Insurance questions need advice

[Maxihurst2033]

As a young guy who plans on getting an implant after college, what is the deal with insurances? I keep reading about constant rejections. Most jobs I've applied to offer aetna, UHC, BCBS and Kaiser. Do employers decide not to cover those in need of procedures and revisions for a device that offers a better quality of life? Are we stuck paying out of pocket for an implant and revisions like people have 18k to 30k+ hanging around if your not over 65? This surely can't be right. My ed is t1 diabetes related and scary to think about the future.

Any of you guys out there, how did u do this? Younger people? I don't mind paying for the implant but revisions are tough to tell when you will need it. People should be covered. This is frustrating to read, anyone want to clarify? Is getting an individual insurance better?

[dg_moore]

When I got my implant in 2008 I had employer-provided United Healthcare. They covered the procedure nearly 100% with no questions asked. However, many, many men here have had different experiences with their employers and other insurance companies. In general, as you say, it is the employers and not the insurance companies that determine whether various procedures are covered. This is not an easy problem to solve unfortunately.

[Maxihurst2033]

So even after an implant and you have worry about revision costs. How do people do this? What happens as you get older and start a family? You need a shit ton of money on the side for the next procedure, when that happens? Do dr offer revisions with a discount? This is a life long struggle.

[Old Guy]

So even after an implant and you have worry about revision costs. How do people do this? What happens as you get older and start a family? You need a shit ton of money on the side for the next procedure, when that happens? Do dr offer revisions with a discount? This is a life long struggle.

You shouldn't need a revision for 10-15 years, maybe more. Failure rates are very low. Remember the posts here are mainly guys who have or had issues. There are thousands of men with implants who don't come here to say it's working fine, they're busy using it.
Insurance varies with each company, and policy. My UHC policy (wife's work) covered 80%. Insurances may also have requirements making you try other solutions first. The only way to know that is read the policy regarding surgeries.
Don't make it a life long worry. If you need an implant to engage in sex, do it. Without sex you won't start a family.

[Maxihurst2033]

I suppose my worry is that if I do get it, say an infection happens or it needs to be replaced before 10-15 years, which can happen. What are you going to do? You would need immediate attention but if your employer excludes it or forces you to fight to your wits end, how is this right? Imagine having pain or infection and have no money for revision? Are you suupose to wait on them?

I'm probably going to have to shop for my own individual health insurance once I secure a good job if group insurance isnt going to exclude the IPP. I will have a monthly fee and a pretty high deductible but if they cover implants and revisions when deductible is met, I will be fine. Even for a short period. I'm sure it can happen. Just trying to figure things out when the day comes.

[Gt1956]

It is my understanding that the first implant is the hardest to get some insurance companies to cover. For some reason, so I've been led to believe. That replacing any kind of implanted device is viewed differently than getting the first one.
Standard warnings apply. I have no first hand experience, I'm not a doctor. Please verify how your policy views both situations.
For what little its worth. I've seen way more posts about getting the first implant covered. At this moment I can't think of a revision that was held up by the insurance company. But I would think that it has happened.

[Rider1400]

I have BCBS of Illinois although I live in Arkansas. I’ve heard that a small percentage of the many different BCBS do cover IPP. Obviously mine did, it was a 80% til out of pocket hit 2,200 and then full coverage. I had already met my deductible and so total out of pocket was $2200. Hopefully my insurance would not change before I need a revision but would assume since it was covered that a revision would have to be guaranteed to be covered no matter if they changed. Also revisions are less as the implants themselves are lifetime warranties and are said to be $8,000-$10,000 of the cost, so you just pay for hospital and Dr cost

[newbie443]

Health care cost is a concern not just for employees but also employers and insurance companies. It seems that implant surgery is avoided a great deal to reduce these costs. Buying your own insurance through the market place is expensive. I had coverage with my market place plan but it did not cover all the cost and had restrictions on who I could go to for this. The only doctors I had coverage with were low volume doctors with a history of poor results. May of been different if I live in an area with better doctors. But then again maybe not. So even if you have coverage you may have to pay (my local uro business office gave me 4k to 7k estimate that had to be paid up front). I paid out of pocket to go to a better doctor. Had I had the choice to have a lower cost non coverage plan for implant surgery I would have done it. And used the difference to pay out of pocket.

Some things to consider are location. Look for an area with very good implant doctors. If you can I would think a federal job would have coverage. State government depending on the state may also been a good place to look. The best thing would be to request a copy of the insurance policy when you apply. That way you can check for coverage and an exclusion for penile implants. Then you need to find out what doctors are in network with that policy. Or like you wrote get the best paying job and then if it is not covered start putting aside money.

Good luck.