Does Medicare Cover the Urolift Procedure?

By Daniel Petkevich

Dec 6, 2022

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Good news, you're covered

If you are suffering from BPH, there's good news. Urolift is covered by Medicare Part B. But you should be aware that depending on which Medicare plan you have, you could save thousands of dollars on the procedure. So what plan is right for you? Let's find out.

What is the Urolift Procedure?

Urolift is a minimally invasive procedure that uses tiny implants to open the prostate, relieve symptoms of benign prostatic hyperplasia (BPH), and improve bladder flow. The procedure is performed on an outpatient basis using local anesthesia and usually takes less than 30 minutes to complete. Afterward, you can expect some mild discomfort for several days, and urination may be slightly frequent, but it should not interfere with normal activities. Recovery generally takes about a week, and the results are often long-lasting.

Does Medicare Cover the Urolift Procedure?

Yes, Medicare Part B covers the Urolift procedure when it is deemed medically necessary. However, coverage and costs vary by plan. Traditional Medicare (Part A & B), Medicare Advantage, and Medicare Supplement plans cover the cost differently. You should talk with your healthcare provider or insurance company to determine what you will be responsible for paying out-of-pocket.

How Much Does the Urolift Procedure Cost?

The cost of the Urolift procedure depends on your insurance coverage and plan. On average, the cost of the Urolift procedure can be $14,600. Medicare Part B recipients who are approved for the procedure can expect to pay 20 percent of the total cost as their coinsurance. In some cases, you may be subject to an additional deductible or copayment. If you are on a Medicare Supplement Plan G, you would only be responsible for the Part B deductible. You should contact your healthcare and/or insurance plan provider for specific details.

What are the Side Effects of the Urolift Procedure?

The Urolift procedure is generally considered safe and effective. However, as with any medical procedure, there are potential side effects. The most common side effects include pain or discomfort at the site of the implantation, blood in the urine or semen, urinary tract infection (UTI), and temporary retrograde ejaculation. Talk to your doctor about any concerns you have and the possible risks associated with the procedure.

Risks and Benefits of the Urolift Procedure

Yes, the Urolift procedure is generally considered safe and effective. It is minimally invasive and does not involve any cutting or removal of tissue. The procedure has been studied extensively in both clinical trials and observational studies and has proven to be a reliable treatment for BPH symptoms.

The Urolift procedure can provide relief from BPH symptoms such as difficulty urinating, frequent urges to urinate, weak urine stream, and nighttime urination. It can also improve urinary control, reduce the need for medications or surgery to treat BPH, and may even reduce the risk of developing prostate cancer. Moreover, the procedure is minimally invasive and can be done quickly in an outpatient setting. Talk to your doctor about the risks and benefits of the Urolift procedure for you.

Conclusion

Urolift is an effective minimally invasive treatment option for BPH. It can be covered by Medicare Part B when determined to be medically necessary. However, coverage and costs vary by plan. Be sure to talk with your healthcare provider before pursuing treatment. This content is for informational purposes only. For any Medicare-related questions, we are here for you. Call Fair Square Medicare today.