Adoption Resources

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Oct 17, 2005



Susan - I read your post to the writer of that blog - you are 100% right in all you are saying. I read that article too (at my RE's office believe it or not). On another note, I wish you the best. I am starting IVF this cycle and at the same time, I have started the adoption process (even though they frown on it). Both are hard. I just want a family. Good Luck in making your decision.


AD HOMINEMS: appealing to people's emotions and prejudices instead of their ability to think.

That must have been the phrase of the day in the Health Business Blog, even if it wasn't true as you presented the side that the majority of people fortunately never experience in factual and a succinct manner. Bravo (aka poop-in-a-group).

Thanks for so eloquently standing up for the cause. And by the way, the comparison comment on the implants was my grin for the day.

David E. Williams of the Health business blog


Thanks for your comments on the Health business blog post. I hope it was clear that I'm not attacking IVF, bur rather advocating insurance coverage for fertility treatment and trying to make the broader point that the availability of more information and consumer choice in health care --what the consumer directed health care movement is all about-- is not a panacea for cost or quality.

The comments about adoption, breast enhancement and so forth are not mine.

I wish you the best.

David Williams

B. Mare

I don't think you were incomprehensible at all. In particular I thought your knee injury analogy was good.

It chaps my ass too when people try to argue on the basis of "medical necessity". As if that can be so closely circumscribed in every case, and as if insurance should only cover life-threatening illnesses- because really, unless it's going to kill you, is anything a "medical necessity"? That's such a black and white way to look at life, and in my view, not a very realistic one.


I didn't go to the linked sites (where the debate is taking place), but I think you have done a tremendous job here in this post. I was wondering if I could have your permission to reproduce some of this work you have done to send to my Representatives? I've been fighting this battle (with Congress) for nearly 2 years now.


Great position paper.



You sold me and I'd only like to add to the 'vanity issues' section of the argument.
In cases of endometriosis, pregnancy is looked at as the best chance for a cure and in my case (not unique) IVF is likely the only way to obtain that cure. Without a pregnancy, my endo will continue to grow unchecked by the normol hormonal cycle of a pregnancy leading to ongoing debilitating pain, more complex laproscopic procedures performed by only a handful of surgeons in the U.S., billed at even higher amounts than the $18,500 for the first one. I could develop incontinance, up my way through more and more potent narcotics and potentially face the loss of not only my tubes, ovaries and uterus but a kidney or two. Vanity. Just a folly of mine.


Rock fucking on, Susan!!!!!!!!!!!

Lut C.

This one is going into my 'Keep' folder.


Maybe another issue... but what puzzles me is the enourmous difference in costs for IVF between different western countries. In New Zealand state of the art IVF costs a little less than US$5000, drugs included. My insurance does not cover it, but I can have two government funded cycles next year. Also in South Africa and Australia you can get state of the art IVF for a good price in private clinics. So until the insurance companies have changed their policies based on your great article, come over to this side of the planet, have a great holiday included and you still save money...


Excellent. Imagine telling an absurdly fat american who doesn't exercise that insurance won't cover their knee surgery? They'd go ballistic. Yet a lot of infertiles are paying every dime for their own treatment - ridiculous,despicable. Fyi - MA clinics charge insurance co's between $5,000 and $7,500 per cycle.

labia lady

I second Heleen's comment about coming down under....... I honestly do not know what we would have done if it wasn't covered by government subsidy & insurance company.


You are so clever. Marry me? No, wait, adopt me?


In one year, my insurance company spent about $25,000 on surgery, drugs, doctors fees and tests to diagnose and treat my Endometriosis. If they have to, they'll jolly well do that every year until I hit menopause, making the bill for my treatment a cool half a million dollars.

They won't, however, spend $11,000 on IVF which (unlike trying 'naturally') has a good chance of slowing the progress of the Endometriosis, therefore actually SAVING my insurance company money in the long run.

Let's see. $500,000. $11,000. Tough choice.

