Hi there,
I was diagnosed with endometrial cancer. Most people who get endometrial cancer are post-menopausal and the standard treatment is a total hysterectomy. However, I’m in my 30s, and meet the criteria for ‘fertility-preserving treatment’ involving hormonal therapy and regular biopsies to monitor for any sign of recurrence until I have a child (after which, I will have a hysterectomy).
I am covered by private health insurance. However, when I asked them to approve my hysteroscopy procedure for the purposes of a) cancer-monitoring biopsies and b) inserting the IUD (hormone treatment), they declined the whole procedure because of the IUD.
Their reasoning was:
- they don’t cover fertility treatment (this procedure is definitely not fertility treatment)
- they consider the IUD to be a standard procedure that a GP can do
- they don’t cover the procedure because it’s ‘unconventional treatment’ for endometrial cancer - they will only cover a total hysterectomy
Frustratingly, they’ve told me that they would have no problems covering this exact procedure with the IUD if it was for the purposes of treating endometriosis or heavy periods.
(There is something so wrong about an insurance company pushing paying patients out onto an already overwhelmed NHS system to boost their profit margins.)
I have two questions:
- Is it possible for me to pay for part of my treatment and have the health insurer pay for the part that they definitely do cover? If I was only getting the hysteroscopy for the purposes of biopsies alone I would be covered. Can I pay for the IUD separately even though it would happen in the same procedure?
- Do I have any other options/rights here? They consistently misquoted my policy and my oncologist’s report in their reasoning to decline treatment so I really have trouble believing them when they say they have grounds to decline my procedure.