[Bug_Lady]

I am so fed up. I started my period at 11. Massively irregular - which was to be expected with starting so early. Parents SEEMED supportive of birth control....that is until I asked for it. Ended up going by myself to an OBGYN to get it on my own since they wouldn't. Ever since then it has been a roller coaster. I have been on and off bc because it just tears me up. From 17-20 I had terrible pains every month. Went to the OBGYN again and had an ultrasound where they told me I had a growth. Had a hysterosonogram (some of the worst pain of my life) at which they told me I had over a dozen cysts on each ovary and a polyp in my uterus. Changed bc. Got worse. Changed it again - this has been okay. Still have extreme pains before, during and after my period. Still have random bleeding throughout the month.

My old ob tried to have me do an IUD bc all of my symptoms point to high estrogen levels. Which has also been shown to be a risk for breast cancer - which multiple aunts on both sides of my family as well as both grandmas have had. They're all survivors but one of my aunts was diagnosed before age 40 so I'm considered very high risk.

With all of this - an IUD would seem like a medical necessity. Cut out my estrogen intake from bc, up my progesterone, cut out my additional risk of breast cancer, cut down on periods and cramps....SEEMS LIKE A NO BRAINER.

No to my insurance company! But guess what....my graduate stipend (which I struggle paying bills paycheck to paycheck) is STILL too much money for me to qualify for medicaid to be covered by the state.

I don't understand why my extreme pain, irregular periods, PMS, weight gain etc....is not considered a medical necessity. I guess I have to be just completely immobilized for them to give a **** about me. wtf. Not even trying to get into politics but our healthcare system is SO MESSED UP!!!!!

[lizzardb63]

Did you ever try Planned Parenthood? You can get birth control (maybe even the IUD) for little to no cost there, especially if you have a limited income. I'd definately check it out. Otherwise...is there anyone who could borrow you the money? A friend? A relative? It sucks you have to deal with this month after month. I know you said that you are living pay check to pay check, but if you go on the Mirena website, they do have payment plans... maybe you can work something out with the company.

[Bug_Lady]

I called Planned Parenthood and I qualify for the highest discount which is 75% but still leaves $400 out of pocket. My mom is retired and on a fixed income so I can't really ask her. My sister is in the middle of a divorce as well as being treated for cervical cancer so she (would like to) but can't help. My dad is in the same boat as me working construction so his business has been slowing down with the economy.

I have called and made an appt with my ob and will try to talk to her more. I am just going to keep on her. I can't stand this pain anymore. I have to find something else...

[Little]

I suggest trying to search the internet for an "excuse" to give your insurance company as to why you need an IUD. I bet somebody else out there has had this issue and figured a way through it; you just have to hope they've blogged about it. You might start with "how do I get [company name] to pay for IUD" It's not really about what your OB says ... it's about what convoluted combo of situations your insurance company will deign to accept.
A note - even with insurance coverage, that IUD is not going to be free. I got an estimate on one, and it was still going to be in the area of $100 with decent insurance. Save your pennies. It is very, very frustrating and my heart goes out to you.
Edit: You can also ask your OB's insurance department to total up having you pick up the IUD at the pharmacy as a prescription and bringing it to them for insertion. That was the way my doctor's office estimated it for me, and they said it was much cheaper than the alternative.

[lizzardb63]

Wow, $400 seems steep! $1600 for the Mirena is extremely expensive. I've known it to be between $500-$1000. That's a bummer. Yeah I would definately do what Little said. Research and try to find anything to help.

[Bug_Lady]

The only problem is they will not accept anything unless it comes from my ob. It would have to be something observable by a doc. It was recommended by my last ob but that was a few years ago. We switched ins co at the beginning of the year so I thought maybe they would work with me but not so far.

I would almost see my extra risk of breast cancer as a medical necessity. It is no secret that additional estrogen increases your chances of BC and I already have such a large family history of it that it seems simple enough. Pay for less estrogen now to not pay for cancer treatment at 40?

Most of my symptoms are consistent with high estrogen levels so I think the hormonal kind that releases progestin would be better than the copper kind but the copper kind is less expensive.

I will def google it. Thanks for that idea. I hadn't thought about that yet. There might be something from someone else that I do have but hadn't realized as a "symptom". I will check it out and see what I find...

[Little]

Oh, I had assumed that your OB was willing to work with you to get it covered. Often they have to use the right wording, file the right way to get things paid for or get it covered at a greater percentage.

The IUD I got the estimate on was the progestin version (I think Mirena.) I couldn't take any estrogen-based BC because it affects milk supply. Definitely check out the idea of having it sent to the pharmacy, I think the insurance department suggested that to me because my prescription copay was much lower than the percentage charge I would have paid for the doctor's office to order it directly. It's all about your OB (and any applicable office personnel) though - if s/he/they don't want to be helpful in getting things paid for by the insurance, you are going to have a really hard time. I find doctors who work at a group practice and have specific personnel who deal only with insurance do the best job at this.

[Bug_Lady]

After searching, it looks like most women who get it covered for medical necessity have issues with abnormal bleeding which I definitely have. Another I found was due to a nodule on her uterus. I haven't had a hysterosonogram for a long time but the last time I did I had at least 1 polyp in my uterine lining and I typically bleed for 2-3 days outside my period - while being on BC. If I'm not on BC I will go 2-3 months without having a period and then bleed for a month straight.

Talked to my mom yesterday and apparently my mom had to take my sister to the hospital a couple times when she was a teenager (she is 11 years older than me) due to ovarian cysts. My mom has also had issues with it but she said it pretty much went away after she had kids. I don't plan on having kids for another 5-10 years and I definitely do NOT want to deal with this random bleeding and cramps until then.

This is a group practice that is associated with a hospital. It's the women's health clinic of the regional hospital. I called to see if my old medical records had been faxed over to make sure I don't go to the appt with no info but haven't heard back.

[Bug_Lady]

I just left the OBGYN. I told her about my consistent issues with cramps/bleeding/cysts and what not and she said that the receptionist will call my insurance within the next couple days and say that my doc recommends I have an IUD bc I've been on several different pills and nothing is relieving my pain or bleeding. That doesn't guarantee insurance will pay for it but we're on to the next step....they said I should find out by the end of the week whether it will be covered or not.

Wish me luck!!

[Bug_Lady]

So I was turned down yet again by my insurance. Then I called the school and apparently, due to Obamacare, all birth control - except surgical sterilization - is covered by university insurance - including Mirena. And, since I am on an assistantship, my healthcare is discounted 60%. This takes my costs down to about $45/month and my IUD will be covered. So, not to start a political debate, but I'm so happy this was upheld the other day. It's the only way I have access to the IUD. I'm so glad I can finally get this. Thanks for the support, ladies