A disappointing setback

[OregonStrong]

I did find through searches there is a doctor in network (I have Moda insurance) in the Portland, OR area Dr. Stanley Myers. His website says he does implants and has worked with Drs. Eid, Perito before, but I've never seen his name come up on this board before, so I don't know what kind of volume he does, cost, etc, but again, it may be a moot point if my insurance won't cover any of this. Kinda wish Kramer's office had looked into this earlier, not one week before the surgery, I hate to have to cancel on them last minute due to insurance issues (and having already booked flight, hotels).

[Larryb8x8]

No dishonesty whatsoever I have Blue Cross Blue shield. With your testicular implant problem they questioned nothing. I personally didn't want to do it either. I believe in the Lord

[Captain1117]

Sorry to hear about this development.

[warrenw]

Kinda wish Kramer's office had looked into this earlier, not one week before the surgery, I hate to have to cancel on them last minute due to insurance issues (and having already booked flight, hotels).

Is there any possibility you could put the charges on a couple of credit cards or other short term loans? Also ask Kramer for a cash discount since you won't be using insurance, that could save 10% or more. Lastly, your medical expenses are tax deductible for federal and maybe state taxes, so that could help some.

Bottom line, being this far along with planning and scheduling, you are so close, try to make it work with Kramer as planned.

[cobylinks]

Think about a go fund me.
I'd throw in a few bucks to help a brother who was getting the shaft.
no pun intended.

[OregonStrong]

Kinda wish Kramer's office had looked into this earlier, not one week before the surgery, I hate to have to cancel on them last minute due to insurance issues (and having already booked flight, hotels).

Is there any possibility you could put the charges on a couple of credit cards or other short term loans? Also ask Kramer for a cash discount since you won't be using insurance, that could save 10% or more. Lastly, your medical expenses are tax deductible for federal and maybe state taxes, so that could help some.

Bottom line, being this far along with planning and scheduling, you are so close, try to make it work with Kramer as planned.

I could probably put these on credit cards if I had to, but what happens if I got an infected/defective implant? If you read some of my older posts, I am a much higher risk for infections because of some previous fillers and such I had done. Reading old threads, one guy on here had to pay $70,000 for removal of an infected implant and salvage operation, since his insurance wouldn't even cover the initial implant. I hate to play the what if game, but if insurance is going to possibly be that way, I am not sure I want to take that risk, it could ruin me financially.

[Waynetho]

So Kramer's office called, their insurance person who does precertification called my insurance provider and it appears implants are a plan exclusion. I thought I had good insurance but my employer is self funded for insurance costs and therefore they probably made decisions to keep costs down for all employees which I understand. This sucks though. I dont have $24,000 to pay out of pocket. Gonna talk to my HR to see what can be done. Didnt want anyone in my company knowing about this, but unavoidable now. This is disheartening. May have to cancel the surgery now. I dont want to wait til I'm 65 and Medicare to fix this.

I had a similar exclusion in my employer-funded insurance but there was an INCLUSION for treatment of PEYRONIES DISEASE as that is a physical injury and the gold-standard treatment/repair for PD is an implant. Your insurance probably excludes implants for enhancement and possibly for erectile dysfunction since there are other treatments such as VED and injections that can treat ED. PD is best treated by IPP.

Check with your Insurance Admin to see if they cover implants to treat PD.

I was approved right out of the gate because I had severe PD with ED.

[OregonStrong]

So Kramer's office called, their insurance person who does precertification called my insurance provider and it appears implants are a plan exclusion. I thought I had good insurance but my employer is self funded for insurance costs and therefore they probably made decisions to keep costs down for all employees which I understand. This sucks though. I dont have $24,000 to pay out of pocket. Gonna talk to my HR to see what can be done. Didnt want anyone in my company knowing about this, but unavoidable now. This is disheartening. May have to cancel the surgery now. I dont want to wait til I'm 65 and Medicare to fix this.

I had a similar exclusion in my employer-funded insurance but there was an INCLUSION for treatment of PEYRONIES DISEASE as that is a physical injury and the gold-standard treatment/repair for PD is an implant. Your insurance probably excludes implants for enhancement and possibly for erectile dysfunction since there are other treatments such as VED and injections that can treat ED. PD is best treated by IPP.

Check with your Insurance Admin to see if they cover implants to treat PD.

I was approved right out of the gate because I had severe PD with ED.

I emailed my insurance company about a few issues, hopefully I'll hear back tomorrow, but the PD won't work in my case, mine is straight as an arrow.

[Waynetho]

I emailed my insurance company about a few issues, hopefully I'll hear back tomorrow, but the PD won't work in my case, mine is straight as an arrow.

My severe PD wasn't totally visible. I had a bit of an upturn (30 degrees or so) and a bit of hourglass on the right side.

What I did have was a nickel-sized plaque where the hourglass depression was, another plaque on the left side a ways back and a large 2 cc plaque at the base inside the right corpus cavernosum along with the beginnings of a pretty severe plaque at the base on the other side.

Much of this wasn't visible very much but it was still enough to qualify as PD. Have your doctor examine you for *ANY* plaque - anywhere within your distal or proximal corpora. Any plaque in the crus may affect your erection.

[OregonStrong]

I emailed my insurance company about a few issues, hopefully I'll hear back tomorrow, but the PD won't work in my case, mine is straight as an arrow.

My severe PD wasn't totally visible. I had a bit of an upturn (30 degrees or so) and a bit of hourglass on the right side.

What I did have was a nickel-sized plaque where the hourglass depression was, another plaque on the left side a ways back and a large 2 cc plaque at the base inside the right corpus cavernosum along with the beginnings of a pretty severe plaque at the base on the other side.

Much of this wasn't visible very much but it was still enough to qualify as PD. Have your doctor examine you for *ANY* plaque - anywhere within your distal or proximal corpora. Any plaque in the crus may affect your erection.

Good suggestions, wonder if Dr. Kramer can appeal to this fact afterwards and get things covered retroactively.