Page 1 of 1

PD, ED and Insurance

Posted: Sun Nov 13, 2022 7:31 pm
by Anthony
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

Re: PD, ED and Insurance

Posted: Sun Nov 13, 2022 8:41 pm
by squirrel
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.

Re: PD, ED and Insurance

Posted: Sun Nov 13, 2022 9:03 pm
by 68CatFan
I am also DoD. I have BCBS federal PPO, and they cover penile implants.

Re: PD, ED and Insurance

Posted: Sun Nov 13, 2022 9:13 pm
by Anthony
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.

Re: PD, ED and Insurance

Posted: Sun Nov 13, 2022 10:45 pm
by GoodWood
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.

Re: PD, ED and Insurance

Posted: Mon Nov 14, 2022 9:50 am
by Old Guy
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.

Re: PD, ED and Insurance

Posted: Mon Nov 14, 2022 10:55 am
by Floridaspeedo
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

Re: PD, ED and Insurance

Posted: Mon Nov 14, 2022 12:53 pm
by squirrel
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.