The new insurance company denied the appeal for the P17 injections. After making several phone calls back and forth between the nurse's office, the insurance company and Makena, this is where everything stood:
- This insurance company denied coverage because the only pre-term birth that I had was not a singleton, and even though I had pre-term contractions that required hospital intervention, it's still considered a full-term birth, so I don't have a history of pre-term birth.
- Because insurance denied coverage I did not qualify for any co-pay assistance from Makena.
- If I wanted to move forward with the P17 injections I would need to pay out-of-pocket for the meds
- If I pay out of pocket through a "local" compounding pharmacy the cost will be $440 for the entire pregnancy. If I pay out of pocket for Makena it will cost $3000.
- Despite the fact that my doctor spoke several times about how P17 was the only drug FDA approved for compounding, he's not willing to write a prescription to a compounding pharmacy.
Two days later (18w1d, May 15) I had my cervical length check and I had the third u/s tech that works in the office. I casually mentioned something about getting to get a peek at the baby. Her response was a rough, "I don't do abdominal when it's a cervical check." I told her very sternly that even if I only saw the baby for 2 seconds I needed to see. I don't know if it was my tone or what, but after she did her measurements (3.9cm without compressions) she turned the monitor so that I could see Bean. I didn't get any pictures to take home, but I did get to see a heartbeat.
I'm still furious. I'm angry that the three u/s techs aren't consistent in their cervical u/s. I'm angry that the note I asked to be put in my chart for the u/s techs to make sure they show me that Bean is still alive isn't in there, so I have to deal with people telling me I can't see Bean. I'm angry that the nurse is a moron. I'm angry that my doctor seems to be a non-advocate for me. Jon said that we should give the doctor a chance to explain why he's changing his tune, that maybe the nurse isn't relaying all the accurate information or that the doctor doesn't know what a huge price difference there is between the compounded vs. non-compounded versions of the med.
We meet with the doctor tomorrow.