My Sterilization Experience: Part 2

FIRST APPOINTMENT — JULY 25, 2016 (Insurance co-pay: $25)
The road to sterilization began with a call to my primary care physician. I was super nervous about even saying those words out loud to another human being so I wrote up a script for myself before the call and used it when I spoke to the receptionist. Feel free to use this if it helps you!

I dialed my doctor’s office and got the receptionist. I said, “Hello, I’m a patient of Dr. [name] and I would love to chat with her about my current birth control method and inquire about switching to a permanent option.” She said okay, pulled up a calendar, and then booked me for an appointment for July 25th. Very straight forward!

On the day of my appointment, I sat and had a casual chat with my doc. I described the intense migraines with aura I’ve been experiencing, as well as the depressive mood swings I’ve been having while on Sprintec. I told her that after twenty years of hormones, I’m tired of all the side effects. I’m also done with all the anxiety of missing a pill or wondering about a late period. I told her I'd love to live without the constant fear of an unplanned pregnancy. I explain that I'm happily and thoroughly childfree and have an equally happy, childfree partner who I love dearly. I ask about sterilization.

My doctor, being the awesome lady she is, listened carefully and then went over all the different options for sterilization. She mentioned the non-hormonal IUD implant Paraguard, but we both agreed that it could create a whole new set of side effects and at this stage of my life, was more of a hassle than a help. So we settled on tubal ligation as the best solution for sterilization with the least amount of risk and side effects.

I know that I was very fortunate in that I received no push back or hesitation from my doctor. I assume this was very likely due to my age (36) but she is generally fantastic when it comes to listening, understanding, and addressing my needs. She gave me a referral to an OBGYN surgeon in my network that she highly recommended. I had to call them next and have this same conversation. On the way out, I get my printed referral sheet and pay a $25 co-pay for the office visit.

OBGYN SURGEON CONSULTATION — SEPTEMBER 1, 2016 (Insurance co-pay: $25)
I called the number from the referral letter. I said “Hello, I’ve been referred by my primary care physician to chat with the OBGYN about having a tubal ligation. I’d love to set up an appointment if you have availability.” They were very nice over the phone and gave me a few dates of availability, based on my schedule. I set an appointment for September 1st.

On the day of the appointment, I met the OBGYN doc. He was all smiles and super friendly, I warmed up to him instantly. We sat and chatted about my birth control history. He asked me why I was seeking sterilization specifically. I repeated all the things I’d told my PCP. I detailed my exhaustion from the horrible side effects, the anxiety about unplanned pregnancies, and my desire for relief from both. I then explained that I was happily childfree and had been for my entire life. I described my wonderful boyfriend who was also enthusiastically childfree. I mentioned how my brother is planning for a family and how I will enjoy being an aunt in that capacity, but I’m just not personally interested in becoming a parent myself.

He smiled, nodded, and said, "Okay!" Then we talked about sterilization methods (Essure, clips, cutting, burning, etc.) He included Paraguard as a semi-permanent method just to be all-inclusive but never pressured me about opting for it (which was appreciated). After explaining the different methods, he said he personally prefers to perform a bilateral salpingectomy (removal of the fallopian tubes) instead of a tubal ligation (blocking or severing the tubes) because it eradicates the risk of tubal regrowth (recanalization) and also lowers ovarian cancer risk by 30%. I said that sounded awesome.

He outlined the procedure and the risks. Then he gave me a consent form to sign for the surgery. After signing the paperwork, we looked at the calendar and set a date for the procedure. His calendar was open anytime after the 15th, so I consulted my work schedule and called my mom to consult hers (since she’d be coming up to play caretaker for my recovery). We settled on October 7th, a Friday about five weeks out where both our jobs could accommodate a few days off.

After being approved and setting a date, I was sent over to the lab to give blood sample so they could run a panel prior to the procedure. I assume this is to check for any weird infections and to make sure I’m healthy enough for surgery. I obliged and was out the door twenty minutes later with a band-aid in my elbow crook and a $25 co-pay for the office visit.

INSURANCE???
I asked my surgeon, his receptionist, and the billing/accounts lady about what's covered. Their response was, “I don’t know.” No one there really had any idea about costs. They recommended that I contact my insurance company directly. I called the insurance company and they also said, “I don’t know.” No one knows anything! They said they technically won't know anything until the procedure is billed and processed through their system. Meaning, after I’ve actually had the procedure done. I’m a big fan of “buy now, pay later”, but only when I know how much I’m paying. I don’t like to deal with ambiguity, especially with potentially five-figure health bills.

So my next route was to look over the insurance website, under my specific plan. It listed "voluntary sterilization for permanent birth control" as being covered (thanks to the Affordable Care Act) and having a $250 copay under my particular plan. There was no more information. No breakdown for various methods. No mention of additional hospital / anesthesia fees. Nothing, because the American health care system is a steaming pile of shit. But it is what it is, and I have to deal with it if I want anything done. So I decide my health, my peace of mind, and potential threat to my reproductive health options post-presidential-election is worth the roll of the insurance dice. I have some emergency savings. I will use them if necessary.

Next on agenda: A Pre-Op Consultation!

© Photo credit: I Heart Guts Plush Toys.