PD, ED and Insurance

The final frontier. Deciding when, if and how.
Anthony
Posts: 28
Joined: Mon Aug 19, 2019 8:40 am

PD, ED and Insurance

Postby Anthony » Sun Nov 13, 2022 7:31 pm

My journey started about 5-6 years ago. I am 50yo so no Medicare for me…
I have been on injections for about 2 years and cannot get or maintain an erection without the shot. The pills and vacs no longer work. About 6 months ago I started to have painful erections and powered through. I also noticed the top of my penis down by the base was quite sensitive and felt something of a lump that didnt go away. Ive been without sex for about 2 months due to work and this weekend my wife and I attempted to have sex. Penetration was extremely painful and while she said she liked whatever was going on for the 2 minutes I tried to perform she asked me to step back and said “your penis is very curved”. My penis used to be stick straight, now it has a 20%ish curve and also it was somewhat football shaped, now it seems more of a fish or hourglass shape….
Im thinking the time is near to implant. I cant go on like this…
So, about a year ago my insurance said they do not pay for IPP (a United Healthcare thru DOD Civilian Service plan) but Im hopefully the absolute lack of erectile function without a shot and now possible PD will make a strong case. Im not sure plication or Xialaflex (sp) are good either as Ill still need injections which Im assuming will turn into a cycle of this. I dont have the income to pay out of pocket. Anyone have experience with this?
I will be making an appointment with my urologist tomorrow to get examined but that appointment will take weeks to get in so getting my ducks in row.
I was in TX but now am in Knoxville TN. Ive been seeing Dr John Lacy if anyone has had surgery with him please let me know how it went. TIA for any help you can give
50 yo. MI on 5/30/16, 5 stents, 6'-215lbs active and daily exercise since. Type II Diabetes, 7.0 A1C. Scheduled for implantation 05/02/2023 with Hakky in ATL 3 years on Trimix, lead to PD 55°curvature. Current size: 6-1/2”bpl, 6-1/2” girth.

squirrel
Posts: 24
Joined: Sat Jul 31, 2021 10:42 pm

Re: PD, ED and Insurance

Postby squirrel » Sun Nov 13, 2022 8:41 pm

Do you have a choice of insurance plans like other federal employees? Open season starts this week and would be a good time to switch to a health care policy that covers implants. I had GEHA (united healthcare) and they would not even cover an implant for any reason other than transgendering. Go figure. I had to switch insurance during open season for my procedure to be covered.

I used Dr. Brian Christine in Birmingham, AL.
56 years old
E.D. for 6 years
Testosterone Replacement
Implanted 20 APR 22 AMS 700 LGX

68CatFan
Posts: 393
Joined: Fri Mar 27, 2020 12:58 pm

Re: PD, ED and Insurance

Postby 68CatFan » Sun Nov 13, 2022 9:03 pm

I am also DoD. I have BCBS federal PPO, and they cover penile implants.
Fifty-one years old. ED started at age forty. I took Cialis for eight years and used Trimix for almost three. Implanted 12/6/22 by Dr. Jonathan Clavell. AMS 700CX 21cm.

Anthony
Posts: 28
Joined: Mon Aug 19, 2019 8:40 am

Re: PD, ED and Insurance

Postby Anthony » Sun Nov 13, 2022 9:13 pm

What upsets me is I have the high plan and pay the highest cost. I fear having had a heart attack switching may open pre-existing issues. I did notice that they will pay for gender reassignment surgery. Seems like that would be an equality issue to offer one group but not another that has an actual medical problem.
50 yo. MI on 5/30/16, 5 stents, 6'-215lbs active and daily exercise since. Type II Diabetes, 7.0 A1C. Scheduled for implantation 05/02/2023 with Hakky in ATL 3 years on Trimix, lead to PD 55°curvature. Current size: 6-1/2”bpl, 6-1/2” girth.

GoodWood
Posts: 832
Joined: Sun Jun 16, 2019 1:07 pm

Re: PD, ED and Insurance

Postby GoodWood » Sun Nov 13, 2022 10:45 pm

squirrel wrote:Do you have a choice of insurance plans like other federal employees? Open season starts this week and would be a good time to switch to a health care policy that covers implants. I had GEHA (united healthcare) and they would not even cover an implant for any reason other than transgendering. Go figure. I had to switch insurance during open season for my procedure to be covered.

I used Dr. Brian Christine in Birmingham, AL.


Which insurance plan does cover implants as a Fed Employee? I hear mixed things.
55yo, NYC. ED started at 40. 50 units BiMix + Atropine (Pap 30/Phen 6/Atr 0.2). Prostaglandins caused aching. Doses increasing. A cock ring helps. Phallosan Forte tension devise to maintain size. Eager to talk about implant experiences.

Old Guy
Posts: 2700
Joined: Tue Mar 31, 2020 4:31 pm
Location: Ohio

Re: PD, ED and Insurance

Postby Old Guy » Mon Nov 14, 2022 9:50 am

UHC paid 80% of my implant surgery. They denied it at first, my surgeon's office sent paperwork proof 3 or 4 times requesting coverage. Then a rep called me and sounded like she was trying to talk me out of it, telling me all the worst possible outcomes. When I asked if her husband had ED would she be fine with no more sex the rest of her life? Approved.
Basically, if pills and injections don't work, you are a candidate for an implant.
Nov. 8, 2019
4+ years, Coloplast Titan OTR
Married 36 years to my beautiful young bride
Always here to answer questions if you PM me

Floridaspeedo
Posts: 305
Joined: Fri Jun 17, 2022 11:15 am

Re: PD, ED and Insurance

Postby Floridaspeedo » Mon Nov 14, 2022 10:55 am

Anthony wrote:What upsets me is I have the high plan and pay the highest cost. I fear having had a heart attack switching may open pre-existing issues. I did notice that they will pay for gender reassignment surgery. Seems like that would be an equality issue to offer one group but not another that has an actual medical problem.



Anthony My implant was covered but it was burind in"gender re-assignment."

Joe
ED survivor 5 years. Tried pills, Gainswave, PRP, Bi-Mix/Tri Mix (worked 50% but very painful for 24 hours after injection.) 55 Gay - Single Titan Coloplast implanted June 1st, 2022, scrotal in Miami by Dr Billy Cordone..,very happy. Zero regrets

squirrel
Posts: 24
Joined: Sat Jul 31, 2021 10:42 pm

Re: PD, ED and Insurance

Postby squirrel » Mon Nov 14, 2022 12:53 pm

GoodWood wrote:
squirrel wrote:Do you have a choice of insurance plans like other federal employees? Open season starts this week and would be a good time to switch to a health care policy that covers implants. I had GEHA (united healthcare) and they would not even cover an implant for any reason other than transgendering. Go figure. I had to switch insurance during open season for my procedure to be covered.

I used Dr. Brian Christine in Birmingham, AL.


Which insurance plan does cover implants as a Fed Employee? I hear mixed things.


BCBS Federal is the only plan I could find that covered Implants and I searched through all of the plans offered. BCBS is not the cheapest but with an implant, I will have to stay with them should a problem arise.
56 years old
E.D. for 6 years
Testosterone Replacement
Implanted 20 APR 22 AMS 700 LGX


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