Doctor Disgruntled


I am more sympathetic than you might guess but still disagree with some of the assumptions that characterize your post. For example, Medicare's definition of "medically necessary" is not a universal one, from either a legal or ethical standpoint (meaning other third-party-payors like ins. cos. can set their own standards for 'necessity' and also meaning that reasonable people can disagree intellectually about how to define medical necessity).

Then, you are arguing about what insurance companies "should" pay for based on comparing infertility to other covered services - and by that standard, you aptly show there are many viable comparisons between covered treatments and not-covered fertility. The problem here is that companies "should" cover (1) what they promise to cover and (2) what they choose to cover, which we assume is based on their financial best interests - remember, they're trying to make a profit on your payment$ - and possibly on their social/ethical interests - probably they want to appear sympathetic and generous, so as to attract more clients.

You take the view that providing IVF is a money-saver for the companies, but I'm skeptical. Sadly, it's probably cheaper for them to let women with infertility just hang, and pay for their own treatments, especially because as you point out, women trying to conceive are highly motivated, often emotionally desperate, and many will make enormous sacrifices even for the chance of having a child. Thus, the company can sit on its cash and let you do all of the work. I'm not convinced that except in extraordinary cases (possibly as in endometriosis, but even this seems unlikely to me) that effectively purchasing a pregancy helps an ins. co. save money in the long run.

Finally, dictating what MUST be covered by an insurance company tends to raise the costs of insurance - laws that mandate psychiatric coverage or birth control pills, both of which have been the subject of popular legislation, with politicians happy to crusade against rich companies "discriminating" against women or the mentally ill, force people who don't want or need those services to subsidize the care of those people who do. That may be ok with you (and reasonable people may disagree about this philosopical issue), but an alternative would be to free the industry of restrictions, and allow smaller players to explore niches like, say, FERTILITY insurance.

This is currently impossible under laws mandating what "Should" be offered, and prevents a solution that really would help lots of women like you - selling fertility insurance to women in their 20s that would cover IVF and whatever else they might need in later life.

Just some thoughts. My best wishes for you in your quest, truly.

Doctor Disgruntled

kate #2

You are my hero. I love the passion with which you approach this debate. Just last weekend, I mailed off yet another round of letters to my Sentators demanding insurance coverage. My DH say it and said, "Oh No! What are we going to get arrested for now?" lol


Well said! It is incredibly painful for my husband and I to accept that the only reason we don't have a child right now may be that we don't live in a state that requires insurance to cover infertility treatments. We are hoping to find a way to raise the $12,000 to fund an IVF on two teachers' salaries. It is SO not fair!


What about the higher rate of birth defects associated with birth defects? I'm not arguing on the basis of economics for the insurance companies. I'm arguing that it's not fair to the child that is potentially conceived, to bring him into the world with the significantly higher likelihood that they are going to have birth defects.

There was an article at Popular Science called "Sally has 2 Mommies and 1 Daddy", that might be interesting reading.


Great argument. Let me know if there's any way I can help you fight for coverage.


I just wanted to say thanks and respond to the comment that an infertility mandate would "force people who don't want or need those services to subsidize the care of those people who do". Isn't that what all infertility patients are doing? We subsidize the care of pregnant women, because insurance is mandated to cover prenatal care. This is a service we will never use.
That is all insurance companies and subscribers do, subsidize the care of others. We pay for triple heart bypass for people that ate fattening foods for decades and refused to exercise. We pay for surgery to correct shattered limbs following a bungee jumping incident. We pay for chemotherapy, surgery, and radiation therapy to treat lung cancer, caused by nearly 30 years
of smoking. We pay for prescriptions for Viagra so a man can engage in sexual activity.
Insurance and we as a society are symbiotic, yet somehow the infertile got the short end of the stick.

Doctor Disgruntled

Yes, that's exactly my point - you and I are forced to subsidize the care of other people precisely because of mandates that force companies to offer specific types of coverage. If we weren't, the companies would be free to offer insurance products that would be much cheaper for most people, freeing up lots of $$ for you to buy what care you choose, and also allowing for the existence of a "fertility insurance" product I described above. You're saying the solution is "force coverage for more stuff" (which would raise the cost of medical insurance for everyone). I'm saying is "force coverage for nothing," and let the free market work. Then you would be much more likely to afford coverage of the type you want.

