Fibroid surgery coverage

Fibroid surgery coverage refers to a health insurance benefit that pays for medically necessary procedures to remove uterine fibroids, such as myomectomy or hysterectomy. Most major US insurers, including UnitedHealthcare and Blue Cross Blue Shield, cover fibroid surgery if symptoms like heavy bleeding or pain meet clinical necessity criteria documented by a physician.

Coverage typically excludes elective or cosmetic procedures related to fibroids, such as surgeries solely for fertility enhancement without medical indication. Preauthorization requirements exist with Aetna and Cigna, meaning patients must obtain insurer approval before scheduling fibroid removal.

Out-of-pocket costs vary; for example, the average deductible ranges from $1,000–$3,000 on employer-sponsored plans according to KFF 2023 data. Medicaid covers fibroid surgery in all states when deemed medically necessary by a licensed provider.

Medicare Part B covers outpatient fibroid removal after meeting the annual deductible of $240 (2024). Insurers often require imaging evidence–such as ultrasound reports–to confirm diagnosis before approving coverage for surgical intervention.

Some policies impose limits on hospital stay length post-surgery; for instance, Anthem restricts inpatient stays to 48 hours unless complications arise, as stated by YourInsurance.info (Your Insurance Info).