FrankTalk.org

I went to a uro a couple of weeks ago on a referral from my primary doc for a general uro check-up. Everything fine, prostate in good shape, and then we talked about ED. He was in agreement with what I have done in the past, and agreed that injections would work in place of the pills which didn't do much for me. We set the appt for an injection and doppler for Mon 8/12.

On Friday the uro's office called to tell me that my Medicare Advantage plan had not approved the procedure. I contacted my insurance and was told that the Medicare Coverage Guideline on ED was that it is not a NECESSARY medical condition and that they don't cover Lavitra, Cialis and Viagra or any ED treatments. I kept the appointment and paid the cash price and the uro is understanding and will work with me. I will go for the second (teaching) injection in a week or so.

My questions for any who have had this insurance problem.....

Do any of the Medicare Advantage plans offer Ed treatment to non-surgical patients?
Is there a Medicare Supplement that offers this coverage?

I'm thinking I already know the answer, but would appreciate any feedback on this issue. Maybe I need a part-time job with benefits

phoenix, I believe the Med Adv plans balk at covering some things. It costs a lot, but Medicare Supplement policies are accepted by many more providers. It's the way it is, but it's not cheap.

My wife and I got cherry picked by an ins co to get the plan F supplement. It still costs us around $300 each month, but it's cheaper than United Healthcare endorsed by AARP (I am 74 and she is 72). I was pissed when I saw that they paid AARP a significant amount to get their endorsement.

If you or your wife have any significant health issues, It's probably hard or impossible to get a Med Supplement policy. My wife was accepted in a heartbeat, but it took some time for me and all I have is HBP and Chol both treated with meds.
Are you in the Phoenix area? I'm in Tempe.

tomas,

I am in the West Valley, just past the 101.

I am 73 and have a few medical issues that are well controlled. After I posted the above I looked at a couple of the supplement policies. I didn't delve into them as to the coverage, but figured the cash price at my uro was considerably less than the premium would be. For the first shot and a doppler he charged $206 and for the second shot (my turn) he is going to charge his lowest office rate. Then I shouldn't have to see him for a year, and the office visit should be covered as an annual all things uro exam.

Re AARP: I haven't seen what they got for their endorsement, but several years ago I realized that they were no longer an advocate, but just another business. Make money, spread it around as 'salaries' and keep their non-profit status.

We shall see what happens in the future, but until then Enjoy!

Pete

My primary insurance is Medicare and my secondary is United Health Care (not through AARP). I have a private prescription plan through my former employer.

Accordingly, my meds are covered separately and my Uro vists every 3 to 6 months are covered by Medicare (primary) and UHC (secondary).