Wise insurers ?

The final frontier. Deciding when, if and how.
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Positivemofo
Posts: 2
Joined: Sat Mar 21, 2026 1:40 pm

Wise insurers ?

Postby Positivemofo » Tue Mar 24, 2026 6:34 am

Tajkarimi : ​"Many of you are wondering whether your health insurance will cover this three-piece implant. In the past five, ten years, almost 45 to 55% of health insurances, private payers, have started to deny covering this procedure. Even Medicare in six states requires pre-authorization, so this procedure is becoming self-pay.
​I was talking to one of the chairmans of a academic center in New York City who also performs high-volume prosthesis, and he told me that even for insurance patients, the hospital is balance billing his patients after the insurance pays the amount of payment that—which is almost the cost of the surgery—hospital still bills the patient close to 25, $30,000 for the balance billing.
​For those of you who think that, 'Oh, my insurance is going to pay the whole thing,' they're not going to pay the whole thing. Most likely, you're going to get more bills from anesthesia, from surgery center, hospital, from surgeon, possibly for balance billing."

https://www.youtube.com/watch?v=chHOM5Buwsw

Kodixx
Posts: 980
Joined: Wed Jan 08, 2025 5:32 pm

Re: Wise insurers ?

Postby Kodixx » Tue Mar 24, 2026 1:25 pm

For anyone who hasn't been thru the process, do your own research and consultations to determine what's real. Do not rely on general 'information' like in the post above. I was implanted about a year ago and my experience was not like that.

- Chuck
Feb 2025 58yo, 38 w/ greatest wife ever
AMS CX, Tenacio, Dr Broghammer (excellent) pre-op L:7", post-op @ 9 mo L: 6.5=>7.0" G: 5.5=>5.75"
2wks pain, cycling/sex @ 7wks, minor pain until 10wks, felt like 'new normal' sex @ 16wks


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