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Hi everyone

Any insurance guys here in the forum that know the answer if any of the Obamacare participants cover an implant.



kind regards

Welcome to the site. I have bought my own health insurance for about 15 years. When Obama care started I bought a BCBS Gold EPO plan from BCBS that was the exact same plan as sold on the marketplace. I did not qualify for any discounts through the market place. It did and does have coverage for implant surgery for physical damage. And requires treatment with medication prior to surgery. Pills and injections. And prior approval by BCBS was needed. As it was an EPO plan BCBS had a network I had to stay in. And it is expensive.

newbie443 wrote:Welcome to the site. I have bought my own health insurance for about 15 years. When Obama care started I bought a BCBS Gold EPO plan from BCBS that was the exact same plan as sold on the marketplace. I did not qualify for any discounts through the market place. It did and does have coverage for implant surgery for physical damage. And requires treatment with medication prior to surgery. Pills and injections. And prior approval by BCBS was needed. As it was an EPO plan BCBS had a network I had to stay in. And it is expensive.

How much is it?

FreddyFree wrote:

newbie443 wrote:Welcome to the site. I have bought my own health insurance for about 15 years. When Obama care started I bought a BCBS Gold EPO plan from BCBS that was the exact same plan as sold on the marketplace. I did not qualify for any discounts through the market place. It did and does have coverage for implant surgery for physical damage. And requires treatment with medication prior to surgery. Pills and injections. And prior approval by BCBS was needed. As it was an EPO plan BCBS had a network I had to stay in. And it is expensive.

How much is it?

My BCBS premium is 1200.00 a month this year with a 1500.00 deductible and 4500.00 max out of pocket. And I only have coverage in part of my home state of Kansas. So if I was out of my coverage area and broke my arm or leg or any non life threatening medical event I would have to pay out of pocket or return to my coverage area for care.

Another company had out of network coverage but deductibles, premiums, and max out of pocket was nearly twice what the BCBS plan I have is.

For me it was a tough to let insurance off the hook but local doctors only do 2-3 IPP a year and do not do revisions or repairs. So I paid out of pocket to go to doctor who specializes in IPP surgery. My local uro's business office advised insurance would not cover some of what they did for the surgery like an over night stay and would need between 4-7K up front to schedule. They also advised the results was so poor by the doctors that many men elect to have the device removed. I may have saved travel expenses and a few hundred in medical expenses if I stayed local and used insurance but the cost was not that much more to keep me from going to a better doctor. The doctors in your area may be a lot better with IPP than mine.

That's good news for next year i will switch to BCBS of florida my premiums is about 400 and similar deductibles

kind regards

Check with whatever BCBS insurance your looking at specifically about implants. I have BCBS of Illinois and it is a PPO.. saying that…. When I talked to the lady at Texas urology she said most BCBS does not cover IPP. I got the DR code implant code and common diagnosis code from her and about an hour on the phone found out my plan did in fact cover all the codes including revisions. When I called her back she was pleasantly surprised and said she would quit telling people that BCBS doesn’t cover IPP.

My BCBS didn't cover an IPP procedure.
In fact it wouldn't cover the consultation visit with my urologist to discuss it.

i am retired and medacare will pay for a inplant for me

Richardwad wrote:My BCBS didn't cover an IPP procedure.
In fact it wouldn't cover the consultation visit with my urologist to discuss it.

I am in florida i will check bcbs i have oscar health and if you call them the first contact say that they do cover it and we pay 25%, so does the website portal, but no much doctors accept Oscar health i have an appointment (april 05) with one of the good ones Doctor Ranjith Ramasamy from university of miami, lets see what happens.

kind regards