Again, best of luck. This argument pales in comparison to the stress and difficulty you're experiencing. My best wishes.

Doc Disgruntled

Blue Cross of California

Treatment shall be covered by health insurance as health coverage should be covering all health related events.


I agree with what you are saying. However, I'd like to point out that a vast majority of the insurance plans out there do NOT cover hearing aids...I should know, in the past few years I have shelled out $3K for mine.

Infertile Canadian

Here is a silly one for you... here in Canada, we have socialised medicine, which covers most medical procedures, but obviously not cosmetic ones.

My partner is sperm challenged, as as a result we require IVF/ICSI to get pregnant. However, as the insurance see it here *I* am not infertile, and therefore do not qualify for this now "elective" procedure.

Ahhh...Sexual discrimination in the insurance biz...


I love the fact that I found this web site!!

I live in Massachussetts, where it is supposedly mandated that the insurance policies covers infertility. Well I have been trying for years. I am 32 years old and was diagnosed with PCOS. I have seen doctors after doctors and all say to me that I need to see a reproductive endrocronlogist to treat my PCOS which is the cause of my infertility, BUT they say (the doctors)that my insurance will not cover. I have Medicare for insurance, which I did research and found that they do cover infertility under the policy manual, also the rep I spoke to said that "as long as it is medically necessary, I can be treated". Well, I do believe PCOS would be medically necessary. What should I do. Medicare states that they didn't put a hold in the system to prevent me from further treatment and the doctors office says otherwise. Now the RE told me that Mediace does cover the infertility treatment, but not the IVF. Hello that sounds like shit!! I am seeking treatment for my infertility, but I still have to sign a self pay waiver and pay $450.00 out of my pocket for the consult. A consult that Medicare pays. Can anyone help? Suggestions? This is so upsetting!!!

The comments to this entry are closed.

Adoption To-Do's


    Total Expenses So Far: $21,531

    Select country (Korea) (11/14/05)

    Select agency (11/17/05)

    Tell our families

    Receive preliminary application

    Preliminary App filed (12/5/05):

    • Fill in application
    • Photo of us, photo of house
    • Write medical statement, elaborating on treatment for depression
    • Line up four non-relative references
    • One copy of tax returns from past three years
    • Pay $200 fee
    • Notarized adoption services agreement $10
    • Fedex to Agency $15

    Receive Big App (12/15/05)

    Receive Korea Adoption Guidebook

    Home Study Paperwork: (1/19/06)

    • S: Complete "Personal Data" form with 67 essay questions
    • S: 1 photocopy birth certificate
    • S: Complete Authorization of Release of Information - Employer Verification
    • S: Criminal Record Statement
    • S: LiveScan fingerprint form (for State of California: criminal and child abuse index)
    • S: Schedule LiveScan fingerprinting appointments
    • S: LiveScan fingerprints done, pay $65
    • S: Medical Exam, including HIV and TB tests
    • S: Medical Report filled out by doctor
    • T: Complete 51 essay question "Personal Data" form
    • T: 1 photocopy birth certificate
    • T: Complete Authorization of Release of Information - Employer Verification
    • T: Criminal Record Statement
    • T: LiveScan fingerprint form (for State of California: criminal and child abuse index)
    • T: Schedule LiveScan fingerprinting appointments
    • T: LiveScan fingerprints done, pay $65
    • T: Medical Exam, including HIV and TB tests
    • T: Medical Report filled out by doctor
    • Complete detailed Financial Statement
    • 1 photocopy marriage license
    • Photo of baby's room
    • Map & directions to home
    • Copy all, keep for records
    • FedEx packet to agency, $15 (1/12/06)
    All 4 non-relative references return 3-page, 10-essay questionnaires directly to agency (1/28/06)

    Home Study Part 2: (4/3/2006)

