44yr PSA180 Gleason9 non-metastatic. Surgery or Treatment?

@prettypass2000
So the first PSMA scan was covered by the German insurance (TK) after the urologist at the Uni Klinik Heidelberg requested it and my local urologist (not the one at the SLK Gesundbrunnen) wrote me an Überweisung. I got the PSMA scan at Uni Klinik Heidelberg as they were able to offer a appointment in a 2 week window versus the SLK in Heilbronn, where i had to wait 1.5 months for the next open spot.
The second PSMA scan I did again at Uni Klink Heidelberg. This time it was not covered by the insurance, and both Heilbronn and Heidelberg had the same cost (1600 Euros). I chose Heidelberg since they already had the data from my previous scan and they were able to include in the report a comparison between the first and second scan. Also, Heidelberg was able to give me the appointment a lot faster.
For this one I paid out of pocket. Since I am a Vet and the cancer is service related to my time in the Navy, I will be reimbursed by VA.
If I may ask, is your husband associated with the military? Is he a Vet as well?

@dinu My husband is not in military, but we use American insurance (CIGNA) here. We got PSA test done at UniversityKlinik Tuebingen on 29 Jan and then got PSMA PET/CT scan there on 4 Feb. We met with the chief urologist for the result on 12 Feb. So far, we have two appointments with radiation oncologists: one at Uni-klinik Tuebingen on this Friday and another one at Ludwigsburg Hospital on 2 March (the chief urologist here but he used to be at Uni-Klinik Tuebingen).

Unfortunately, we do have to pay everything out-of-pocket for outpatient visits like this, so sometimes they considered us "self-payers". CIGNA has been reimbursed us on all cancer-related costs, including the cost of second opinions we've got. From my personal experience, the medical fees are so varies here. That's the reason why I always go to couple places and get cost estimations & the chief physicians' portfolio to compare and choose the one we think it is best for us medically and financially. It's been mind blowing experience navigating through German medical systema and dealing with their billing departments, plus CIGNA.

P.S. It seemed the PSMA price at Uni-Tuebingen is higher. They quoted me 2,500 euros but They haven't sent the actual bills. I'll keep you posted when I get the actual bill. I'm anxious to know the exact cost. They always gave me estimation that is double of what the actual bills are.

Sorry you're joining this club!
A year ago my 55yo husband thought he just had enlarged prostate but PSA was almost 300, then CT showed it outside prostate, biopsy Gleason were mostly 8 and 9s. Then psma pet scan showed it all over his body!!
So far treatment has been firmagon shots (was supposed to switch to lupron after the first injection but doesn't want to) then zytiga and Prednisone pills plus he did chemo over the summer.
Another psma pet scan showed great improvement! Just a few spots still there.
He eats perfectly and exercises and is "fine" but who knows how long it'll last!
Cancer sucks!

@prettypass2000
Cost wise, when i did my second PSMA at Heidelberg, they gave me sheet to sign and there the price was listed, so it was upfront. PSMA was 1600 Euros. I also did not get the bill yet. Last September when I stayed overnight in the UniKlinik Heidelberg after my biopsy, I received the bill almost 3 months later. They are using an external service provider, similar to a bill collector in the states. So it takes time for them to process all the bills.

@beaquilter
thanks for sharing and i am glad that your husband is doing fine.
I am prepping up for the RARP in the next month or so. I do not have an exact date.
Are you guys based in the States or overseas?

In any case stay strong and be positive.

@prettypass2000
So the first PSMA scan was covered by the German insurance (TK) after the urologist at the Uni Klinik Heidelberg requested it and my local urologist (not the one at the SLK Gesundbrunnen) wrote me an Überweisung. I got the PSMA scan at Uni Klinik Heidelberg as they were able to offer a appointment in a 2 week window versus the SLK in Heilbronn, where i had to wait 1.5 months for the next open spot.
The second PSMA scan I did again at Uni Klink Heidelberg. This time it was not covered by the insurance, and both Heilbronn and Heidelberg had the same cost (1600 Euros). I chose Heidelberg since they already had the data from my previous scan and they were able to include in the report a comparison between the first and second scan. Also, Heidelberg was able to give me the appointment a lot faster.
For this one I paid out of pocket. Since I am a Vet and the cancer is service related to my time in the Navy, I will be reimbursed by VA.
If I may ask, is your husband associated with the military? Is he a Vet as well?

@dinu Thank you so much. Best wishes to you and wishing you speedy recovery after the RARP. We're based in Germany. My husband works here, and we've been here since 2017.