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Advanced Prostate Cancer
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PSMA Tests and Social Security - What is your Experience?

I am going to be taking a PSMA test. I am told that generally insurance covers the PET scan part of the test, but that you have to pay for the contrast agent out of your pocket.

I am new to Medicare. It is my understanding that if Medicare is paying for treatment, they will not permit that same provider to charge extra for anything. Does that mean that under Medicare, in order to get a PSMA test, I will need to find a provider that doesn't accept Medicare and then pay for the entire test myself?

2 Replies

Hopefully you have a Medicare SUPLIMENT, I have mine with AARP/United Health Care, they are excellent! I'm not conversant with PSMA but all my scans with contrast have been fully covered, less your CoPay etc; minor charges compared to original cost!

I use SUPLIMENT "N", but I believe "F" covers and costs a little more, also United HC told me of a new one, I think it was "G" or maybe "I"?


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If I can help, just ask, I might have an answer? :-)


If you can, choose a Medigap policy which pays for everything owed after Medicare pays. The Medigap policy has an additional monthly charge. In my case it is working for me. Look into this since we are in the enrollment period for 2018.


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