<p><strong><em>Creative solutions to make your dreams a reality</em></strong></p><p>When I set out to get pregnant as <a href="https://esme.com/voices/perspectives/whats-a-solo-mom" target="_blank" class="wordlink">Solo Mom</a>, I quickly realized that my fertility treatments would not be covered by health insurance. I also realized I would need lots of doctor’s offices, vials of frozen <a href="https://esme.com/resources/c/assisted-reproductive-technology" target="_blank" class="wordlink">sperm</a>, and shots of hormones and other drugs. And, in my case, it eventually involved using an egg donor. Initially I was put off by the exorbitant costs. But I did not give up. Instead I got creative!</p><p>So what can you do when coverage for fertility treatments runs out or does not exist? Don’t despair. There are a number of options to help you realize your dream. You just need to be flexible and tenacious. </p><p><strong>Get creative—do your homework</strong></p><p>First of all, take a look at the fine print of your health insurance policy. Sometimes physician fees are covered but technical procedures are not, or vice versa. Many times infertility testing is covered if it is related to an underlying medical condition. For example, you may be able to get coverage for a sonogram to assess your endometrial lining or time an insemination if your doctor codes the tests as treatment for an irregular menstrual cycle. </p><p>You may also be able to appeal a denial by your insurance company. To do so, you and your doctor will need to write a letter, explaining why the treatment is medically necessary and not experimental. </p><p>If you do have to pay out of pocket, you should be able to deduct these expenses on your tax return. Or you may be able to use pre-tax dollars to pay for treatment through a medical spending plan, thereby reducing your out-of-pocket costs. </p><p><strong>Financing and refund programs at IVF clinics </strong></p><p>Many fertility clinics offer various plans to help offset the cost of fertility treatments, such as special financing loans or share of cost programs that provide multiple cycles at a reduced rate. For a set payment, you receive a number of prepaid ART cycles (usually three). The cost is usually more than a one cycle but less than three cycles. So if you get pregnant on the first try, you’ve overpaid, but if it takes three tries, you come out ahead. It’s basically a roll of the dice. Some programs offer a refund of 70-100% of your prepaid fee if the treatment does not result in a <a href="https://esme.com/resources/c/pregnancy" target="_blank" class="wordlink">pregnancy</a>. </p><p>In most cases, to qualify, IVF has to be medically indicated, and you may be required to transfer all embryos retrieved from the initial cycle before starting a new stimulation cycle. With all such programs, make sure you understand the fine print. Familiarize yourself with the programs at several different clinics, as they can vary greatly. </p><p><strong>Vacation IVF</strong></p><p>Finally, if you are more of an adventurous spirit, you may consider going abroad for fertility treatment. Many countries offer fertility services at a fraction of the cost in the U.S. I traveled to Mexico to use an egg donor for about a quarter of the price of a U.S.-based clinic. I had a lovely beach vacation and got pregnant on the first try.</p><p>Many who pursue fertility treatments abroad find that being in a foreign country, forced to take a break from their busy day to day life provides a helpful ingredient, relaxation, that boosts their chances of getting pregnant. The list of countries with IVF clinics is long, so it is possible to combine a vacation with a visit to many different countries. </p><p>Remember there are downsides to going abroad. The drastic reduction in price may mean that the success rates will not be commensurate with the premier clinics in the U.S. The clinics also differ culturally from the U.S, often having slower response times and offering fewer details and hand-holding. I, as a former attorney, was shocked at the simplicity of the contract for services provided to me. Many times, I had to tell myself to relax and trust the process because it did not comport with my U.S. sensibilities. (<a href="http://choicemamababyproject.com/blog-2/archives/11-2013.html" target="_blank">You can read a detailed account of my experiences here</a>.) </p><p>Many foreign clinics realize that most patients are using precious vacation days to pursue treatment. Thus, they minimize the number of days required to be abroad by having their patients complete much of the preparatory treatment in the U.S. In my case, I only needed to be in Mexico for about 7-10 days, though I stayed longer just to lay on the beach a few more days. My OB/GYN was willing to prescribe necessary medications and order initial tests. But if you do not have the support of a U.S.