Insurers Start Putting Patients First - Women Deserve Minimally Invasive Options to Treat Fibroids

  • by: S.K.
  • recipient: David S. Wichmann (United), David Cordani (Cigna), Gail K. Boudreaux (Anthem), Bernard J. Tyson (Kaiser), Bruce D. Broussard (Humana), Michael F. Neidorff (Centene/Health Net)

Most women don't realize that more than 70% of women in the United States will be affected by uterine fibroids before the age of 55. With this condition can come significant symptoms; including heavy menstrual bleeding, menstrual periods lasting more than a week, pelvic pressure or pain, frequent urination, difficulty emptying the bladder, constipation and backache/leg pain. With more than 10 million symptomatic women in the U.S. each year, it has been estimated that uterine fibroids cost the economy upwards of $34 Billion.

I am a mother of four and was impacted by fibroids in the last two years. The pain and bleeding associated with the fibroids have significantly impacted my life. Because I was considered past childbearing, several physicians told me the only option to treat my fibroids was a hysterectomy.

Hysterectomy is the most common surgical treatment for uterine fibroids and recently the American College of Obstetrics and Gynecologists acknowledged that upwards of 60% of hysterectomies are unnecessary.

I am many years away from menopause and I like many women do not want to have my uterus removed if I have other options available to treat my fibroids. Because of the size, number and location of my fibroids surgeries like myomectomy were not a possibility and thus I was told again and again hysterectomy was my best option. I finally found a physician who presented to me multiple treatment options including a less invasive alternative, which allowed me to keep my uterus and just treat the fibroids. It was also important because this new option, which was known as Laparoscopic Radiofrequency Ablation, allows women to recover in three to five days versus the three weeks I was being told to expect if I decided to undergo a hysterectomy.

After an emotional process of finding a better solution to address my Fibroids, my insurance company Cigna denied my procedure. I appealed the denial and ultimately went to multiple levels of review including what is known as an "independent" review. What I learned through this process was that since my company was self-funded, Cigna was able to select, hire and pay their own "independent" reviewer. My five appeals have all been denied and I am still suffering both with my symptoms and my option is still limited to hysterectomy.

Insurance companies such as United Health Care, Cigna, Anthem, Kaiser, Humana and Health Net are putting their profits before their patient's interests. Over the last five years, these insurance companies have seen record profits while patients are using less and less healthcare and our out of pocket expenses have steadily increased. While I am paying more for healthcare insurance, when I need to use it, I can't. Where is the accountability to patients?

Insurance companies should begin to give patients options and start by covering less invasive alternatives to hysterectomy. Stop putting profits before patients.

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