantage of COBRA and maintain my Massachusetts insurance. Even at $500/mo, it's cheaper than paying out of pocket. But then I realized that my Massachusetts insurance was only good in Massachusetts, and I couldn't exactly spend two weeks a month living at the Brigham. Panic set in, until I realized that old employer had an out-of-state insurance plan for it's out-of-state employees. And, thank goodness, moving out of state is a "qualifying event" that lets you switch insurance plans, even if you're no longer employed. Under COBRA, you're still entitled to take advantage of a qualifying event. So I am continuing to shell out $500/mo for Massachusetts-level coverage.

So far, it's probably been a wash: one complete cycle and one canceled cycle here in OK have probably not cost more than $2000, and I've now paid $2000 in COBRA premiums (though I've also used that insurance for other medical care, so I'm still a bit ahead). But if I maintain COBRA for the full 18 months, it will cost $9000, significantly less than IVF would cost if our next Clomid cycle doesn't work. And we should have time for two IVF cycles in 2010.

Regardless, I feel so lucky to have been able to bring my insurance with me. I'll gladly pay the additional premium for the infertility coverage. But in OK I don't have that choice. I should have been able to bring my insurance with me no matter what. And my medical records should have followed me, but they didn't. My current insurance carrier tried to deny my first OK IUI because it didn't have my records from Boston, even though I'd requested them from the B&W six weeks earlier. I think we've worked it out, but it shouldn't have been that hard.