I have Anthem Blue Cross/Blue Shield and my policy covered the DaVinci
robotic surgery one year ago just the same as it would have covered any
other surgery. I think it would be difficult to argue that this surgery
is experimental given its widespread use and the number of hospitals
that have acquired the technology in the recent past. Of course, the
answer is going to depend a lot on what your hospital and surgeon are
charging. In my case, I think the hospital wasn't trying to recapture
all of its costs through billing. It was explained to me that insurance
companies have a favorable view toward the robotic surgery because of
the shorter hospital stays and less risk.

I assume you are in NY state. I am also, and have a Blue Cross HMO. I
received written approval for daVinci from them, and am scheduled for
9/18.

The answer is yes.  Moreover if opt to have it done in manhattan you
have the option of using sloan-kettering hospital and its doctors -- I
believe this is the only insurance they accept.

Also, my husband had this done with Dr. Tewari of NY Hospital.  We
recommend him highly.

Leah

This is an important question.  I perform these regulary at Newark Beth
Israel in Newark.
Almost all insurances cover this.  The last one in my area was Cigna,
who just last week officially said its OK, but who had been
precertifying them on a case by case basis without a problem.

The only issue I am familiar with is a patient of mine who flew from
California to have it done because his insurance (Kaiser) was an HMO
and did not approve it.

I agree with the recommendation of Dr Tewari, as I give out his name
often for second opinions.

I am in NJ and usually have a 3-4 week wait, but the wait isnt the
important thing.

My best advice- find a doc you trust, a hospital that you like and is
convenient, and then the timing should not be important.

I run a blog if anyone is interested on robotic surgery and had an
insurance posting if you would like more info.

http://www.njurology.com/RoboticSurgeryBlog/2006/07/when_having_insurance_doesnt
_p_1.php

Good luck,
Dr Savatta

I visited the robot in June '05 and my insurance (which is one of the
Medicare Advantage plans) covered the operation. I don't have a reference,
but I think Medicare approved robotic assisted prostate surgery a couple of
years ago. Since it's accepted by Medicare, I don't think any insurance
company will consider it as experimental.

.

Tom,

Sorry to hear that you have joined the club.  I have been reading about your
biopsy and now your surgery decision.  I had surgery in June and am now 11.5
weeks out.  My surgery was open and I was in the hospital a little over 24
hours, I looked for the doctor first and the procedure second.  Basically I
went with what my doctor did, and he had done over 3,500 operations and is
nationally recognized.  I joined the local Man to Man Prostate Cancer
Support Group right away which helped a lot because I got to interact with a
whole range of guy's with prostate cancer from advanced to early detection.
The big benefit for me was finding out about the best Surgeon's and
Radiologist and Hospitals in my area and having guys in my area to talk
with.  I also visited a hospital out of state to get a second opinion.  All
this took 6 months from the time I first got my elevated PSA test and my
pathology report was very good, negative margins etc.  So the bottom line is
take some time because as time passes the really scary feeling you may have
now lessens as you talk with more folks and realize your not alone.  One
other point, I chose the doctor and hospital close to home and I was glad I
did because more than likely you will have some issues, and you don't want
to have to resolve them long distance, plus the ride home is pretty
uncomfortable so you want it short and smooth, take a pillow and look at
this link it really helped me get ready.
http://www.phoenix5.org/Basics/treatsides/vossRP/vossRP1.html.

Best wishes,

Mike