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Tulsa Pro and Insurance
Seriously considering TULSA PRO. I appear to be a very good candidate due to my localized tumor location in the transitional zone (nearer to the urethra). PSA 4.5, Gleason 3+4=7 in one core, PIRAD 5 spotted on MRI, location is front base left side. Anyways, talking to a couple of centers in Florida that do TULSA PRO one is cash only and other is Mayo Jax. If you’ve done TULSA PRO focal ablation (not whole gland) what was your cost and were you able to get insurance to pay for any of it? If you did it at Mayo Jax did they help you with insurance? It seams to be very pricy at these cash only facilities. Just curious.
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Just contact BCBS and let them know your plans. Yes, they just started accepting it this last Fall. I had mine done on a Weds afternoon. Wife and I went on a 2 mile hike Thursday morning. Removed Cath on Friday am. All done. No pain meds. Just keep the tip moist with Lidocaine cream.
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Have you had the Tulsa procedure? Did BCBS coverage as expected?
I did and I am really happy with the results. Just went on March 26th for my 3 mos PSA and the results were outstanding. 0.51. Yes BCBS paid 100% since my max out of pocket was met. Had the precedure done on 12/10. They did a Hemi gland ablation to the entire front half of my prostate. Zero urinary, zero ED, and had sex 3 weeks after the procedure. I am very happy with my results and Dr said the 3 mos test exceeded expectations. Let me know what else you want to know.
What Anthem BCBS pays can vary based on if it is paying or is administering for a company that is paying. Its official policy is that HIFU/Tulsa Pro is not medically necessary for prostate cancer (reviewed 11/25, published 1/26). In that case they do not even honor any discount they have and say you owe the full billed amount to the provider. Other BCBS organizations may pay. Glad you got procedure paid but is still probably a fight for most patients in USA that do not have classic Medicare.
https://www.anthem.com/medpolicies/abc/active/gl_pw_d091799.html
@jim18 Ok, I paid $0.00.
@aktbear I had the TULSA PRO done Nov. 2024. I paid out of pocket $33K. No pain, no side effects. Wore catheter for two weeks and then everything was normal. My last PSA was 0.8 and my Dr. said cancer is gone. My VA benefits paid everything except for the procedure. I highly recommend getting TULSA if at all possible.
Just published: Use with insurers on appeals
https://radiologybusiness.com/topics/medical-imaging/magnetic-resonance-imaging-mri/mri-guided-ablation-effective-surgery-prostate-cancer-treatment
@bobbygene 100% 🔥💯
@thmssllvn Great article and I 100% agree. I’m so happy I took the time and had time to investigate all my treatment options and chose Tulsa Pro. It was definitely the right option for me. I pray that the cancer is gone and won’t come back.
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1 ReactionI had Tulsa Pro, mentioned my cost above, but am now having a recurrence so not too happy these days. I think one thing I ran into, and maybe it helps somebody if I mention it, but Dr Scionti told me he would take 70 or 75% of prostate out with Tulsa. It appears he only did about 40% in talking to imaging and other places since him. 40% was NOT enough to get all my cancer. If he had done what he told me I would be probably fine. Now he doesn't want to handle me so pooh (putting it kindly) is all I think on that. Anyway, if getting Tulsa, my experience says higher % ablation fraction is a good idea. Again, just bringing it up so anyone else getting Tulsa can opt for higher ablation fraction. Do 70% or whatever, not 40%.
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