Surgical treatment is the gold standard of care for endometriosis. However, this is a costly procedure. In many cases, health insurance covers part of or all the costs. But in some cases, patients will have to pay the total costs or at least a part of it from their pocket. Many patients are now looking for surgery and wonder what the out-of-pocket cost looks like. If you had endometriosis surgery or have figured this out with your insurance and doctor, please share what the out-of-pocket costs looked like. Your experience will help many people understand the procedure costs and make an informed decision.
Endometriosis
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December 10, 2024
Is the emotional toll of navigating insurance and out-of-pocket expenses for endometriosis surgery sometimes more daunting than the physical pain itself? How do the financial stresses of medical care impact your mental health and decision-making process regarding surgery? Let’s discuss the unseen costs that go beyond just dollars and cents.”,
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Given the high out-of-pocket costs associated with surgical treatment for endometriosis, should we be questioning whether the financial strain is justified? What alternatives have you considered, and do you believe the potential relief from symptoms outweighs the economic impact? Share your thoughts and experiences.”,
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My insurance covered everything besides the deductible, co-pays and my expert excision surgeon.
So around $15,000 out of pocket.
There wasn’t a high volume MIGS (minimally invasive gynecology surgeon) in my network. I argued and argued with my insurance company on this and their response was just “we have providers in network who treat endometriosis.” I lost my appeal. They refused to cover any of it. Their reviewing MD was a general doctor who knew nothing about gynecology.
I had surgery out of network and my endometriosis ended up being much more invasive than previously thought so instead of it being an outpatient surgery, I had to spend the night. No complaints with being safe.
My out of pocket costs were around $20-25,000.
I was diagnosed with stage IV endometriosis. My surgeon told me that the disease everywhere but he removed all of it. I have zero pain. He told me I NEVER would have been able to have children. I conceived two cycles after surgery. I would have likely gone through many unsuccessful fertility treatments and spent much more money. It’s so incredibly sad to me that this is what people with endometriosis have to go through.
I live in Belgium. I have an insurance for hospitalization provided by my employer. I had surgery in November and didn’t pay one euro. If I wasn’t insured through my employer than I would be through health care and then I would have to pay around € 200. Life is good here.
Both surgeries were out of state for me. My 2nd Exision surgery & Abdominal Reconstruction (NJ)
I paid $9,500.00 1wk prior to surgery (surgeon’s fee) then after insurance covered hospital aspect I was left with $2,300.00 left to pay over time in montly payments. Insurance covered up to $74,000ish. For my 3rd Exision surgery/Hysterectomy/Rule out Thoracic/Diaphragmatic endo (GA) I paid up to $12,000.00 for the surgeon, the surgeon asst. fee & a hospital deposit along with travel; gas,food,meds,hotel stays which came out to another $3000.00 out of pocket, plus multiple chest xrays around $60.00 & Thoracic surgery portion around $231.00 out of pocket for me & Insurance covered $2,300.00. ATM Insurance is pending my surgery and hospital stay which is around $78,000 more or less. Awaiting my out of pocket cost.
$19,000. Insurance didn’t want to cover any of the $140k surgery (also included a myomectomy) but surgeon office appealed and got everything but the discounted surgeon’s fee covered. Cost Also includes copays/deductibles for hospital stay and anesthesia. I’ve spend just as much on after care and pain management. A family member’s GoFundMe covered my surgeon fee. Otherwise I’d be much more debt right now.
Medical expenses were about about $750.00 out of pocket. They billed the insurance over $75,000.00. Then 2 nights in a hotel and food expenses. Overall, I had a much better experience then most. I have good medical insurance and pay about $4,000 a month for private insurance.
Over $60,000 US out of pocket, including my flights, AirBNB, rental car and fees for the endo surgeon, thoracic surgeon, general surgeon, anesthesia, pathology, radiology and the hospital’s charges. This was AFTER the self-pay discount from the hospital and the surgeons. Without those discounts, I would have owed another $70,000 on top of that.
$10,000.00
My first surgery was in Feb 2020-just diagnostic laparoscopy & cystoscopy. The doctor & hospital was in network for my insurance. I ended up paying about $1200 in copays for that procedure and pre/post op appointments. My excision surgery along with a hysteroscopy, appendectomy, and another cystoscopy was November 2020. Since they were the same year, the first surgery helped me hit my deductible. The second surgeon and hospital was also in network so I paid $0. It was totally covered! My insurance paid almost $45,000 so it absolutely would not have been doable without the right coverage.