Do I meet the criteria for this coverage? Info provided

(Not sure if this is the right flare)

For a long time I was convinced my insurance would not cover this procedure. After rereading, I’m starting to wonder.

My situation: I’m a 20-year-old woman with endometriosis. This means my uterine lining grows in places it should not be. I’ve been living every single day in complete agony and sometimes can’t make it through the day. The only way to get rid of it is through this surgery. I want to be able to have children someday. Not soon, but someday. Many women who have this condition turn out to be infertile or even end up having to get a whole hysterectomy.

What my insurance says they’ll cover with it: The use of laparoscopic or transcervical radiofrequency ablation as a treatment for symptomatic uterine fibroids (e.g. excessive uterine bleeding or pelvic discomfort caused by uterine fibroids) is considered medically necessary when all of the following criteria are met:

Uterine preservation is desired; and Fibroids are less than 10 cm in any diameter; and Uterine size does not exceed 16 weeks’ gestation.

Back to me: I’m just slightly confused as to whether I meet the criteria or not. If someone could help me understand this a little and help me figure out if my explanation sounds like I do or do not I’d be so extremely grateful.

submitted by /u/EggplantSoul33
[comments]

See also  Confused middle man between insurance and provider