Medicare and Prostate FAQs
What Does Medicare Cover for Prostate Cancer?
Medicare Part B covers two prostate cancer screenings:
Digital rectal exams
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:
Surgery
Radiation therapy
Cryotherapy
Hormone therapy
Chemotherapy
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:
Reactions to anesthesia
Bleeding from the surgery
Blood clots in the legs or lungs
Damage to nearby organs
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:
Urinary incontinence – unable to your urine or you may have leakage
Stress incontinence – urine leak when you cough, laugh, sneeze or exercise
Overflow incontinence – problem with emptying your bladder
Urge incontinence – suddenly you need to urinate
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.
YM05012301