Those that are considering prostate surgery and are covered by Australian Medicare may find that their financial burden is lessened, but could find other parts of their experience lacking. Knowing beforehand what to expect regarding insurance and prostate surgery can help avoid many surprises, including finding out something isn’t covered until it’s too late.
While prostate surgery is a vital part of treating prostate cancer, especially if the cancer has been found in the earlier stages, it is not always considered an automatic treatment for other prostate problems, such as an enlarged prostate. While an enlarged prostate is not considered to be a life threatening illness, it can cause some severe symptoms that can be quite painful and debilitating.
Whether or not the patient is covered by Medicare or through a private insurance carrier, in order to have the procedure covered, the patient and the doctor must work together to provide both documentation of the condition and proof that alternatives have been explored, leaving prostate surgery as a final option for treatment.
It will be up to the doctor to be able to provide clear documentation of the progression of the condition, as neither government-funded insurance nor private insurance will cover an unwarranted surgery. In some cases, private insurance companies will even refuse to cover a surgery if they feel that it can be treated in a less invasive manner.
Those that are covered by Medicare may find that their financial responsibility for the surgery may be lessened if they go into the hospital as a public patient.
This leads us to exploring alternatives to surgery. Insurance companies will want to be assured that other methods of treatment have been attempted with documented results before giving the go-ahead for surgery. Since an enlarged prostate can also be successfully treated through diet, supplement and exercise, they may wish to see proof that these were attempted for a reasonable amount of time before giving their assent for covering the surgery.
Those that are covered by Medicare may find that their financial responsibility for the surgery may be lessened if they go into the hospital as a public patient. However, these patients may not have the luxury of choosing their own doctor, and some of the medications may not be covered, leaving their cost to the patient.
Of course, those that are covered by private insurance institutions or wish to pay for their surgeries themselves may find other surprises if they do not research what will be expected of them beforehand. It is strongly recommended that anyone considering prostate surgery contact their insurance carrier to learn what their individual plans will cover and what they will be expected to take responsibility for. This is the best way to avoid the shock of a shocking hospital bill when you’re still recovering from prostate surgery.
