February 27, 2015 by Tony Novak
The nation’s two largest commercial health insurance carriers – United Healthcare and Anthem – now require pre-approval of coverage for hysterectomies, a procedural delay that may add up to 30 days wait time for women who need the procedure.
The tightening of coverage for this procedure comes after gynecologists have failed to appropriately self-regulate the use of the procedure and the FDA has failed to ban the morcellators, a device used in hysterectomies, that is a known cause in accelerating cancer in some portion of women who undergo the procedure. Morcellators trigger the spread of cancer in up to 1 in 300 women who undergo the procedure.
Some third party consumer watchdog groups have accused gynecologists of failing to act ethically and appropriately and say there is clear evidence that hysterectomies are over-prescribed.
Others note their concern about commercial health insurance companies dictating medical care by controlling the payment system. The Wall Street Journal carried an update on this issue today.
Cigna and Aetna do not require pre-approval for the procedure so this may be a criteria to consider in the selection of an insurance plan. Not all of these carriers are available in all locations; see FreedomBenefits.net for location-specific choice of carriers.