    • Receive & pay invoice for home study $3066 (2/1/06)
    • Schedule social worker visits (2/10/06)
    • Childproof house (smoke detectors, fire extinguishers, outlet covers) $40
    • Social worker visit #1 (joint) (2/21/06)
    • Acceptable Medical Conditions Form (2/27/06)
    • From that details how "open" an adoption we are willing to consider  (2/27/06)
    • Social worker visit #2 (S only) (2/28/06)
    • Social worker visit #3 (T only) (2/28/06)
    • Sign up for module 1 & 2 of parenting class
    • Book travel for parenting class in Southern California
    • Modules 1 & 2 of agency parenting class (in SoCal) $500 (1/21/06)
    • Receive 2 completed, certified, notarized copies of Home Study (4/3/2006)

    Agency sends Home Study to Korea (HSTK) (4/7/2006)

    Sign up for modules 3 & 4 of agency parenting class

    Take modules 3 & 4 of agency parenting class (4/9/06)

    I-600A filed with US-CIS (Advanced Processing of Orphan Petition for Visa) (4/6/2006):

    • I-600A form
    • Copy certified Home Study
    • S: Photocopy of birth certificate
    • T: Photocopy of birth certificate
    • Photocopy of marriage license
    • Copy of most recent federal tax return
    • Proof of medical insurance
    • $545 fee + $140 for FBI fingerprints = $685
    • Cover letter
    • Copy all for records
    • Mail to US-CIS San Francisco

    FBI Fingerprinting:

    • US-CIS acknowledges receipt of I-600A (4/12/06)
    • FBI Fingerprinting appt. scheduled (different than LiveScan fingerprints)
    • FBI Fingerprinting completed, for each (4/28/06)

    Receive I-171H (Approval of I-600A) (5/11/06)

    Pick baby name

    Arrange for medical evaluation of referral

    Receive Referral (12/29/06)

    • Child's presentation letter
    • Child's information
    • Photographs
    • Medical records
    • Confidential background information

    Medical evaluation of Referral by Oakland Children's Hospital (1/10/2007)

    File Referral Acceptance Paperwork: ($140 + $12) (1/6/2007)

    • Child Information Transmittal
    • Pay invoice for $17,500
    • 3 Placement Agreements - all notarized
    • T: 4 Statements of Adoption (for child's Korean passport) - all notarized
    • 3 Travel Option forms
    • 1 Foreign Travel Release - notarized
    • T: 2 Affidavit re INS Vaccination Requirements
    • T: 2 I-864 Affidavit of Support for Immigration
    • S: 2 I-864A Contract between Sponsor and Household Member
    • Copy of entire last year tax return, with ALL attachments
    • Copy of all last year W-2 and 1099 forms
    • T: Photocopy of birth certificate (again)
    • S: Photocopy of birth certificate (again)
    • T: Copy of 2006 paystubs
    • S: Copy of 2006 paystubs
    • Photocopy of marriage license (again)
    • Photocopy everything for records
    • FedEx to agency (1/6/2007)

    Receive child's "legals" from Korea (in English & Korean): (1/22/2007)

    • Affirmation and Oath Certificate (attests these documents are true and correct)
    • Certificate of the Guardian (certifies Korean agency was guardian)
    • Statement of Guardianship (transfers guardianship from Korean agency to American agency)
    • Extract of Family Register (birth certificate equivalent)

    I-600 visa petition form filed w/ US-CIS: (1/25/2007)

    • I-600 form
    • Copy of I-171H
    • Copies of child's legals
    • Originals of child's legals, with note and SASE envelope requesting they be returned
    • Copy of child report
    • Copy of child photos
    • Copy of most recent 1040 tax form
    • Copy of I-864
    • Copy of I-864A
    • Letter with visa cable instructions
    • Fedex to US-CIS San Francisco $25

    Meanwhile, the Korean agency works away:

