Humana Denied Treatment for BPH

[Kurtkampy]

Hi my name is Kurt, I'm 61 and suffering from BPH. I had it come on the last 3 years or so to the point I have a very weak stream, and only void half my bladder. My doctor recommended treatment about a year ago, the Greenlight Laser. I didn't want to have this because of the possible side effects, and lately he has told me they are now doing the Urolift procedure which is less invasive and less side effects and quicker recovery. The problem is Humana has turned it down because they are calling it experimental even though it has been around over 5 years and has a great success rate. What makes me angry is most of the major insurers cover this, such as United Health Care, Anthem, Blue Cross, Aetna, and Medicare. My doctor has stated I need treatment soon, so I can't wait for Medicare, and the out of pocket expense would run about $34,000, so I am stuck in limbo. I was wondering if there are other guys in the same position as me? My doctor's office even wrote an appeal on my behalf and Humana turned it down again. They even have the rep from the Urolift company contacting Humana about their decision and it's just extremely frustrating, Humana holds a healthy relationship with my wife of 32 years in their hands. So if there are others in my position, or will be soon, maybe a few more calls and letters to Humana may help. Thanks for listening.

Kurt

[Kurtkampy]

As it was explained to me, they would like to do the procedure in the office but hasn't been approved for this yet. Therefore it has to take place in the hospital, where cost are much more expensive. I believe one of the higher cost is insurance cost for the hospital, which is added on to the procedure.

[Kurtkampy]

I am on alfusozin for BPH. Even with that I can only void about half my bladder. So in the long run I will run into problems. Humana is suppose to cover it soon, but I'll see if I can wait that long. The decisions and appeals take for ever and I don't have that long to wait.