-based doctor, it can be tricky to obtain medications. You may need a prescription from the foreign doctor and to order the prescriptions by from a UK or Canadian pharmacy, which often has the added benefit of being cheaper than buying the drugs in the U.S. </p><p>Make sure you do your research and know what to expect. Find other women who have travelled to the same clinic and can vouch for the services. You can find discussions on chat rooms and get referrals from past patients. There are people who act as liaisons and can provide additional information about various clinics. They can also help make your experience more enjoyable and smooth by translating, recommending hotels, providing trusted taxi cab drivers, and more. </p><p>Not everyone is well suited to going abroad. So make sure to ask yourself some questions to decide whether you are a good candidate. Most importantly, do you like to travel? Do you feel safe in a foreign country? Do you generally trust people and enjoy different cultural experiences? Can you suspend your expectations of our health system and embrace another approach? </p><p><strong>Good practice</strong></p><p>The road to pregnancy can be challenging and very expensive when you don’t have insurance coverage. But with some determination and creativity, you may uncover some surprising solutions. And that will be good practice for solo motherhood!</p><hr><p><span style="font-size: 11px;">Image via Shutterstock.com</span></p>
<p><strong><i><span style="font-size: 20px;">A look back at the day my ill-fated marriage became the law of the land</span></i></strong><strong><em></em></strong></p><p><strong>The good news</strong></p><p>I was sitting on my back porch wrapped in a hoodie to ward off the early morning chill. A freelance writer and solo parent, this summer I’ve been avoiding child-care costs by waking up at 5:45 a.m. and cranking out a few uninterrupted hours’ work before my kids need me. </p><p>But on the morning of June 26, I was interrupted. At 7:17 a.m. my phone pinged. I ignored it. Then it pinged again. And again. A rush of anticipation charged through me: <em>SCOTUS</em>. </p><p>I grabbed my phone, read the string of messages: </p><p>“SCOTUS rules marriage bans unconstitutional!”</p><p>“Marriage Equality for All!”</p><p>“Happy day!”</p><p>“OMG! Just heard the Supreme Court decision!”</p><p>“Yes!!!”</p><p>Sitting on my back porch, phone in hand, tears welling in my eyes, I experienced—physically—the sensation of my body pushing against a brick wall, and finally, brick by brick, feeling the wall crack, crumble, give way.</p><p>All. Fifty. States.</p><p><strong>My activist family</strong></p><p>For ten of the past eleven years, my family stood on the front lines of the marriage equality movement. Starting with my marriage to Tracie—with our firstborn attending in my belly—at San Francisco City Hall, during the Winter of Love 2004; through the ups and downs of California’s Proposition 8 campaign; to the celebration of our legal marriage, with our two children as witnesses, in 2008; to this final SCOTUS decision—we have marched, campaigned, donated, and spoken with media, domestic and international, radio, film, and print. </p><p>And now marriage equality is the law of the land. </p><p>And Tracie and I are starting <a href="https://esme.com/resources/c/divorce" target="_blank" class="wordlink">divorce</a> proceedings.</p><p><strong>In the shadows</strong></p><p>The need for legal relationship recognition among same-sex couples first came to national attention during the height of the AIDS crisis in the 1980s to mid-1990s. Lifelong partners not only were losing their beloveds to a terrifying epidemic, they were barred from hospital rooms and treatment decisions by unsympathetic medical staff; they were banned from memorial services by homophobic family members; they were losing their shared homes and belongings because no laws protected their rights to community property, to pensions, to death benefits for grieving spouses. </p><p>These end-of-life protections held center stage in the SCOTUS decisions both to dismantle the Defense of Marriage Act in 2013 and to affirm marriage as a civil right this past June. SCOTUS has made it clear that all loving couples deserve access to the dignity and the legal protections of civil marriage, in life and after death. </p><p>But standing in the shadows next to happy couples celebrating their love and marriage benefits is something no one wants to talk about: in establishing a legal foundation for marriages that last, the marriage equality movement also has laid a safe, clear, and legal path for those people, like Tracie and me, who have decided to divorce.