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[Final Update] My insurance won't cover UTIs for males. Yes, I'm in the US.
(self.mildlyinfuriating)
this post was submitted on 25 Jun 2023
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Mildly Infuriating
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I’m not going to defend health insurance companies, but this is not because of your insurance. CVS will only see patients with simple medical problems because they 1) are not equipped for more in-depth diagnosis and treatment and 2) don’t want the liability associated with such. UTIs in males are medically complicated, by definition which has a very specific meaning. Males don’t just get UTIs like females do, because the male urethra is significantly longer, providing significantly more protection from bacterial retrogression to the bladder. The long story short is that if you are a male with a UTI you need to go to an actual healthcare facility and see a qualified professional, not an NP/PA at your local CVS.
Source: am a pharmacist
You explained how getting UTIs for men is different than women, but you don't really explain how treating it is more complicated.
Because it's much less likely for men to get a UTI in the first place, it's much more likely that if they have one, that it's not a simple "throw some bactrim at it and it will go away" situation. With a male UTI, there's a higher chance that the UTI is in fact a symptom of a more serious issue, rather than the issue itself. And determining that requires diagnostics that are beyond the scope of what can be done at a minute clinic.
So why no referral?
Because someone needs to collect a comprehensive history from the patient to decide what kind of/if a referral is needed. The assembly line care at CVS isn’t geared for this.
It’s different because it requires significantly more diagnostic effort to determine the root cause, which corresponds to more effort to treat. Women have a urethra that’s extremely short. They can get a UTI from routine activities like having sex or wiping from back to front after having a bowel movement. The treatment for cases like these is extremely simple: just prescribe an antibiotic.
With males, the urethra is so long that it’s almost impossible to get a UTI because of things like these. When males get a UTI, they are caused by things like kidney stones, anatomical abnormalities, indwelling catheters, etc. Your average CVS practitioner is not going to be able to order imaging and determine whether your kidney stone needs to be broken up. Or make the determination as to whether surgery is needed to correct some other abnormality. Additionally, these complicating factors that cause UTIs in men can lead to more complications down the road. For example, if you have a kidney stone causing a UTI, you don’t have cystitis (infection of the bladder) but rather pyelonephritis (infection of the kidney). Giving an antibiotic will not treat this because the stone will continue to seed the infection. Meanwhile, you are at increased risk of having the infection spread to your blood (sepsis), which doesn’t generally happen with cystitis.
CVS cannot help you with this. Frankly I wouldn’t trust CVS with my primary care even for the categories that are in OP’s picture because CVS’s exam room care is meant to make money, not provide comprehensive care.
I'm not saying you're incorrect, but this is inconsistent with my experience. I have had about 6 or 7 UTIs, and across multiple urgent care facilities, the experience has mostly just entailed me getting urinalysis, something a MinuteClinic is capable of, and being prescribed antibiotics. Once they sent me to an ER instead and that time I was giving imaging, but it seems like plenty of places are willing to just make the call to prescribe antibiotics and recommend following up with a primary care provider afterwards. This has also always been covered by insurance. I'm not saying they've ever solved the root problem, but they have no issue treating the symptom. I'm not sure what I'm missing or if my city's healthcare just sucks or what.
And yes, I know that statistically something is wrong with me. I've talked with my new primary care provider about it and they're basically just telling me to monitor it and give them a call if it happens again.
Riiigghhttt! I can understand that that differences in physical biology demand different attention. That's not what I'm complaining about. It's the way it's set up. I was told that at my appointment. Why not just refer me to a specialist? The website could've even just referred me to urgent care. But, no, their goal is to obfuscate and irritate until the patient gives you and pays out-of-pocket.