My hysterectomy post surgical care has been DENIED by Aetna.
Furious doesn’t adequately describe the white-hot anger coursing through me right now.
Apparently spending over 4 hours on a surgical slab (instead of the projected 1 1/2 hours) having a COMPLETE hysterectomy, having almost as many things I am allergic to as my mother (even with an arm full of plastic allergy warning bracelets I did have an allergic reaction to SOMETHING while I was there a couple of times), indeed had severe pain…..it wasn’t enough for them to cover me for post-surgical care. Which was a matter of hours, not a matter of days I might add.
Apparently the scar tissue, cysts, and fibroids they removed along with my uterus, fallopian tubes, and ovaries wasn’t enough to cover me for post-surgical care.
Apparently, according to Aetna, a full hysterectomy is supposed be the same as ordering a burger and fries from the Wendy’s or McDonald’s drive-thru. Or like having a hang nail snipped off during a manicure.
What woman wakes up, snaps open her compact, powders her nose and says “Oh goody, I am going to have a hysterectomy today!”????
My surgery was medically necessary and so was my care. Who the freak knew Ebeneezer Scrooge was behind decision-making for major gynecological surgeries at Aetna?
The irony is I have now spent a couple of weeks flat on my back recovering from this surgery. I have had to come to terms and acknowledge to myself that yes this was major surgery. But to my health care insurer, it was just like a drive thru burger and fries or getting a hang nail clipped.
As far as Aetna was concerned I guess I was supposed to leap up off the operating table and rip out the catheter and sprint for the hospital exit.
Good to know as a woman I am valued. Or is it I am only valued as a woman as long as I make no claims against my policy?
Note to the Obama administration: Obamacare is a big fat zero because the same old stuff keeps happening. I was pushed out of the hospital after my breast cancer surgery and now this. I am done. This is B.S. and I am done.
I am throwing this back into the lap of my hospital and my surgeon. There is no reason why I should not have been completely covered. I figure if I can pay the outrageous pre-surgical co-pay BEFORE I have my surgery or they won’t give me my surgery than they can figure this out with Aetna.
I don’t know about you but I am tired of this nonsense surrounding “female” surgeries for lack of a better description. Because we all know if this was involving a man’s penis or a man’s horrid reaction to a little blue pill, it would probably be covered wouldn’t it?
Of course now that I am publicly complaining about Aetna, will they find a reason to cancel my policy even if supposedly they are not able to under Obamacare? See that is the thing: we are at the mercy of health insurance companies and conniving politicians. Is it about our care or their profit margins and campaign finances?
Bottom line in the end: my doctors planned my care. They didn’t do anything unnecessary. This is crap.
ihavebreastcancerblog 
This is absolutely disgusting!!! You are completely correct leaving this to the doctor, the hospital and the insurance company to fix. Since when is a hysterectomy an outpatient procedure??? Who ever made that determination needs to be fired and then made to have the same procedure. I’m so pissed for you its not even funny.
Thank you for sharing, it is important to tell your story. In a world where viagra is covered for men but birth control pills are not we need to obviously make some changes. And, the only way for that to happen, it seems, is to yell it from the mountain tops. The fact that Aetna has denied coverage is completely ridiculous and absurd. I am sorry for what you are going through. Throw it back to them and keep us posted on what happens. I hope you are feeling better and recovering well!
Nice to become acquainted with your blog 🙂
Lisa
Lisa I am a HUGE fan of your blog and we share a fondness for pink moons 🙂 can’t tell you how much it means to me to have you leave me a message that you read this post. I hope this note finds you well. I am healing, but it is truthfully much slower than my breast cancer surgery
Well now I am a HUGE fan of your blog! My apologies for not finding you sooner. I have been very remiss in keeping up with blog reading (not good) and more remiss in writing on my own blog. I start so many posts – either in my head or in draft form – and most of the time find myself either not finishing or simply not posting.
I will endeavor to do more writing. I sort of lost interest after losing so many fellow bloggers. It has been a brutal few years in our blogosphere. Sometimes I can’t bring myself to write. But, you are inspiring me to take it back up.
I have had my own experience with surgeries after breast cancer and I was amazed at how much longer it took for me to recover than from the mastectomy. Even years out now.
I hope your recovery speeds up and that you feel well very soon!
Hugs, xoxo
Lisa
Unconscionable is what they are. To send you that letter, put you in that position, after a MAJOR surgery, as if you have a squadron of attendants to which you can toss it so they can “take care of this”…
GIVE. THEM. YOUR. HELL.
Breast cancer victim here too (I consider ‘survivor’ more a term relating to the treatment thereof, but I have my own issues, these are merely semantics). Found a lump, no lie, a week before my husband’s prostate cancer surgery. Lump turned out to be…I dunno, never got a straight answer, perhaps that chewing gum I swallowed when I was 10? But ultrasound saw it below (NOT mammogram, that never did, mammography, the great lie for far too many of us) – small cancer. Took over a month for me to get that answer, due to bullshit from the imaging center I was capitated to by the insurance company (had I been allowed, ha, to go to any of the THREE breast centers within 14 miles of my home I’d’ve had an answer within two weeks…that waiting, the delays, they BROKE ME).
Insurance company responsible for delaying my diagnosis for over a month. Same imaging center jerking me around afterward for my preadmission MRI, now about to delay my treatment…after surgery and radiation, making me jump through hoops to go out of network for a lymphedema specialist they didn’t have to deal with my “new normal” due to treatment, said it was covered, a year later telling me none of it was…
My husband was lucky enough to regain continence within a couple weeks of his surgery (too many men don’t at all), but the erectile function he had prior has yet to return two years later (yay more lies!). The insurance company covered all of SIX Cialis pills in the couple of months following his surgery (for therapy). He could barely stand from the surgery when I had to go down my own awful road…thieves. They are thieves.
Stand your ground. Give no quarter. They are WRONG and they need to pay.
We gather so much anger, us cancer-stricken folks, with nowhere to aim it….
OPEN FIRE on those monsters. ESCALATE. Take names, notes, and hides, Let your emotions rip them instead of you, give up on being all dignified, toss that concept. YOU ARE THE PATIENT AND THEY ARE FURTHER INJURING YOU. You do not need this crap. This affects your recovery in too many ways for them to blithely throw you by the wayside and skip along their money-littered way.
I’ve been reading your blog for a while now, we met briefly ages ago and I doubt you’d remember me, but I know you are a spitfire. Seen it in action. I know you’ve got more cajones than I do and even I have cowed the insurance company with pure reason, rage and…sobbing. Ugh, I know, but 1) I couldn’t stop it if I tried and 2) it seemed to get the point across.
I didn’t have much help from my docs, since I didn’t think to ask, ha! But I’m writing this in sympathy and support and hopefully you can keep this flaming arrow in your quivver.
Screw those guys, seriously.
All the best, Carla. For true.
Carla for the win! YARRRRRR!
🙂
I don’t know who this is because I don’t recognize the email address but I wanted to say thank you. Thank you for caring