Patient Insurance Coverage

Boston Scientific, the manufacturer of SpaceOAR Hydrogel is devoted to partnering with healthcare professionals and patients to navigate today’s ever-changing health insurance system.

Does Medicare cover and reimburse for the SpaceOAR Hydrogel procedure?

Yes, currently all Medicare Administrative Contractor’s (MACs), cover and reimburse for the SpaceOAR Hydrogel procedure.

How can I find out if my insurance company will cover the SpaceOAR Hydrogel procedure?

Boston Scientific’s Benefits Verification and Pre-Authorization Team can confirm if SpaceOAR Hydrogel is considered a covered procedure and if a preauthorization is required by your insurance carrier, and verify any out of pocket costs associated. Please contact your physician’s office to work with our benefits verification team prior to scheduling your SpaceOAR Hydrogel procedure.

Is there a financial assistance program available for SpaceOAR Hydrogel?

Unfortunately, there are no formal financial assistance programs available for the SpaceOAR Hydrogel procedure through Boston Scientific.

What if my health insurance company has denied coverage for the SpaceOAR Hydrogel procedure?

Please work with your physician’s office to contact Boston Scientific’s Benefits and Pre-Authorization Team.

My health plan does not consider SpaceOAR Hydrogel as medically necessary. What can I do as a patient?

If your health insurance company has denied coverage for the SpaceOAR Hydrogel procedure, we recommend appealing the decision;

  1. Contact your health plan directly and request a copy of the denial letter. After careful review of your appeal rights, you may use the enclosed letter of medical necessity template and submit a formal appeal directly to your insurance plan, or;
  2. You may work with your physician’s office on submitting your denial to Boston Scientific Benefits and Pre-Authorization team for support.
  3. If you are enrolled in an employer-sponsored health plan, this guide and sample appeal letter may be helpful as you pursue coverage.

Have more questions? We can help.

Sign up to receive more information about SpaceOAR Hydrogel. Our patient education team can provide you with details about how SpaceOAR Hydrogel works, what to ask your doctor and how to find a doctor in your area.

Are you a physician looking for more information? Please click here.

Caution: U.S. Federal law restricts this device to sale by or on the order of a physician.

SpaceOAR Hydrogel is intended to temporarily move the rectal wall away from the prostate during the course of radiotherapy treatment for prostate cancer, and in creating this space it is the intent of SpaceOAR Hydrogel to reduce the radiation dose affecting the rectum. 

SpaceOAR Hydrogel contains polyethylene glycol (PEG). As with any medical treatment, there are some risks involved with the use of SpaceOAR Hydrogel. Potential complications associated with SpaceOAR Hydrogel include, but are not limited to: pain associated with injection, pain or discomfort from the  hydrogel, site inflammation, infection (including abscess), inability to urinate, urgent need to urinate, constipation, rectal muscle spasm, damage to lining of rectum, ulcers, fistula (a hole between rectum and bladder, urethra, or skin below the scrotum), perforation (hole in prostate, bladder, urethra, rectum), necrosis (dead tissue), allergic reaction (local reaction or more severe reaction, such as anaphylaxis), embolism (blood vessel blockage is possible and may happen outside of the pelvis, potentially impacting vital organs or legs), fainting, and bleeding. Please talk to your doctor about the risks and benefits related to using SpaceOAR Hydrogel. If one or more of these complications occur, you may need medical treatment or surgery. URO-1288805-AA APR 2022

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Content of this web site is for Informational Purposes only and does not constitute medical advice and should not be used for medical diagnoses. Boston Scientific strongly recommends that you consult with your physician on all matters pertaining to your health or to address any clinical/medical questions.

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URO-747416-AC OCT 2021