Insurance Coverage for Greenlight Laser Prostatectomy for Patients of New York Urology Specialists
by Dr. Alex Shteynshlyuger, a board-certified urologist and specialist in the treatment of enlarged prostate and complex urinary problems using minimally invasive approaches. He is one of the first urologists in the US and NYC to offer Urolift as a treatment for enlarged prostate. Our Manhattan offices are easily accessible for patients in Queens. Bronx, Brooklyn, Westchester and Long Island.
Greenlight Laser Procedure: Covered by All Medical Insurances
Greenlight laser ablation of the prostate for treatment of enlarged prostate and BPH is covered by all insurances. Greenlight laser is proven to be effective in the treatment of symptoms of BPH, obstruction and urinary retention. Preauthorization is typically necessary for commercial insurances prior to surgery.
Medicare Coverage of Greenlight Laser PVP for BPH
Medicare has approved payment coverage for Greenlight laser PVP for treatment of enlarged prostate in men in the United States, Puerto Rico, Virgin Islands and other US territories. There is no need for preauthorization for patients with traditional Medicare.
For patients who have Medicare Advantage plans such as Cigna Medicare, Aetna Medicare, UnitedHealthcare Medicare and Blue Cross Medicare plans, preauthorization is typically necessary.
Medicare pays for 80% of the cost of Greenlight laser PVP treatment for enlarged prostate. Secondary insurance typically pays the other 20%. Patients who do not have secondary insurance are typically responsible for 20% copayment.
What are the Requirements for Insurance to Cover the Cost of Greenlight Laser Therapy for Obstructing Prostate?
In order for health insurance to cover treatment with Greenlight laser for an enlarged prostate, a man needs to have had an appropriate evaluation by a board-certified urologist. This evaluation is performed at New York Urology Specialists offices. A typical evaluation includes measurement of uroflowmetry, post-void residual volume in the bladder, prostate volume and urinalysis. Cystoscopy and urodynamics are often performed prior to Greenlight laser vaporization and ablation of the prostate.
Typically, insurances require that patients have tried medical treatment for an enlarged prostate such as Flomax, Uroxatrol or finasteride. Men for whom medical treatment does not work or who have side effects to medications qualify for Greenlight laser therapy for enlarged prostate.
Men with persistent symptoms such as frequent urination, urinary urgency and slow urine stream despite taking medications such as Flomax also qualify for Greenlight laser PVP (photo vaporization) of the prostate.
All men who are in urinary retention, who require catheterization or unable to void are candidates for Greenlight laser of prostate or laser enucleation of the prostate.
What Costs are Covered by Insurance for Treatment with Greenlight Laser Prostatectomy?
For patients who are eligible for Greenlight laser prostatectomy and who have an insurance plan, all costs of treatment including hospital costs, anesthesia costs and surgical costs are covered. If you plan has deductibles or co-insurance, you will be responsible for them. Medications used after surgery if necessary are also typically covered by health insurance.
Why Choose New York Urology Specialists for Treatment of Enlarged Prostate (BPH) with Greenlight PVP Surgery?
- All treatment is performed by a Board-certified urologist experienced in treating men with symptoms of BPH using medical therapy, minimally invasive therapies, lasers and open surgery.
- We are one of the few practices in the region to offer a full range of options for treatment of BPH.
- We offer BPH treatment options under local anesthesia which avoids the risks, costs, and recovery from general anesthesia. Most men are able to return to office work and other normal activities the next day.
- Extensive Experience: Hundreds of men treated successfully using medical therapy, Urolift, lasers for BPH (Holmium, Thulium, Evolve, Greenlight lasers), Bipolar TURP, traditional TURP, open suprapubic prostatectomy, robotic suprapubic prostatectomy for BPH.
- We treat men with BPH who have heart problems (hypertension, CAD, CHF), renal failure (ESRD) on hemodialysis, men on blood thinners such as aspirin, Lovenox, Coumadin (Warfarin), apixaban, rivaroxaban (Xarelto).
When it comes to experience and innovation – New York Urology Specialists are a step ahead. Better Science Means Better Care. We specialize in minimally invasive highly effective treatment for symptoms of enlarged prostate and BPH. Many treatment procedures are performed in the convenience and privacy of office settings under local anesthesia.
Medicare and major insurances accepted. Urologist. We offer affordable rates and financing options.
Schedule an Appointment with Dr. Shteynshlyuger:
Dr. Alex Shteynshlyuger is a fellowship trained board-certified urologist with expertise in evaluation and treatment of urinary problems in men. He uses modern effective and proven treatment methods including Urolift for BPH. He is highly recommended by top primary care physicians in the New York area.
He has successfully performed hundreds of prostate procedures in adults. Greenlight laser procedures are performed in the office under local anesthesia, in a surgical center and affiliated hospitals under anesthesia.
We offer affordable, highest-quality urology care with or without insurance. Find out our office hours or directions to our office. We offer weekday, weekend and evening office hours.