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Does Medicare Cover Prostate Surgery and Cancer Treatment?

 

Discover what Medicare does cover for prostate cancer, including screening, biopsy, surgery, and other treatments.

David Minaya
May 3, 2022

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Medicare and Prostate FAQs

What Does Medicare Cover for Prostate Cancer?

Medicare Part B  covers two prostate cancer screenings:

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Digital rectal exams
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PSA blood tests
How Much Does Prostate Screening Cost?
If your doctor accepts Medicare assignment , original Medicare covers the cost of one PSA blood test per year. After you pay the annual Part B deductible, a yearly digital rectal exam costs you 20% of the Medicare-approved amount.
What Does a Prostate Biopsy Cost?

To diagnose prostate cancer, your doctor may perform a prostate biopsy. The cost depends on your Medicare plan. A Medicare Supplement plan or Medicare Advantage plan may cover the cost of your prostate biopsy.

Prostate Surgery Does Medicare Cover it?
Medicare can cover inpatient or outpatient  prostate surgery. Typically, outpatient hospital stays are less than 24 hours. If an outpatient observation service lasts longer than 24 hours, you must get a Medicare Outpatient Observation Notice (MOON). What you pay as an inpatient or outpatient may be different. Medicare Part A covers your inpatient hospital stay. Medicare Part B covers doctor services that may include prostate surgery.

Prostate Cancer Treatments

Some prostate cancer treatment options  may include:  

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Surgery
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Radiation therapy
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Cryotherapy
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Hormone therapy
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Chemotherapy 
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Immunotherapy

Surgery for Prostate Cancer

According to the American Cancer Society , the main type of surgery for prostate cancer is a radical prostatectomy. The surgeon removes your prostate gland in this operation and may also remove lymph nodes to check them for cancer.

The risks of prostate surgery may include:

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Reactions to anesthesia 
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Bleeding from the surgery 
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Blood clots in the legs or lungs
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Damage to nearby organs
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Infections at the surgery site
 

Your risk depends on your health, age, and the skills of your surgical team.

Side Effects of Prostate Surgery

You may experience the following side effects  from prostate surgery:  

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Urinary incontinence – unable to your urine or you may have leakage
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Stress incontinence – urine leak when you cough, laugh, sneeze or exercise
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Overflow incontinence – problem with emptying your bladder 
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Urge incontinence – suddenly you need to urinate
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Erectile dysfunction – unable to keep an erection

Shop for Medicare coverage at Senior Healthcare Direct. Call 1-833-463-3262, TTY 711 to speak with a licensed agent or get a quote.

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