VEDs and Insurance Coverage

[dtwarren1942]

The handle on my Agusta Medical VED pump broke. I called AMS to inquire about a replacement. I was advised that Medicare stopped covering VEDs last July.

I called United Health Care (my supplemental insurance provider) and was advised that VEDs were still on their approved Durable Medical Device list.

Has anyone experienced receiving an amazing private health insurance coverage on their penis pumps since July, 2015?

[dg_moore]

That's interesting re Medicare vs. UHC. In general, the supplemental insurers will not pay for anything that does not qualify for Medicare coverage (such as acupuncture, for example), but maybe the rules are different for DME.

[dtwarren1942]

I have a continuous glucose monitor which is not covered by Medicare, but is covered by UHC. Hopefully, the same will be true of the VED.

I believe Medicare covers an implant (let me know if I am wrong) which costs thousands, but will not cover a VED which costs hundreds. I wonder what the logic is.

[ocitgo]

If you are a vet the VA covers them. There is still empathy for veterans. I got one the very last month that Medicare covered them. It is a high end $500 model. It is far better than the sex store pumps. It is funny that Medicare covers implants that cost 100 times more than a pump.

[dtwarren1942]

I called AMS and ordered the Soma ED negative pressure device aka penis pump ($110 for pump only) and will submit a claim to UHC with a copy of doc's prescription and see what happens.

Note that the price of the device is significantly (about $300) less than when it was covered by Medicare.