Having Kids After My Hysterectomy
STORY TIME
I may live in Los Angeles now, but I am originally from the South, so family is very important to me. (As it is to many women, regardless of their location.)
When I found out I had cervical cancer and needed to have a hysterectomy, the first question I asked my doctor was:
What are my options for a future family?
She quickly assured me that in the state of California, egg freezing is required by law to be covered by insurance in the event of “iatrogenic infertility,” meaning infertility caused by cancer. What a relief.
Egg retrieval could begin after my surgery so the procedure wouldn’t accidentally carry cancer cells from my cervix into my ovaries.
Luckily, I only needed surgery, but if I also needed radiation, she said, they would move my ovaries out of the way to protect them from the radiation and preserve the eggs.
I made an appointment with my referred fertility specialist and got an ultrasound of my ovaries, and everything looked normal (aside from the missing uterus.)
I was so excited to get started. Until the clinic handed me a folder of papers telling me I would need to pay around $7,000 in order to get the ball rolling.
I was confused. I was told this should basically be free because I had cancer…
As it turns out, the clinic where the actual procedure is done doesn’t accept insurance.
How that is possible is still a mystery to me to this day.
This was when I dug into my insurance plan to confirm that yes, they did cover egg retrieval for iatrogenic infertility. But I can’t tell you how many times I had to explain to my insurance provider that I was NOT doing egg retrieval for IVF (which was not covered), but that it was a completely different section of the plan.
This is when I started hearing Kris Jenner in my head: If you hear "no,” you’re talking to the wrong person.
So I made sure to study up on my plan and the iatrogenic infertility law (SB 600) so I could confirm with my insurance and offices that yes, this IS covered and WILL be free, dammit! It will just end up being a reimbursement situation. (Which always makes me nervous.)
But Steph, what if I don’t live in California?
If you have insurance, I would encourage you to take a deep dive into your plan and see if it covers procedures for “iatrogenic infertility” specifically. It will be different than IVF (which is typically not covered) so if you have a digital version and can Command + F, that is ideal. If not, I would encourage you to keep this in mind the next time you are eligible to update your insurance.
Knowledge is power. You should know your insurance top to bottom, as it relates to your cancer needs because often times, the insurance advocates on the phone don’t know your specific case, may not care or are instructed to put up as many road blocks as possible so you need to be ready to counter everything they say until you get what you need.
Again, I’m from a very passive, Southern family, so this assertiveness is a skill I’ve had to learn. And it CAN be learned for you too, I promise. :)
XO Steph
*BTS photos from my first fertility consultation appointment to determine if I am a good candidate for egg freezing
More Q & A
Q: What if I also need radiation after surgery?
A: My doctor told me if I needed radiation, they would move my ovaries out of the way during surgery to protect them from the radiation. Consult with your doctor on their plan as it may differ.
Q: How can I enforce California SB 600 if the fertility clinic my doctor uses doesn't accept insurance?
A: California SB 600, also known as the California Fertility Preservation Law, requires insurance companies to cover fertility preservation services for individuals undergoing medical treatments that could affect their fertility. If your fertility clinic doesn’t accept insurance, here are some steps you can take:
Verify Coverage: Make sure that your insurance plan actually covers fertility preservation services under SB 600. You can do this by reviewing your policy or contacting your insurance provider directly. Ask for written confirmation of your benefits.
Get Pre-Authorization: If your insurance plan covers fertility preservation, request pre-authorization or a treatment plan from your fertility clinic. This will help ensure that your treatments are covered and that you’re following any required procedures for reimbursement.
Contact the Clinic: Even if the clinic doesn’t accept your insurance directly, ask if they can provide a detailed invoice or receipt. Some clinics are willing to work with patients to help them get reimbursed by their insurance company.
Submit Claims Independently: If the clinic doesn’t accept insurance, you may be able to pay out-of-pocket and then submit a claim to your insurance company for reimbursement. Keep all receipts, invoices, and documentation related to your treatments.
File a Complaint: If you encounter issues with getting reimbursed or if your insurance provider is not honoring the coverage, you can file a complaint with the California Department of Insurance or the Department of Managed Health Care.
Seek Legal Assistance: If you have trouble resolving the issue, you might consider speaking with a lawyer who specializes in insurance claims or health care law. They can offer guidance and help you understand your rights under California law.
Explore Other Clinics: If possible, look for other fertility clinics that do accept insurance or are in-network with your insurance provider. This can help streamline the process and reduce out-of-pocket costs.
Navigating insurance and fertility treatments can be complex, but knowing your rights and options can help you manage the situation more effectively.
*This is not medical advice. Please talk with your doctor about your specific needs.