The Evil HMO


My HMO (i’ll call them hotdog) is known for not covering necessary procedures.  They recently got sued because they have been providing terrible mental health services for a long time.  A few years ago, my ex husband and I had to threaten a lawsuit and go through a grievance process to force them to pay for his therapy after he was hospitalized. Good times.

I had to choose a new OB in my area because I’ve only been seeing reproductive endocronologists since I moved back up here.  I figured I would have a much better shot getting this covered if the referral came from an OB and not someone in the infertility department.  The doctor was pretty clear that the removal is necessary foe me and my future (fingers crossed) baby to have  healthy pregnancy.  It is not related to getting me pregnant, so it should be covered under my plan.  But given my past experience I don’t trust them a bit.

The OB was nice enough.  She said that doctors are split on whether fibroids really need to be removed.  She suggested I get a second opinion and implied that Dr. Cowboy might be trying to make more money by insisting I need surgery.  I told her that my doctor doesn’t even do those types of surgeries and that he was writing a letter to them to ask that they do it.

I left very confused and frustrated.  I just want someone to tell me what to do.  Based on my conversation with this OB I think getting this surgery is going to be a fight.

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