</p><p><strong>The “failure” stage</strong></p><p>As a media point person in the marriage equality movement, in the aftermath of major losses and wins, I got used to answering reporters’ most common question, “How do you feel?” </p><p>Today’s answer: It’s complicated.</p><p>When Tracie and I first decided to separate a year ago, I felt an acute sense of failure. This is a common stage in the divorce process. The “till death do us part” societal expectation, along with the individual hopes and dreams newlyweds carry into marriage—they can lead people to experience divorce as a deep, personal failure. A few months after Tracie and I separated, that feeling of failure faded to the background, but the SCOTUS announcement brought it back, front and center.</p><p>For some gay and lesbian couples, this failure stage is compounded by social circumstances. Whether we have chosen to participate in the LGBT rights movement in a public way or not, everywhere gay and lesbian families go, we become, de facto, representatives of all same-sex parents. At the taqueria, at the beach, at the public library, Tracie, our boys, and I were never just “the Dumesnil-Vickers family,” we were an in-person example of those gay families people were talking about on the news. </p><p>I didn’t mind that, really. If the presence of our family at the local park somehow contributed to a larger positive narrative about gay families, so be it. But now that Tracie and I are moving toward divorce, I feel not only as though I have failed to realize my own hopes for my marriage and family, but also that I’ve failed to uphold the “happy, healthy lesbian family” image that has helped open the hearts and minds of the American public to LGBT people.</p><p>Of course, I would never consider someone else a failure for choosing divorce; I do that only to myself. This sense of failure is nothing more than an ego-driven form of self-criticism. Intellectually, I understand that. I also understand that the mind’s logic does not heal the heart’s pain. So the best thing I can do right now is to acknowledge my emotional truth: at this moment in time, in the face of arguably the biggest win yet for gay rights, I feel like a failure. And that hurts.</p><p>Clearly, I still have some healing to do.</p><p><strong>Marriage equality benefits all of us</strong></p><p>In the weeks following the SCOTUS decision, I’ve noticed a distinct difference between the political wins of my married past—wins that were simultaneously “for our family” and “for all loving couples”—and this final marriage equality win. According to my pouting, petulant inner child, today’s win is for “loving couples who are still together,” who still have hope for “happily ever after.” </p><p>But the SCOTUS ruling is not just for same-sex couples who are still together. The impact of the decision extends far beyond the lives of the couples now queuing up for marriage licenses around the country. The marriage equality movement has created a significant, positive shift in public attitudes toward the LGBT community. The momentum from this win will fuel ongoing fights for federal nondiscrimination legislation, for transgender rights, for safe schools, and ultimately for full, lived equality for all LGBT people, including the divorced and solo parents among us.</p><p>As I see it, the power of the win extends even beyond the LGBT community. The success of the marriage equality movement has shown my children’s generation, unequivocally, that hard work, resilience, and an unrelenting belief in fairness really do lead to dramatic and lasting social change. How better to empower young people to continue bending the long arc of history toward justice? How better to empower our children to persist in the face of challenges?</p><p><strong>Reason to celebrate</strong></p><p>A couple years ago, when marriage equality states started springing up across the country, I printed out two blank United States maps and gave them to my boys. Together we marked all the marriage equality states: nine, at the time. Then we started a tradition: when a new state welcomed marriage equality, we would fill in that blank on the map and celebrate with ice cream. </p><p>This morning, when the boys woke up, I told them about the SCOTUS decision by handing them my phone, this image emblazoned on the screen: </p><p><img src="/assets/img/cms/redactor/jaDumm6z4m8XwYuX.jpg" alt="" style="display: block; margin: auto;"></p><p>“Really?” they asked. “<em>All</em> the states?”<br></p><p>I smiled and nodded. “<em>You </em>helped do this, you know. <em>You</em> helped make this happen.”</p><p>The looks on their faces—the wonder, the pride—those are reason enough to celebrate this win.<br></p><hr><p><span style="font-size: 11px;">Map image: </span><a href="http://www.lgbtmap.org/" target="_blank"><span style="font-size: 11px;">LGBTQMap.org</span></a></p>