Is Rezūm Therapy covered by insurance?
Rezūm Therapy is considered a covered benefit by Medicare and most private insurance. However, there is no guarantee of insurance coverage for a particular procedure or product. It is the responsibility of the patient to contact their insurance provider for specific coverage information.
How can I find out if my insurance company will cover the Rezūm procedure?
We recommend a verification of benefits be done with your insurance company several days, if not weeks, in advance of the scheduled Rezūm procedure. The verification of benefits is a crucial component to understanding the exact coverage criteria under your plan. Your plan may require a Prior Authorization and/or allow for a Pre-determination. These processes are meant to allow your health insurance company the opportunity to evaluate your treatment plan and specifics of the request to review for medical necessity. Please ask your doctor’s office about your anticipated coverage options.
How much does Rezūm Therapy cost?
Cost depends on your insurance company and your benefit package. While more and more plans cover Rezūm Water Vapor Therapy, it’s always a good idea to discuss any deductibles or out-of-pocket costs with your doctor’s office up front. However, there is no guarantee of insurance coverage for a particular procedure or product. It is the responsibility of the patient to contact their insurance provider for specific coverage information.
What if my health insurance company has denied coverage for Rezūm Water Vapor Therapy?
If your health insurance company has denied coverage for Rezūm Water Vapor Therapy, you may want to appeal the denial by following these steps:
- Contact your doctor’s office and ask if they will submit an appeal on your behalf.
- Contact your insurance company and ask to appeal the decision. They will be able to provide you with next step instructions.
How can I find out if my claim for Rezūm Water Vapor Therapy has been submitted to the insurance company?
To find out if your claim has been submitted to your health insurance company, you can contact your doctor’s office directly or contact your insurance company (using the telephone number on the back of your insurance card). You may need to know the date your procedure was performed. It is often best to have this and your insurance information readily available prior to your call.
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All treatments have inherent and associated risks. The Rezūm System is intended to relieve symptoms, obstructions, and reduce prostate tissue associated with BPH. It is indicated for men ≥ 50 years of age with a prostate volume 30cm3 ≤ 80cm3. The Rezūm System is also indicated for treatment of prostate with hyperplasia of the central zone and/or a median lobe. Potential risks include but are not limited to painful urination (dysuria), blood in the urine (hematuria), blood in the semen (hematospermia), decrease in ejaculatory volume, suspected urinary tract infection (UTI), and urinary frequency, retention or urgency. You should talk with your doctor about benefits and risks before moving forward with any treatment option.
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