Wednesday, May 11, 2011

Vasectomy Reversal Insurance Coverage

Before I tell everyone what happened with my insurance coverage for my vasectomy reversal, let me tell everyone how I'm feeling first. Last night was a decent night. I can't say I have any complaints about pain. I had various sensations yesterday, but no nerve pain and nothing so serious that it bothered me. I did notice that the sensations I did have on my right side, just below my abdomen, were constant. As a side note, I had 2 E.J.s yesterday. That makes 3 in 24 hours. That probably sets a personal record for me in the last 6 years. I'll be curious to see if that has any impact on my sensations or pain.

Also, I'm not taking the rapaflo anymore. I didn't wake up to pee last night, which is good. Hopefully, I'll feel okay without it, because I really didn't like the way it made me feel, in general. But, if I have to take it, then so be it. I'll keep you posted how I feel without it.

I'm trying to adopt the philosophy that the continuous pains I have are like when you work out too hard and have that lactic acid build up. So, if I can just trick myself into thinking that, then I think it helps me deal with it better. Now that I'm pretty much recovered from my weekend of sod, I'm going to try to get back on the treadmill. Nothing too strenuous, just get back in the habit of going to the gym and getting on the treadmill.

Okay, now about the insurance. Before I had my vasectomy reversal, I called the insurance to see if they'd cover the procedure based on medical necessity. After checking with them a total of 4 times before my reversal, I was given the clear impression that it would be covered based on medical necessity. One month after my reversal, they denied the claim. Many phone calls later I found out that the pre-reversal letter of eligibility and all the info the representatives told me was given to me in error. They told me there was nothing that could be done and I would have to appeal our employer to see if they'd cover the procedure.

I was somewhat confused, but mostly furious that they would tell me it was eligible beforehand, and then say it isn't eligible afterward. Well, for whatever reason, the insurance company called me yesterday and said they had changed their mind. They would, in fact, cover my reversal as if it were any other surgery allowed by the plan! All I can say is, "Thank you God!". We've been praying for this ever since we first discovered the claims were denied.

Interestingly, this change of mind came after our first appeal with the insurance company - after they told us there was nothing more they could do. But we really feel the Lord's hand was upon this situation. Before I had made my decision to have the reversal, I actually prayed that God would help us through the decision making process and guide us as we pursued a restorative solution to my vasectomy side effects. This is the first, maybe second, time we've really ever just turned something like this over to God, asking Him to help us. Usually, we just make decisions and hope for the best. Not surprisingly, that hasn't worked out very well for us.

We've gone from what amounted to a $50K medical bill to something much more manageable. Now don't ask me why things worked out so well in this area for us when it doesn't for others. But I really think God wants me to let the world know that He's there for them too. I think He just wants people to trust Him. I'm the first to tell anybody that I'm not sure how to do that sometimes. I don't have the answers, but I do feel compelled to write on this journal every day and let people know that Jesus is a huge part of my life. I couln't get through this PVPS thing without Him. Certainly, we wouldn't have been able to get through this insurance thing without Him. Even if they decided not to pay, my wife and I feel like it all would have worked out, some way. Maybe it would have just taken longer or maybe we would have been able to negotiate a lower bill. I don't know what that would have looked like, but the hope would still be there.

I guess this was a little preachy and I apologize for that. But I wanted to share what Jesus is doing in my life. How he's helping me get through this. How there is no other explanation for the insurance changing their minds, after our appeal and after they said there was nothing more they could do for us. It's just remarkable if you think about it. That is why I wanted to share it with whomever might read this journal entry.

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