Urolift Procedure for BPH and Enlarged Prostate – Cost and Insurance Coverage
Dr. Shteynshlyuger is a board-certified urologist and specialist in the treatment of enlarged prostate and complex urinary problems using minimally invasive approaches. He is the Director of Urology at New York Urology Specialists. He is one of the first urologists in the US and in New York City to offer Urolift as a treatment for enlarged prostate. Dr. Alex Shteynshlyuger is an experienced, board-certified urologist who is among the first doctors in the United States to offer the Urolift prostate procedure to men for treatment of enlarged prostate.
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Cost of Urolift Procedure: Considerations
There are two parts to consider when discussing the cost of the Urolift procedure.
The first part is a professional fee charged by the urologist performing the procedure. If the Urolift procedure is performed in the office settings this charge will typically include facility costs and nursing costs as well as supply costs used to perform the procedure.
If the procedure is performed in the hospital or surgical center, a separate fee is typically charged by the hospital or surgical center for the facility use and anesthesia. It is obviously less expensive to have the procedure performed in the office under local anesthesia.
The other cost consideration is the actual cost of the Urolift implants. A typical patient will need anywhere from 4-6 Urolift implants. Some patients may require more than 6 Urolift implants to be placed during the procedure to obtain the maximum benefit. These implants are fairly costly with overall cost close to $1000 for each implant.
Good New: Insurance Coverage for Urolift Procedure
Most insurance companies recognize that Urolift is a good treatment option for many men with BPH. As a result, our insurance specialists at New York Urology Specialists are able to get insurance coverage for most men with commercial individual and employer-provided insurance as well as with Medicare.
Good New for Men with No Insurance or High Deductible: Urolift in Our Office Saves you $$$
New York Urology Specialists is a leader in offering Urolift procedure under local anesthesia. In fact, more than 80% of our patients have the Urolift procedure done in the office setting under local anesthesia whether they pay out-of-pocket or are covered by insurance.
The procedure takes 15 minutes to perform. Most men have minimal discomfort and are able to go home an hour after the procedure. Safer than having the procedure done in the hospital as our infection rates are lower and there is no risk (or cost) of general anesthesia.
This saves you tremendous amount of money compared to what hospitals charge – so much hospitals won’t tell you the price!
Flat Fee for the Urolift procedure? You are paying too much!
if you have been offered a fixed price for the Urolift procedure you are probably not getting the best deal. Ask how many Urolift implants are included in that price and what will happen if you require more than that number of implants for an optimal result? What would happen if you require fewer implants than that are included in a ‘flat-fee’ pricing? Most likely with flat fee price you will get fewer than optimal amount of Urolift implants and will pay a premium for these.
At New York Urology Specialists our goal is to provide an optimal outcome for our patients at a fair price. For this reason, we do not offer flat pricing. Because we did not make money on Urolift implants, we have no incentive to use more Urolift implants than is necessary. Our fee for each Urolift implant simply covers the cost of the implant and the handling charges.
Overall Cost of Urolift Procedure
The overall cost of Urolift procedure should also include the cost of the evaluation. All patients interested in Urolift procedure will need to have at the very least a cystoscopy in the office to evaluate whether they are a candidate for the Urolift procedure. Cystoscopy performed elsewhere will need to be repeated as it is a visual evaluation and this 3-dimensional perspective cannot be obtained from a report of a cystoscopy performed elsewhere. A urodynamic test may also be necessary.
How do costs of Urolift Procedure compare to using Medications for the Treatment of Enlarged Prostate
Typical medications for BPH and Enlarged prostate are Flomax or Rapaflo often used in combination with a medication such as Proscar (finasteride). Typical out of pocket cost for these two medications runs $150-200 per month or $1800-$2400 per year; over 5 years the cost is more than $10,000. For patients with insurance and copay of $20 per prescription per month, the cost will run anywhere from $240 for one medication to $480 for 2 medications. Over the first five years, the cost would be expected to be $1200 to $2400.
Urolift for BPH: Making it Affordable
Urolift procedure offers a comparatively good investment compared to medical treatment. Financing options are available.
Insurance Coverage for Urolift Procedure
Medicare and many other insurances cover the cost of a Urolift procedure. If you are interested in the Urolift procedure, please schedule an evaluation. If you are a candidate for the Urolift procedure we will request coverage determination from your insurance company. Typically insurance companies require pre-authorization for a Urolift procedure. We cannot obtain preauthorization until the doctor has evaluated you and determined that you are a candidate for the Urolift procedure.
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.
Dr. Alex Shteynshlyuger is 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 in New York City to offer Urolift as a treatment for enlarged prostate.