In the United States, more than 26 million women have uterine fibroids, and more than half of those women experience symptoms ranging from mild to debilitating.
Uterine fibroid symptoms can significantly interfere with a woman’s family, social, and work relationships. Usually, there comes a point when she can no longer endure the symptoms and she seeks treatment.
Anyone who does not feel well and seeks medical attention does not need the additional stress of worrying about how they are going to be able to afford their treatment. Most people rely on their health insurance plans to help cover all or some of these costs.
Some of the first questions they have are “Does health insurance cover fibroid removal?” and “How much does fibroid surgery cost with insurance?” or for some, “How much does fibroid surgery cost without insurance?”
Let’s take a look at some different treatments for fibroids and their associated costs as well as what to expect in the way of health insurance coverage for these treatments.
Fibroid Removal Treatments
The most performed procedures to treat fibroids are hysterectomy, myomectomy, and uterine fibroid embolization.
A hysterectomy is a surgical procedure that is performed to remove a woman’s uterus. During a hysterectomy, other reproductive organs such as the cervix, ovaries, or fallopian tubes may also be removed. The three types of hysterectomies include:
- Total hysterectomy;
- Partial hysterectomy;
- Radical hysterectomy.
Myomectomy surgery is done to remove uterine fibroids (noncancerous growths) that grow in and around a woman’s uterus. During a myomectomy, a surgeon uses one of several techniques (laparoscopic myomectomy, robotic-assisted, open myomectomy) to cut the fibroids out one at a time and remove them.
Uterine Fibroid Embolization (UFE)
Uterine fibroid embolization is an effective treatment for fibroids that does not require surgery, hospital stays, or a long recovery time. During this non-surgical procedure, the blood supply to the fibroids is cut off, causing them to shrink and die, eliminating the painful symptoms. An Interventional Radiologist who has been specifically trained in uterine fibroid embolization performs the procedure.
Does Health Insurance Cover Fibroid Removal?
The good news is that most health insurance companies do cover fibroid removal. Each insurance provider will have its own policies regarding which procedures are covered, how much coverage is provided, and the qualifying criteria for coverage.
Currently, almost all insurance carriers cover some type of surgical fibroid removal procedure (hysterectomy or myomectomy), and non-surgical uterine fibroid embolization is covered by many insurance carriers.
Why Is Uterine Fibroid Embolization Insurance Coverage Not Offered To All Women?
When newer medical procedures or techniques become available, they are not typically quickly embraced by insurance carriers. Even when medical evidence and logic demonstrate that the company would save money in the long run by offering coverage, it seems to take insurance companies forever to come on board.
Such has been the case with uterine fibroid embolization, which has been performed in the US for over 25 years. Many insurance companies do currently cover the UFE procedure but some still do not. UFE benefits both patients and insurance companies alike. Some of the benefits of UFE over hysterectomy or myomectomy are:
- A shorter procedure that is less expensive to perform because it can be done in an outpatient facility;
- UFE does not require a costly hospital stay (a one-night hospital stay averages $2,607 in the United States);
- Fewer complications and adverse side effects;
- During pregnancy, women can still have a vaginal delivery vs myomectomy where a C-section will be required
- Results are permanent vs myomectomy where repeat surgery within 5 years is frequently necessary;
- Fewer follow-up appointments, prescriptions, or recovery-related expenses.
Progress In Uterine Fibroid Embolization Insurance Coverage
Currently, some insurance carriers do offer coverage for UAE/UFE but all women deserve access to this non-surgical uterus-preserving treatment. Several individuals have been working diligently to ensure that UAE coverage is available to women by all insurance providers and there has been a significant breakthrough.
In June of 2022, Rhode Island became the first state to sign into law HB7561 which states that uterine fibroid embolization must be included in the covered procedures of all healthcare insurance policies. Dr. John Lipman of the Atlanta Fibroid Center had a hand in this groundbreaking legislation through his work as the founder and chairman of the Free From Fibroids Foundation. Dr. Lipman was present when the bill was signed by Rhode Island Governor Daniel McKee.
How Much Does Fibroid Surgery Cost With Insurance?
The cost of fibroid treatment will depend upon several factors. These factors include:
- The type of procedure or surgery used to eliminate fibroids;
- Geographic location;
- The doctor performing the procedure;
- Type of facility used (hospital, surgery center, outpatient facility);
- Whether the procedure requires a hospital stay;
- Other costs that also can influence the cost of fibroid surgery are costs associated with MRI or imaging needed, blood work, surgeons fees, anesthesia fees, prescriptions, etc.
Given these many factors, the costs can range widely. Hysterectomies performed in an outpatient surgery center can cost up to $32,000, while hysterectomies performed in a hospital will cost up to $35,000. Myomectomies, which are more complicated surgical procedures requiring more time and complex techniques, can cost up to $42,000. Uterine fibroid embolization, given that it is less invasive and can be performed very safely in the outpatient setting, will typically cost LESS THAN HALF of the surgical options.
Even with insurance coverage, the patient is often responsible for a portion of the expenses. Several elements may be used to determine the financial responsibility of the patient including:
- If the doctor is in your health insurance provider’s network. Often, out-of-network doctors require the patient to pay a greater percentage of the associated costs.
- If the patient has a deductible they must meet before the insurance coverage begins to pay out.
- If the patient has a copay or coinsurance. Many times the insurance company will pay a certain percentage of the cost of a procedure and the patient is responsible for the rest.
Can I Have Uterine Fibroid Embolization Without Insurance?
We understand that fibroid symptoms can affect a woman’s quality of life, and no one should have to suffer from them. If you do not have insurance coverage or if your policy does not cover UFE, we offer a cash price for UFE that is very competitive, particularly given our experience and the fact that the Atlanta Fibroid Center contains a procedure suite with state-of-the-art imaging equipment that is rarely seen in outpatient treatment centers.
The cost of UFE can be broken up into a payment plan, and we also offer third-party financing options.
Which Insurance Covers Uterine Fibroid Embolization To Remove Fibroids?
During your initial consultation, we will go over the UFE procedure and answer any questions you may have. We will also work with you to determine if the uterine fibroid embolization procedure is covered by your insurance provider, and we will review any financial contribution that may be left to you, the patient.
If your procedure is not covered by insurance, or if you do not have a medical insurance policy, we will review with you a cash payment plan and financing options.
UFE is significantly less expensive than the surgical options and offers a higher safety profile and a much lower risk of complications. Contact the Atlanta Fibroid Center today to learn more about becoming fibroid free!