Saturday, September 12, 2009

Another wrinkle

I think the interview for Dream Job went fairly well. I actually ran into a former coworker of mine there who was also interviewing--we seem to go for the same jobs all the time. I'd be genuinely happy for her if she got it, so I'm rooting for at least one of us to make it.

They claim they will make a decision soon. Unfortunately, I'm guessing they won't make a decision by the 23rd, which is when I'm due to start Lupron. See, I was thinking that if I had already been pregnant when offered a new job (if the IUI had worked), I'd just tell them and roll with it, trying to negotiate a decent maternity leave as part of my package. On the other hand, if I hadn't started IVF yet, I'd wait 2-3 months to give myself time to get settled into a new job before diving into ART--also because it doesn't seem quite right to start trying to get pregnant immediately after starting a new position.

But with the possibility of getting a job offer while in the early stages of a cycle, I'm in an ethical and practical tangle. What makes sense? Do I delay starting (easy to do now, since I can just take the pill for an extra week or two) and wait to see what happens? Do I put it off entirely? Do I just go for it and damn the consequences? And what does one do if one is offered a job, say, a few days before retrieval, or while in the middle of stims?

There's a new wrinkle in all of this, too. (Apologies in advance for the eye-glazing tedium of all these insurance details.) Yesterday I got a letter from my former employer, through whom I still have our health insurance (and am eligible to continue through May). To cut costs, at the end of this year they are canceling the HMO plan we're currently on and switching everyone to a PPO plan. From what I remember from when I was selecting health insurance back when I was hired, this plan has NO infertility coverage. It also covers 85% of maternity expenses after an initial copay. That's compared to my current plan, where I pay $25 for the initial OB visit, $250 for the hospital stay, and that's it.

Considering that my first pregnancy involved at least 25 office visits with ultrasound, 3 hospital ultrasounds, one emergency L&D visit, and a c-section with 4-night hospital stay, with the hospital bill alone coming to more than $20,000, I'm thinking that 15% of my maternity expenses could add up to quite a large chunk of money.

I can find other plans open to the self-employed with better maternity coverage, and they'll be comparable in cost to the $1400/month or so that I'll have to pay for COBRA (my continued insurance from my former employer) once the government subsidies run out in November. So if I get pregnant, clearly we'll be switching. And probably even if I don't get pregnant.

But none of the plans available to us have infertility coverage--I remember this from the last time I was self-employed and TTC, and it's why I got a full-time job in the first place. And even if I get Dream Job, it's a very small company (like, less than 25 employees) so I would bet money that their health insurance doesn't cover infertility either. Without insurance coverage, we might be able to afford an injectible IUI or two (I'm guessing with meds, they'd run around $4000 each, given how closely I was monitored last cycle), or maybe an FET, but we couldn't possibly pay for a full fresh cycle without dipping into our retirement accounts.

In essence, if we want to do IVF and have it covered by insurance, we have to do it now. That would get me through beta by November 1, and maybe we'd have time to do an FET before the end of the year if needed.

So from a financial standpoint, it makes sense not to delay. This is also mixed up with all sorts of weird emotions, like what I felt (fear, excitement, nausea, panic) when we got the 35-page IVF prep handbook from the clinic and the pages and pages of consent forms, or what I felt (anger, frustration, jealousy) this morning at the farmer's market running into two moms with children more than a year younger than Bat Girl whom I hadn't seen in a while and who are now quite obviously pregnant.

I don't know. We're going to go to the class next week, and I'm going to get all the meds (which I hope will keep in the fridge). Hopefully by the time I'm supposed to start Lupron I will have some clarity on this.

What was that about health care reform???



Blogger May said...

I'd just do the cycle now. There's never a perfect time. And if you are offered the job, you were in the IVF trenches before it came up, so I think your conscience should be clear. You never know if it'll work, after all. Better to keep things moving.

2:55 PM  
Blogger MoMo said...

I say go for it. The insurance coverage is huge and as May mentioned there is never a perfect time.

9:25 PM  
Blogger Thalia said...

agree with may. go for it, there is never a perfect time.

4:41 PM  
Blogger PiquantMolly said...

UGGGHHH, the cost of infertility always makes me want to die.

Go for it. Do what you need to do. I hate to say "you aren't getting any younger," but . . .

(god, I sound like a grandma)

11:43 AM  
Blogger caramama said...

Go for it! Besides the insurance issue, I don't think you should put your personal life on hold even for the Dream Job! And I really hope you get the job!

1:00 PM  

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