RhoGAMboling: It's the Principal* of the Matter

*It's a pun on the name of my insurance underwriter, not a grammatical error :p

So. Today I am 28 weeks pregnant, and as I am part of the lucky 15% of women with an Rh- blood type, I require an injection of a nifty drug called RhoGAM. The shot is administered to every Rh- woman at 28 weeks, so this should not be a shocking occurrence to insurance companies. My doctor's office does not stock RhoGAM. She'll order it if insurance requires that she supply it; otherwise she writes a prescription and it's BYOR.

4 weeks ago I called my prescription drug coverage number; they do NOT cover RhoGAM. I called the medical coverage number; they said they would cover RhoGAM if the dr. ordered it. I called my ob's office and told the receptionist she'd need to order it for me. She did.

On Monday, 2 days before my appointment, I received a call from my insurance company. Oops, sorry, they don't cover RhoGAM after all. Not prescription drug, not medical, nada. They can give me a "cash discount" at $113 and send it directly to my ob's office. I can try to submit the claim for reimbursement later. But I need to pony up my Visa number on the phone, and they will order it the next day (Tuesday) and have it overnighted in hopes it arrives in time for my 10:15 a.m. Wednesday appointment. Yes, these people knew I needed the RhoGAM for 4 WEEKS and lagged. Why am I not surprised?

Today is Wednesday. And-- everyone get ready now-- the RhoGAM was a no-show. The receptionist at the ob's office got on the phone to my insurance company . . . it's en route now but will not arrive at my ob's office until tomorrow. I have already been charged (Visa.)

Did I mention that RhoGAM must be administered within 3 days of a blood sensitivity screening? Yeah, mine was done on Monday, as part of the blood drawn during my glucose test (see previous blog entry. Enjoy!) That means I must have the injection done no later than tomorrow.

And . . . did I mention that legally, an obstetrician must be present in the office during the administration of the shot?

My ob, however, is scheduled to perform C-sections at the hospital tomorrow. So, we've got three options:

(a) RhoGAM arrives at ob's office tomorrow. Doctor has time in between surgical deliveries to meet me at her office (located next door to the hospital) where she will have just enough time to pee while her medical assistant jabs a needle in my @$$ and sends me on my merry way.

(b) RhoGAM arrives at ob's office tomorrow. Doctor is unable to get away from the hospital, so I will courier the RhoGAM from her office to the hospital next door, where I will go up to L&D and arrange for one of the nurses to give me the shot there. Note: doc has no idea if the hospital will permit this, so if not, we're onto . . .

(c) RhoGAM arrives at ob's office tomorrow. Doctor is unable to get away from the hospital, and hospital will not permit me to receive my shot on their L&D floor. I will, therefore, drive to my ob's office, pick up the RhoGAM, and drive 25 miles to a third-party location: the office wherein my ob's partner practices two days a week and will be working tomorrow. (Coincidentally, this office is also home to my daughter's pediatrician, so at least I know where the hell I would be going.) That office would administer the injection.

So tomorrow is Field Trip Day . . . so I can put anywhere from 40-55 miles on my car, $113 out of my pocket, for a drug that is required, standard treatment for 15% of the pregnant population because my insurance company 1. claims they will not cover the drug and 2. failed to ship it in a timely manner. While 6 months pregnant, arthritic, and asthmatic, juggling a toddler who's got a runny nose and is exceedingly cranky.

Whee!