BPH Options

[Trooper]

Agree this really sucks. I can't believe the hospital can't provide a cost but that's Healthcare these days.

I'm pretty sure @grasshoper had HoLEP in Tucson if that works for you. I know Mayo Clinic does it in Phoenix, but not sure of the insurance coverage.

 

[erkevin]

The one Dr. who did HoLEP no longer does it.

 

[marko]

So this morning I was scheduled to have my aquablation........

Yesterday morning, I received a call from my urologist's office that the hospital now says that they are not in my insurance (BCBS) network. A month earlier, they said that they were and apparently someone made a mistake.

Two days ago, the hospital called me 2x. Once to take advance payment for the procedure (my deductible share, $2500) and the surgical nurse also called me to walk me through the procedure, etc.

But yesterday, someone learned how to read?

Only that hospital has the robotic arm for aquablation, so that puts me in a really crappy position. I called the hospital to inquire about self-pay. Transfer back and forth, back and forth, told to look on the website for estimated cost (not there) and never received any answer.

I checked for urologists up in Phoenix to do aquablation; none in network.

This leaves me with very few options:
Appeal through BCBS to get the hospital approved since they are the only one that has aquablation.
Have my urologist do a TURP on me instead of aqua.
Wait until 2026 so I can find better insurance (not really an option).

There is no HoLEP in my area (anymore).

Pretty discouraged and disgusted right now.

My God! This has to be so discouraging. I would try to push forward with self-pay if at all possible.

 

[MichaelB]

This situation is terrible, but what is the point of having insurance if you’re not going to use it. Any chance of an out of state option?

 

[Koolau]

erkevin, I'm so sorry to hear of this hospital SNAFU. Here's hoping you can figure another way though.

 

[grasshopper]

Stuff happens, My HoLEP in Tucson Was covered by AZ BCBS at Tucson Medical Center.

 

[Koolau]

A friend of mine was scheduled for knee surgery and everything was "fine." Just before the surgery she was informed by the hospital that her Veteran's benefits had been canceled. Say WHAT?!

When she called VA they said no, that didn't happen. You're fine. When she checked back with the hospital they said "NO, you have no benefits."

It took her months to get it sorted out. IIRC it was a SNAFU on both ends but not certain of that. In any case, she had to suffer on her bad knee all those months because of some "mistake."

 

[erkevin]

Stuff happens, My HoLEP in Tucson Was covered by AZ BCBS at Tucson Medical Center.

Did Choi do your HoLep?

 

[grasshopper]

Just called AZ Urology Assc, and asked for you. My guy was Andrew Wright. When I asked my urologist who I should pick He said both are good Dr Aye Lwin will get you in and out in one hour. Dr Wright will spend 4 hours, so I chose Dr Wright

 

[erkevin]

Thanks Grasshopper. TMC is in my network. Maybe I can self-pay for HoLEP and have the anesthesiologist and hospital covered by insurance/

 

[erkevin]

Update on my aquablation fiasco. I was very much misinformed last Thursday when I was told that only one hospital had the robotic arm for the procedure.

I met with my urologist today and he said that there is another hospital that does aquablations and that his (my urologist) partner has privileges at that hospital. So I am switching urologists within the same medical building/group.

Unfortunately, a window has now passed as I am committed to travel in April, May, and June. I will have to delay the procedure until late June at the earliest. I will have to live with that and am considering learning self-catheterization as my 127cc prostate has given me many a nighttime episode of "will it or won't it drain?" Being out of the country a couple of times in the near future, i am thinking that this would be prudent.

 

[Trooper]

Good to hear you now have a path to surgery, erkevin. The misinformation is sure frustrating however.

I think your leaning self-catheterization is a good idea, especially with your travel schedule and destinations. You may want to have a close look at your international medical coverage and pick up some medical insurance if necessary. I know you are not on Medicare so you may be covered overseas. Trip interruption/cancellation may not be a bad idea either.

I decided to learn self-cath and am getting trained tomorrow. This is to buy some time to have a consult with a surgeon to explore whether a BPH prostate reduction surgery is right for me.

 

[erkevin]

I am scheduled with my new urologist in 2.5 weeks. It is in the same medical group but at a different location so I am very relieved to no longer have to deal with the previous office staff (the doctor was good however).
As long as I have a plan going forward, I am in a good mental space (applies to all things in life, not just urology!)

 

[Koolau]

I am scheduled with my new urologist in 2.5 weeks. It is in the same medical group but at a different location so I am very relieved to no longer have to deal with the previous office staff (the doctor was good however).
As long as I have a plan going forward, I am in a good mental space (applies to all things in life, not just urology!)

Good to hear. Thanks for sharing your good news.

 

[Trooper]

Good news! Does this mean surgery in 2.5 weeks, or a consult?

 

[MichaelB]

You may want to have a close look at your international medical coverage and pick up some medical insurance if necessary. I know you are not on Medicare so you may be covered overseas. Trip interruption/cancellation may not be a bad idea either.

This is good advice.

 

[erkevin]

Good news! Does this mean surgery in 2.5 weeks, or a consult?

Consult. Already had MRI, urocuff, and cystoscopy. This is really just to meet the doc and see if I am comfortable with him. My window for the procedure temporarily closed as I have multiple commitments in April, May, and June (travel). I will shoot for a late-June aquablation.

 

[erkevin]

regarding travel insurance; I sometimes do purchase it. Mostly, I rely on the Chase Sapphire Reserve benefits. They have $100k in medical transportation, emergency medical coverage (limited), and multiple delay and cancellation of travel reimbursements.

 

[Trooper]

^Great. Just be sure you read the fine print regarding pre-existing conditions. I'm currently evaluating travel insurance for a few trips later in the year, and I've had a few health issues recently so I'm looking for potential gotchas.

 

[nwsteve]

^Great. Just be sure you read the fine print regarding pre-existing conditions. I'm currently evaluating travel insurance for a few trips later in the year, and I've had a few health issues recently so I'm looking for potential gotchas.

Second that re Chase. It has been awhile since I read the actual policy and the exclusions. Frankly was stunned by the narrow limits and pre-existing parameters

 

[qwerty3656]

For the people who are on long-term drugs, why not surgery?

 

[aja8888]

For the people who are on long-term drugs, why not surgery?

Well, for one, I have been under the knife over a dozen times in my life and it has never been fun. Plus, each time you risk not waking up from the anesthesia event. When the pill does not work anymore, I will go for the knife.

 

[Trooper]

When the pill does not work anymore, I will go for the knife.

+1. The pill(s) no longer work for me, so I am self-catheterizing until I consult with a surgeon to see if surgery is an option.

 

[Koolau]

Well, for one, I have been under the knife over a dozen times in my life and it has never been fun. Plus, each time you risk not waking up from the anesthesia event. When the pill does not work anymore, I will go for the knife.

I'm hopeful that when one pill doesn't w*rk, then doubling the dose may w*rk. I understand there are other pills that w*rk by different mechanisms (though with more and potentially worse side effects). I guess I'll take what comes.

 

[Trooper]

One pill makes you larger
And one pill makes you small
And the ones that mother gives you
Don't do anything at all.