Page 1 of 2
What to do and who to chose?
Posted: Tue Nov 14, 2023 6:56 pm
by cth524
First off I was supposed to have the implant done in July but last minute insurance said it wouldn't cover it through my employer with cigna. So the new enrollment this year I switched to BCBS or horizon blue. Open enrollment has closed but still can make changes per hr help. I recieved a call from Dr nurse saying cigna has approved the procedure. Hahaha after I already switched now they say they will cover it, lol. Now here's the issues.
I can have it done by end of year with Justin Parker at USF or next year with my original dr Rafael carrion. I like the idea of Parker since I've met my out of pocket and i am still with cigna but downfall is I have no vacation days left and not sure he's as good as Dr Carrion. The bad with Carrion is I have to meet my out of pocket again and won't be til next year til I get it done and even if they say it's approved and I switch back to cigna and get denied then I have to wait til next January.
I'm going to call cigna and talk with the lady who said it was approved and get a letter. I'll just have to eat the out of pocket. What do you all think?
Re: What to do and who to chose?
Posted: Tue Nov 14, 2023 8:27 pm
by portageriver
To hell with money/out-of-pocket costs, insurance, and/or time - you want the BEST surgeon of the two. That's where you focus, let the rest play out.
That's what I think anyway. I am unfamiliar with the surgeons mentioned so I can't help you there. At least a solution is on your horizon either way.
Re: What to do and who to chose?
Posted: Tue Nov 14, 2023 9:54 pm
by Gt1956
Hmmmm. Go cheap or go best? What could possibly go wrong with the cheap option? Let me think about it.
Re: What to do and who to chose?
Posted: Tue Nov 14, 2023 10:32 pm
by cth524
I guess I'll just wait til next year and hope cigna doesn't reverse the approval on me. Granted carrion is the one I'd rather have do it but moneybis also a factor as im.single and not made of money
Re: What to do and who to chose?
Posted: Tue Nov 14, 2023 10:59 pm
by Mtnmirv
This may sound impractical or impossible but you do not want to shop for this procedure on price alone. If you have to take out a loan to get the best surgeon you can get then find a way to do it.
Re: What to do and who to chose?
Posted: Wed Nov 15, 2023 12:17 am
by cth524
Dr carrion is a top implant surgeon. I just got off phone with cigna a d have the approval number so that is aeesome!!! I think I will wait until he comes back from vacation in January to schedule it to be done. My new Christmas toy, lol
Re: What to do and who to chose?
Posted: Wed Nov 15, 2023 5:26 am
by SteveD
Talk again with Cigna re: out of pocket impact with their initial disapproval and now approval. Will they do an exception and roll-over the out-of-pocket to next year for this one procedure? These policies are not law and you can reasonably - and calmly - explain that their disapproval / then approval has caused a significant financial impact.
Re: What to do and who to chose?
Posted: Wed Nov 15, 2023 9:37 am
by cth524
That is a good point SteveD. This past July I was to have done and met deductible and out of pocket due to many hospital stays from my pancreatic cancer as well. Cigna beat me up and down for months prior to about the denial and approval. Then I complained that why is a woman can have breast implants after breast cancer and it be approved but yet I have prostate cancer and has caused ED and we are not a guaranteed approval whichbis discrimination!! There is even a breast cancer act called the women's breast cancer act of 1988.
Re: What to do and who to chose?
Posted: Wed Nov 15, 2023 9:53 am
by rdnkbiker
I would be careful with Cigna they approved mine conformation # and all and last minute said no left me with a huge bill and still paying on it think you have the right idea by calling but like i said after it was done they said no so just make sure its all good don't be like me get stuck with a huge bill
jim
Re: What to do and who to chose?
Posted: Wed Nov 15, 2023 10:25 am
by Old Guy
I knew nothing about implants before my surgery except it would allow me to have erections again. Can't even remember how I found my doctor, didn't know if he had done numerous implants or I was his first. Bottom line is everything came out fine. Picking a high volume doc might be your choice but expensive. From all I have learned hanging around FT for 3 years there doesn't seem much difference in the final outcome no matter what doc installs the implant.