Insurance for VED (the PUMP)

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7197
   Posted 2/19/2010 4:52 PM (GMT -6)   
I posted about my journey with my insurance company trying to get them to approve Viagra.
It may still be in the hopper, but I'm not holding my breath.
 
The next step will be the PUMP. I understand I need a letter, which I now have (from my doctor).
 
How has your insurance been on the PUMP?
 
Mel

63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms. 

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights.

Next Event: First post-op PSA on 3/1/10


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/19/2010 6:35 PM (GMT -6)   
My BC/BS required a prescription, a certificate of medical need and preapproval. The Uro. office had all the forms for ordering the Osbon, and it was a matter of filling forms and mailing them all off. I think the pumps are listed/coded as durable medical equipment. smilewinkgrin In a lot fo offices, the Osbon Rep. will meet with you and consult then teach proper use. hey make regular round, like drug reps.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
32 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


profman
Regular Member


Date Joined Jan 2010
Total Posts : 55
   Posted 2/19/2010 7:20 PM (GMT -6)   
Hi Mel - my insurance required a doctor's prescription, and paid for 80% of the pump - plus, the insurance company had a negotiated price for the device, so it was less expensive than I thought it would be. I had no problem with this, but insurance companies will vary.
Diagnosed 9/4/09, age 59
PSA 3.5, up from 1.8 year before
First biopsy showed 3/10 positive cores, Gleason 3+3, less than 10% involvement in all three cores, diagnosed as T2a
Thinking of Active Surveillance but
Second biopsy showed 5/10 positive cores, Gleason 3+3, left side (4 postitive cores) had 40% involvement
RRP on 12/15/09, home 12/16
Catheter out on 12/29/09 (failed cystogram earlier)
Path report was all good news, Gleason 3+3, no margin involvement, no perineural involvement, everything clean other than core of prostate, tumor on both sides, but more prevalent on left side, 5% involvement, 42 gram organ
Within two days down to one pad a day, now continent except if I sleep more than four hours
Back to work 1/4/10
First PSA 1/28/10 - nondetectable, next scheduled June 2, 2010
ED present, although blood does flow after Viagra. working with pump now - still trying!


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 2/19/2010 8:41 PM (GMT -6)   
My insurance company didn't pay for the pump. My uro told me to go to a adult store and buy one. It would be 5 times cheaper than the one he could sell and worked just as good. If you don't want to go to an adult store, got amazon.com and search for the ved devices. I bought am impo aid for about $100.
 
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
20 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3731
   Posted 2/19/2010 8:44 PM (GMT -6)   
My insurance paid ~80%. The Uro and rep took care of all the forms.
J

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 2/19/2010 11:36 PM (GMT -6)   
This is covered under durable medical equipment, like a walker, crutches, sleep apnea machine etc.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01


IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 2/20/2010 12:28 AM (GMT -6)   
Mine (Osbon) was covered 80% by insurance, ordered and picked up at a local medical supply store. It was pretty hassle-free.

Idaho
Surgery: Da Vinci; July 31, 2007; 54 on surgery day;
Pathology: PSA: 4.3; Gleason: 3+3=6; T2a; Confined to Prostate;
Post RP PSAs: 09/07 <0.04; 12/07 <0.04; 03/08 <0.04;
06/08 <0.04; 12/08 <0.04; 06/09 =0.06; 09/09 <0.04;
Latest PSA 12/09 =0.05

New Topic Post Reply Printable Version
Forum Information
Currently it is Thursday, April 19, 2018 11:49 AM (GMT -6)
There are a total of 2,953,196 posts in 323,981 threads.
View Active Threads


Who's Online
This forum has 162056 registered members. Please welcome our newest member, PhantomColon.
410 Guest(s), 12 Registered Member(s) are currently online.  Details
81GyGuy, Kent M., GoBucks, sandyfeet, Manticore, APL1881, Beccak, Scaredy Cat, BillyBob@388, BrookieGirl, Redwing57, Imbeccak