The Surest guide to prostate cancer
You have so much to think about with a cancer diagnosis—the last thing you should have to worry about is your insurance. Surest offers comprehensive cancer care coverage. Use this resource to better understand treatment options and your coverage on the Surest plan.
Clinical Advocacy
The Surest clinical team can help you:
• Understand your treatment options
• Find in-network providers
• Coordinate care transitions
• Connect you with helpful resources
Types of doctors often involved in prostate cancer care
Several types of doctors and clinical professionals may be involved in your care. The doctors you see will be specialists in your diagnosis and may include:
- Urologists specializing in the male urinary and reproductive systems
- Medical oncologists specializing in the diagnosis and treatment of cancer
- Radiation oncologists specializing in using radiation therapy to treat cancer
- Surgical oncologists who have special training in cancer surgery
Search the Surest app or website for specialty provider or doctor's name. Copays can vary based on who delivers the service and where that service is provided. Surest copays (prices) are often lower for providers who may help you get better, faster. Share this information with your primary care doctor or oncologist.
Common tests
Laboratory tests
Search by name of test to find locations, copays, and other relevant information.
Urine and blood tests
- Many urine and blood tests, including prostate-specific antigen (PSA), are covered at a $0 copay when done by an in-network provider
- The price for most advanced laboratory tests can be found by searching the name of the test in the Surest app. If you can’t find a specific test, call Member Services at the number on your Surest member ID card for assistance. If your labs are drawn during a provider visit, a copay for the provider visit will apply.
Genetic testing
- Genetic testing is used to look for inherited gene mutations
- Many genetic tests need prior authorization before the test is done. Your in-network provider can initiate this authorization with Surest.
Imaging tests
The price for an in-network X-ray is $0 on the Surest plan. Prices for other imaging tests vary based on location. Note the copay is based on the specific location, not by health care system or group. Ask your provider to send your imaging test orders to the location of your choice.
Computerized tomography (CT) scan
A CT scan uses X-rays to make detailed pictures of parts of your body and the structures inside your body. During the test, you will lie on a table that is attached to the CT scanner. The CT scanner is a large doughnut-shaped machine.
Magnetic resonance imaging (MRI)
An MRI is imaging that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. When you have an MRI, you lie on a table and your body is moved into the MRI machine, where an image is taken of the area of the body being studied.
Positron emission tomography (PET) scans
PET scans use a doughnut-shaped special type of camera, and a radioactive substance called a “tracer” to look at organs in the body. A CT scan is often done at the same time as a PET scan.
Bone scan
A bone scan is a test that identifies new areas of bone growth or breakdown. During a bone scan, a small amount of radioactive substance (radionuclide) is injected into the bloodstream. A camera takes pictures of the location of the radioactive substance in the bone.
Prostate biopsy
A biopsy is a sample of tissue collected from an organ or other part of the body. The sample is then examined by a doctor, or pathologist, trained to look at tissue samples. The procedure of collecting the sample of tissue or cells is also called a biopsy. There are different ways to perform a prostate biopsy. Your provider will talk with you about which type of biopsy is best for your care. The copay for a biopsy procedure depends on the type and where it is performed. Search for the name of the biopsy in the Surest app to find in-network locations and copays.
Second opinions
With an increasing number of cancer treatments available, you may feel uncertain about your treatment plan and the path ahead. Our clinical team can help you understand your options.
They can also help you find doctors for a second opinion on your treatment plan. This consultation is covered by your Surest plan and provides another viewpoint from a specialist. Search the Surest app/website for the provider specialty (“oncologist,” for example) and “find providers” to see area in-network providers in that specialty, along with associated copay amounts. Call the provider’s office you choose and schedule a second opinion consultation.
Common prostate cancer treatments
Active surveillance
This may be an option if the cancer is slow-growing and confined to the prostate (localized). With active surveillance, you'll have regular checkups and tests, but you won’t have treatment unless the cancer grows.
Surgery
Surgery is used to prevent, diagnose, stage, and treat cancer. Surgery can also relieve discomfort or problems related to cancer.
Common types of surgery for prostate cancer:
• Laparoscopic prostatectomy: Removes part or all of the prostate gland using several small incisions in the abdomen, minimally invasive, sometimes involves robotic surgery
• Open prostatectomy: removes part or all of the prostate gland using a single incision in the abdomen
• Transurethral resection of the prostate (TURP): Removes parts of the prostate through the urethra
The copay amount is based on where you choose to have the surgery. Share information with your doctor to help determine the location for your surgery.
Radiation treatment
Radiation therapy uses high-energy particles or waves to destroy or damage cancer cells and to help keep them from growing. The most common types of radiation therapy for prostate cancer include:
- Conventional External Beam Radiation Therapy (EBRT)
- Intensity Modulated Radiation Therapy (IMRT), a type of EBRT
- Brachytherapy (internal radiation)
- Stereotactic Radiation Therapy (high-precision radiation therapy)
Copays for radiation visits are applied per session and the cost depends on the location. Some types of radiation therapy may need prior authorization. Your doctor will initiate this process with Surest.
Drug treatment
Drug treatment medicines may be used alone or in combination and can be given by infusion, injection, or as pills. Types of drug treatments include:
- Hormone therapy
- Chemotherapy that travels throughout the body to reach the cancer cells
- Immunotherapy to stimulate your own immune system to destroy cancer cells
- Targeted therapy that attacks the cancer cell’s inner workings
The cost for the treatment will depend on the type of drug and where you receive it. Injections and infusions can be given in the office, in an inpatient facility, or an outpatient setting. A copay will apply each time you go in for an infusion or injection.
Sometimes, an implanted port or central venous line may be needed for the delivery of drug treatment. Search for the procedure in the Surest app to view your cost for this. Some medications may need prior authorization. Your in-network provider can initiate this process with Surest if needed.
Other services that may be helpful
Dietitian
A visit to a dietitian—and understanding the role of nutrition—can help limit side effects during treatment. Your nutritional needs can ebb and flow as your treatment changes. The copay will depend on the dietitian you see.
Home care
Home care (home health care) services are usually provided through a home health agency. They can offer different types of home care services using nurses, therapists, social workers, home care aides, and medical equipment.
Acupuncture
Acupuncture applies needles, heat, pressure, and other treatments to specific places on the skin, called acupoints. This can help control symptoms such as pain, fatigue, and nausea.
Palliative care
Palliative care can improve quality of life when you have prostate cancer. Palliative care addresses symptoms and side effects, as well as any related psychological, social, or spiritual concerns. Palliative care does not include respite care or hospice services.
Support for stress, anxiety, and uncertainty
A cancer diagnosis often affects the emotional health of patients, families, and caregivers. You are not alone, Surest is here to help.
- You have benefits for both in-person and telehealth mental health care. Look on the Surest app under “mental health therapy” to find your copay.
- Clinical Advocates can help you find care. I'd like some help.
Resources you may find helpful
Member Services can help you with questions about your benefits. Call the number on your Surest ID card for assistance.
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This content is not medical advice. You should always consult with your health care professional.