Fibroid Issues - Worried About Insurance

I'm new and I think I understand all the rules, and I will try not to break any - please let me know gently if I do -

I am also having trouble reading the abbreviations - can I get a list? Thanks

Anyway, I've had problems more severe - for the last three years. My first doc said that periods are hard and to hang in there - YIKES!
The second said I was perimenopausal - (at 35-y-0).

I had horrible cramping that sent me to the ER about three months ago. There was a cyst on on of my kidneys, a large cyst on my ovary (since gone) and a mass low in my pelvis.

I went and had an ultrasound, which revealed a 12 week size uterus with a horizontally laid large fibroid inside.

She put me on vaginally inserted hormones which made me depressed and did not help the bleeding or cramping.

I want a hysterectomy - I've wanted one for well over a year. I want one now more than ever.

Does anyone know what insurance companies need to hear/see in order to approve this procedure?

For help with abbreviations -- click on "FAQ" in the purple area near the top of the page. There's a link to answers to "What do the abbreviations mean?" Hope that helps.

Insurance companies are all different in what they require. Mine, for example, didn't need anything! As long as a gynecologist (spelling?) recommended one, I could go ahead and schedule it. Others require one or more D&Cs or other procedures or treatments before they will pay.

My recommendation would be to call your insurance provider and find out right away. That will take the guesswork out of it for you.

Good luck! It sounds like you are ready for the hyst. However, you might be surprised to learn that there is something less invasive that will work just fine or that your dr. will want to try first. Just do all your research and if you're not comfortable with your first doc, find another!

Insurance companies vary on what they require. The best way to find out is to talk to your doctor's office - whoever schedules the surgery is usually the one that submit it to the insurnace company for approval.

However, I hope your doctor has talked to you about alternative treatments to hysterectomy. It is a serious operation that can have plenty of unintended consequences. Did your doctor mention myomectomy (to remove only the fibroids), ablation (to cauterize the inside of your uterus to get rid of the bleeding) or Uterine Fibroid Embolization (blocking the blood supply to the fibroids, which usually lessens bleeding too)?

My doctor only had a pelvic and transvaginal ultrasound for me (plus the exam) before scheduling surgery. My insurance company had not trouble processing it at all. The odd thing is that my co-pay on the ultrasound has ended up costing me more than the entire surgery.

Take care.

S

I can understand where you're coming from, wanting a hyst and wanting it now. I can also (now) understand the need to be absolutely certain that a hyst is the absolute last treatment.

I also had fibroids, prior to them, "normal" periods (or what I perceived to be normal, from what I've learned from this site I'd say that while they may have been normal for me, the cramps and clots weren't what most others experience). A couple of cervical polyps over the years, just was happy when my GP diagnosed the fibroids and mentioned the word "hysterectomy", and sent me to a GYN. At that time my fibroids were referred to as 6 week size, the GYN said nope, 16 weeks is the "automatic" size for a hyst, we had to try Provera. It worked for a couple of years controlling the bleeding, not the cramps, and certainly not the mood swings.

Finally it stopped working, by then my uterus was 17-18 week size, and it was time. The paperwork lady in the DR's office said that given my history and treatment it shouldn't be any problem getting authorization, and it wasn't.

But PLEASE check on options and alternatives to a hyst. It can be a life altering surgery (for the good OR bad) and once it's done it can't be undone.

Get a second or third or fourth opinion before you agree to surgery.

You may want to check out the Hysterectomy Options and Alternatives Board (click here) at the top there is a great list with links to all kinds of alternatives.

Read and research as much as possible to help you, along with your medical team, make the best decisions for you!

Best wishes!