December 18th 2023
By Ari Parker
Find out if Medicare covers Urolift procedures and what other options are available. Learn about BPH, UroLift, Medicare coverage, and other alternatives for treatment in this post.
As we age, certain health conditions become more prevalent, and we have to take more care to check in with our bodies. A common issue in men over 50 years old is Benign Prostatic Hyperplasia, or BPH. This condition occurs when the prostate gland enlarges and causes urinary problems.
UroLift is a highly effective and minimally invasive treatment for BPH. To perform the UroLift, implants are used to lift the enlarged prostate away from the bladder and relieve symptoms.
If you’re considering the procedure, you might be wondering if Medicare covers this treatment for BPH. Fortunately, Medicare does cover UroLift if it is medically necessary.
Medicare does cover UroLift if it is medically necessary to treat BPH.
Other alternatives to UroLift are water vapor therapy, surgery, medication, or lifestyle changes. Medicare also covers these additional treatments for BPH.
For those facing frequent issues with urination and other bladder problems due to BPH, the UroLift treatment is a safe and minimally invasive procedure for relief. To perform the procedure, a medical professional places an implant around the prostate to push it out of the bladder’s way. UroLift typically takes less than an hour and can be done at your local doctor’s office under local anesthesia. There are no incisions or cutting involved with the procedure—the implants are inserted through the urethra.
The sensation of a full bladder even after urinating
Weakened urinary stream, including having to stop and start
Frequent urination
Sudden need to urinate
Issues with starting urination or straining during the process
Pain during urination
UroLift is a largely successful treatment of BPH. Almost 80% of men reported feeling much better after the treatment. The most common side effects after UroLift are pain and burning when urinating, but most people experience it mildly, if at all.
Without insurance, UroLift is an expensive procedure. The treatment for BPH can cost more than $10,000 depending on how many implants a person needs. Thankfully, Medicare does have coverage for UroLift.
Medicare covers anything that is related to the diagnosis and treatment of BPH, so it will pay for UroLift. It’s also important to know that Medicare covers prostate cancer screenings and blood tests once a year for men over the age of 50. These screenings are preventive services used to detect BPH and prostate cancer. This means the services used to diagnose BPH are covered as well. Both Original Medicare and Medicare Advantage cover the service, though out-of-pocket costs can vary depending on your plan. Consult with your provider to see exactly how much can should expect to pay for UroLift.
Depending on the severity of your condition, doctors may recommend other treatments. If UroLift isn’t right for you, you can also consider:
Lifestyle changes (like adjusting fluid intake) for milder cases
A more invasive treatment, like surgery, to remove prostate tissue pushing against the bladder
Medications to relax muscles in the area
Water vapor therapy—another minimally invasive treatment option for BPH where a medical professional inserts water vapor in the urethra to unblock enlarged prostate cells from the bladder
Because these options are related to the diagnosis and treatment of BPH, Medicare covers them if you need an alternative to UroLift.
Have more questions about what Medicare does and doesn’t cover? Speak with one of our licensed Advisors, who are eager to help you understand your plan and how to get the most out of Medicare. Get in touch by calling us at (855)-900-2427 or scheduling a time to chat with us.