    • Our application is translated
    • Korean agency applies for Emigration Permit with Korean Ministry of Health and Welfare
    • Ministry approves Emigration Permit (aka "EP")
    • Agency gets I-171 (I-600 approval) cable from US Embassy in Seoul
    • Baby tested for Hepatitis B & HIV
    • Visa physical for baby
    • Submit application for baby's IR-4 Visa

    Resubmit our I-600 visa petition after US-CIS screws up (2/9/2007)

    Buy baby gear (3/17/07)

    Baby CPR & safety class (2/17/07)

    Line up a regular pediatrician (3/5/07)

    Line up a pediatric cardiologist (3/14/07)

    Investigate childcare options (3/17/07)

    Line up Daycare (5/25/07)

    Get on preschool waiting list (1/5/07)

    Setup nursery(3/19/07)

    Get life insurance for both

    Write wills with statements of guardianship wishes (both)

    Set up trust

    S: Get pre-approval family leave with HR (1/24/2007)

    Buy gifts for foster family, Korean agency staff (3/16/07)

    Make travel arrangements to Korea ($185 plus 240,000 frequent flyer miles) (3/13/07)

    Wrap-up job for a 15-week leave (3/12/07-3/16/07)

    Finalize leave plans with HR (3/15/07)

    Travel to Korea (3/19/07 - 3/25/07)

    • Meet both foster mothers (3/21/07, 3/22/07, 3/23/07)
    • In-Korea pre-flight medical exam (3/22/07)
    • Go to US Embassy in Seoul to process Class-B Waiver (acceptance of medical condition) 3/22/07
    • Get the final Visa paperwork (3/22/07)
    • Take custody of child! (3/23/07)
    • Long plane ride back to USA (3/25/07)

    USA Medical Evaluations

    • Add baby to my health insurance (3/28/07)
    • Evaluation by regular pediatrician (3/30/07)
    • US immunizations (3/30/07)
    • Evaluation by pediatric cardiologist (4/18/07)
    Receive Placement Confirmation Notice from Agency (3/28/06)

    Receive baby's Green Card in mail (4/16/07)

    Get social security number under baby's Korean Name as permanent resident (4/27/07)

    Receive post-placement packet in mail from Agency(4/15/07)

    Post-placement visits from social worker: (9/12/07)

    • Visit #1 (4/28/07)
    • Visit #2 (6/30/07)
    • Visit #3 (7/26/07)
    • Visit #4 (9/12/07)

    Create and file child "progress reports" with 8-18 photos each, for Korean agency and government, and a letter with photos for foster family (9/12/07)

    • 1-month progress report (4/28/07)
    • 3-month progress report (6/30/07)
    • 4-month progress report (7/26/07)
    • 6-month progress report (9/12/07)

    File US Physician's Examination Report with Agency (4/17/07)

    File Adoption Finalization Paperwork in our county in California (5/1/07) ($20)

    • Form ADOPT-200 (Adoption Request) (5/1/07)
    • Form ADOPT-210 (Adoption Agreement) (5/1/07)
    • Form ADOPT-215 (Adoption Order) (5/1/07)
    • Form ADOPT-230 (Adoption Expenses) (5/1/07)

    RE-File Finalization Paperwork the State changed in July '07 (ARGH!) (11/13/07)

    • Form ADOPT-210 (Adoption Agreement) (11/13/07)
    • Form ADOPT-215 (Adoption Order) (11/3/07)

    Finalize Adoption in County Court

    • Receive "Consent to Adoption" from agency (11/2/07)
    • Schedule court hearing (coming in December '07!)
    • Adoption finalization court hearing (Munchkin is now a US citizen, and his American name is now his legal name!)
    • Have a HUGE Party to celebrate!
    • Send agency/Korea copy of child's adoption decree (child is no longer considered a Korean citizen)
    • Send adoption announcements

    Secure proof of US citizenship for child:

    • Complete & file N-600 with US-CIS, pay fee
    • Receive Certificate of Citizenship
    • File passport application
    • Receive passport
    • Apply to SSA to get status changed from resident alien to citizen, SS# name changed (passport is proof)

    Start the process all over again for kid #2!