Journey to start a family turns frustrating for lesbian couple
“It's crushing. I couldn't believe it. I think I stood there stunned,” said a woman who we’ll call Carol.
Together for 15 years, legally joined in a civil union in August 2012, Carol and her partner were successful, in love, and ready to start a family.
“This is something that we thought really hard about,” she said.
They decided to try in vitro fertilization.
Her partner would carry her eggs after doctors removed a large tumor from Carol's uterus.
“Let me check my medical coverage. Great I'm covered,” she recalled doing.
In her hand was the HMSA policy saying their civil union, made legal in Hawaii in 2012, meant they qualified for insurance.
“It's right there in black and white for everyone to read,” said Carol.
But when their doctor submitted the claim she said it was denied twice.
“Without in vitro, some of these couples would not be able to have a child,” said Dr. John Frattarelli who started the Fertility Institute of Hawaii two years ago.
He said he's helped several same sex couples, and despite Hawaii's friendlier laws, he finds the insurance game to be a sticky one.
“There are challenges with every case,” he said.
“I had never seen my doctor get so angry,” said Carol, shaking her head.
She said despite what appeared to be proof on paper, an HMSA representative said their claim was still denied, adding other problems with their claim, such as Carol being employed by the federal government and because, the representative said, her partner, having to carry Carol's eggs, would be considered a "surrogate."
“She can't be a surrogate if that's my partner,” she said.
“(The representative) said, 'you know what, denied. And we're going to change the wording on it,'” said Carol.
It was a final response to a frustrating experience, casting a shadow on their family dream.
“If they're not going to cover it, don't put it in the book,” she said.
HMSA sent KITV4 a response Tuesday afternoon saying while state law does provide coverage for in vitro fertilization for many civil union couples those enrolled in the Federal Employee Health Benefit plan are not covered.
They say members can file an appeal if they feel their claim was unfairly denied.
Dr. Frattarelli said, despite the legal challenges, he commends HMSA for being the only Hawaii insurance company to cover IVF for civil unions.
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