Did your insurance cover your revision?

The final frontier. Deciding when, if and how.
RichardTheFrog
Posts: 411
Joined: Fri Dec 02, 2016 7:27 pm

Did your insurance cover your revision?

Postby RichardTheFrog » Wed Feb 22, 2017 9:54 am

I'm thinking about 10-15 years down the road.
Implanted by Dr. Andrew Kramer 2/22/17. 18 cm AMS LGX with 2 cm RTE's (total 20cm).

Activated 3/11/17. Best decision I've ever made.

LMCatman
Posts: 1017
Joined: Wed May 08, 2013 11:11 am
Location: South Florida, USA

Re: Did your insurance cover your revision?

Postby LMCatman » Wed Feb 22, 2017 10:34 am

Humana paid for my initial implant and for my revision. I believe Medicare is going to pay for my upcoming revision. I was "out of pocket" a couple thousand dollars each time.....
73 Years old. RP Oct 2010, No erections after, Botched Titan implant April, 2013, Successful Titan revision, April , 2014 by Dr. Paul Perito, Miami. Titan failure Feb 2017. Rev. by Dr Perito March 1st, 2017. Titan failure Nov 2020. New Titan January 2021

Stricck
Posts: 50
Joined: Tue Nov 29, 2016 11:28 am

Re: Did your insurance cover your revision?

Postby Stricck » Wed Feb 22, 2017 2:58 pm

Yes.
Implant AMS 700CX MS (21cm x 12mm with 3 RTEs) on Nov 21st 2016. Activation date Dec 22nd 2016

mtnbiker
Posts: 46
Joined: Tue Jan 24, 2017 8:32 am

Re: Did your insurance cover your revision?

Postby mtnbiker » Wed Feb 22, 2017 4:00 pm

I have BCBS and they covered the whole procedure except for code 54360 for modeling to correct curvature. I filed an appeal and waiting for Dr Kramers office to send over my medical records. The billable amount for code 54360 is $2,350
Implanted on December 28, 2016 by Dr Kramer with a 21 CM AMS LGX. 47 years old and have been dealing with ED due to Venous leak since my 20's.

palace01
Posts: 157
Joined: Fri Jul 18, 2014 6:33 pm

Re: Did your insurance cover your revision?

Postby palace01 » Thu Feb 23, 2017 1:38 pm

I had original in February and revision in July.
In BOTH cases :-
Medicare paid 100% to hospital and 80% to Dr (based on their official rate of course)
Gap Insurance (Omaha) paid the extra 20% of the Medicare rate to Dr.
So I did not pay a single penny (except for parking..)
Age 73
Apr-15-14. RP-Pills, Injections No help. VED(almost old size in tube).
Feb-12-16, Dr Cornell, AMS-CX "18+4" LOTS PROBLEMS!
Jul-6-16 Dr Khera ColoPlast "20+1" Very Unhappy with very short length/width but Dr insists correct

RichardTheFrog
Posts: 411
Joined: Fri Dec 02, 2016 7:27 pm

Re: Did your insurance cover your revision?

Postby RichardTheFrog » Thu Feb 23, 2017 5:48 pm

palace01 wrote:I had original in February and revision in July.
In BOTH cases :-
Medicare paid 100% to hospital and 80% to Dr (based on their official rate of course)
Gap Insurance (Omaha) paid the extra 20% of the Medicare rate to Dr.
So I did not pay a single penny (except for parking..)


Damn I need your insurance.
Implanted by Dr. Andrew Kramer 2/22/17. 18 cm AMS LGX with 2 cm RTE's (total 20cm).

Activated 3/11/17. Best decision I've ever made.

williamb
Posts: 244
Joined: Wed Sep 09, 2015 9:48 pm
Location: south Louisiana

Re: Did your insurance cover your revision?

Postby williamb » Thu Feb 23, 2017 6:53 pm

Mine were. 1st was end October 2015 & revision begining of Dec 2016, 13 months apart and they were both fully covered
Last edited by williamb on Wed Mar 01, 2017 7:19 pm, edited 1 time in total.
born 1949, Cancer 2014, 1st Implant AMS CX 18 + 3 RTE, Oct 2015 by a Houston Doctor. Left with loss of length, Floppy Glans and pain, a very poor job. Revision in Dec 2016 by Dr. Kramer, 21 + 3 1/2 RTEs, LGX, Regained length, Glans supported and no pain.

palace01
Posts: 157
Joined: Fri Jul 18, 2014 6:33 pm

Re: Did your insurance cover your revision?

Postby palace01 » Wed Mar 01, 2017 5:36 pm

RichardTheFrog wrote:
palace01 wrote:I had original in February and revision in July.
In BOTH cases :-
Medicare paid 100% to hospital and 80% to Dr (based on their official rate of course)
Gap Insurance (Omaha) paid the extra 20% of the Medicare rate to Dr.
So I did not pay a single penny (except for parking..)


Damn I need your insurance.


In 40 years time, when you are entitled to Medicare, then hopefully you will - assuming Mr. Trump doesn't take it away of course!
Age 73
Apr-15-14. RP-Pills, Injections No help. VED(almost old size in tube).
Feb-12-16, Dr Cornell, AMS-CX "18+4" LOTS PROBLEMS!
Jul-6-16 Dr Khera ColoPlast "20+1" Very Unhappy with very short length/width but Dr insists correct

dg_moore
Posts: 1885
Joined: Mon Apr 25, 2011 9:34 am

Re: Did your insurance cover your revision?

Postby dg_moore » Wed Mar 01, 2017 6:25 pm

Nobody knows what the insurance landscape will look like in a decade or two. There's not much reason to believe it will be better, cheaper, or more available than it is now.
Dave, 80, Maryland - Implant (Titan) 2008 by Dr. Andrew Kramer (failed Sept 2020) - never used due to a stroke that, among other things, ended my sex life.
Life is not the way it's supposed to be, it's the way it is.

alibaba
Posts: 3027
Joined: Sun Oct 12, 2014 8:04 pm

Re: Did your insurance cover your revision?

Postby alibaba » Wed Mar 01, 2017 9:34 pm

Said they would Monday.
LGX 21cm .Milam 01/13/16. Horror; both service and surgical outcome. hated infrapubic installation. Kramer revision 03/01/17. 22cm Titan +1.5cm extender. Those who think their opinion is the only one that matters are a danger to themselves and others.


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