Noah and Carol Zepelin received a form letter in the mail saying in two months Kaiser Permanente would close the infertility clinic where they had been receiving treatment with the goal of conceiving a child.
For the Zepelins, a couple in their early 30s, it meant starting all over at another clinic after what seemed to them like an abrupt change in medications and procedures.
It meant they had wasted weeks and more than $800 spent out of pocket for testing and treatment at Kaiser’s infertility and reproductive endocrinology clinic at the Skyline Medical Offices in Denver, Noah Zepelin said.
A notification letter was mailed to patients at the end of April that the clinic would close around June 30, Kaiser spokeswoman Amy Whited said. The Zepelins initially had the impression from Kaiser their course of treatment could continue uninterrupted at a replacement clinic. But, they said, no such seamless transition was available. Their new clinic’s staff said the whole process had to begin again at another clinic.
“Part of the issue is that they weren’t communicating with us ,” Carol Zepelin said of Kaiser personnel. “They were kind of unsympathetic.”
About 150 Kaiser Permanente patients have health plans with an infertility and reproductive endocrinology benefit, and an additional 200 to 300 patients, although without benefits, had received or were receiving services through Skyline, the only such Kaiser clinic, Whited said. Of those numbers, some already had conceived.
It’s a small number compared with Kaiser Permanente’s 640,000 Colorado members, Whited said.
Kaiser had to have known sooner of the pending closure than the date they notified clients, Zepelin said.
“I’m sure many dozens, or hundreds, of couples are starting over with all new testing, medicines, doctors, etc. — all at tremendous emotional and financial cost,” Noah Zepelin said. “At a minimum they should reimburse us.”
Denver psychologist Alison Wilson, who specializes in couples’ issues related to infertility, among other issues, said interruption of treatment can be devastating. She isn’t counseling the Zepelins but spoke generally about the process.
“When a couple goes through fertility treatment, it is very stressful,” Wilson said. “They have to navigate through all the treatment options and costs. They form relationships with their treatment teams. It is very time-consuming and time-sensitive.”
It would be difficult to start over, she said.
After the Zepelins complained to the Better Business Bureau and media, they said, Kaiser offered to reimburse them fully.
The time lost is significant for the couple. He’s a schoolteacher. She’s a school counselor. Summer is the time they have available to undergo the exacting regimen of carefully timed medications and procedures. It’s not manageable during the school year, they said.
Among KP’s 1,100 physicians, most specialties are represented, but it isn’t possible to have everything in house, Whited said. Only one physician remained at the infertility clinic. A second physician had retired.
Because of the small patient base, she said, it was largely a business decision to switch from offering the services in house to contracting with other clinics.
It is not a general trend at Kaiser to reduce the number of in-house specialties, Whited said. But the patient numbers had been declining at the 18-year-old clinic in the past five years. Skyline was not offering in vitro fertilization, in which the egg is fertilized outside the body and later transplanted.
Many couples wanted to have that option if intrauterine treatments failed, she said.
While Kaiser plans that have the reproductive endocrinology benefit still retain the coverage, Whited said, patients simply have to look elsewhere in the network to obtain the services. The Zepelins didn’t have the benefit as part of their insurance plan and were paying out of pocket.
“We’re working to help (all affected patients) make the transition,” Whited said.
Every patient’s circumstances are different, she said, and the transition team is considering reimbursement case by case.
Electa Draper: 303-954-1276, edraper@denverpost.com or
