Page 1 of 2
Denied by Insurance
Posted: Mon Feb 10, 2025 2:59 pm
by CarbonBurrito
I have a policy with Anthem BCBS. They declined coverage of IPP. According to the policy's "What is Not Covered" section, "66. Sexual Dysfunction Services or supplies for male or female sexual problems."
This seems like something I won't be able to appeal.
I've had ED issues since 32. A couple years back, I told myself that I was just going to get an implent if my ED wasn't getting better at 45. Now that I'm 45 and ready to make the decision, I find out my insurance won't even cover it.
We just so happen to be switching insurance carriers at the end of the month. So I'll see what the new policy covers.
BUMMER!!
Re: Denied by Insurance
Posted: Mon Feb 10, 2025 3:18 pm
by Implant2025
Don't know where you live, but I flew from DC to Houston for IPP surgery with Clavell. He's awesome.
Re: Denied by Insurance
Posted: Mon Feb 10, 2025 3:23 pm
by CarbonBurrito
Implant2025 wrote:Don't know where you live, but I flew from DC to Houston for IPP surgery with Clavell. He's awesome.
I'm just a short drive from Houston. So, I will be seeing Clavell when the time comes!
Re: Denied by Insurance
Posted: Mon Feb 10, 2025 3:28 pm
by Implant2025
CarbonBurrito wrote:
I'm just a short drive from Houston. So, I will be seeing Clavell when the time comes!
If your new insurance doesn't cover implants, can you opt out and buy your own insurance policy? Having to pay out of pocket totally sucks.
Re: Denied by Insurance
Posted: Mon Feb 10, 2025 4:49 pm
by Lawnman
I’m sorry, but I find the denial completely unacceptable. It’s not right.
Re: Denied by Insurance
Posted: Mon Feb 10, 2025 5:01 pm
by CarbonBurrito
Lawnman wrote:I’m sorry, but I find the denial completely unacceptable. It’s not right.
I completely agree. I find solice in the fact that there is zero "sexual dysfunction" coverage on this policy. So, it's not like anyone reviewed the facts and made a decision - they just deny all cases. It makes me hopeful that I will have better luck with our next insurance situation.
As far as covering the procedure, I hope that a few years of urology visits and doctor's notes will convince them to cover me. Pills work so rarely now, it's almost funny. I don't want to try shots due to chance of scar tissue and even less spontaneity than the pills. I am ready for a real solution here.
Re: Denied by Insurance
Posted: Mon Feb 10, 2025 5:35 pm
by Time2Change
CarbonBurrito wrote:Lawnman wrote:I’m sorry, but I find the denial completely unacceptable. It’s not right.
I completely agree. I find solice in the fact that there is zero "sexual dysfunction" coverage on this policy. So, it's not like anyone reviewed the facts and made a decision - they just deny all cases. It makes me hopeful that I will have better luck with our next insurance situation.
As far as covering the procedure, I hope that a few years of urology visits and doctor's notes will convince them to cover me. Pills work so rarely now, it's almost funny. I don't want to try shots due to chance of scar tissue and even less spontaneity than the pills. I am ready for a real solution here.
Keep fighting for it.
I fought with Cigna for months. Ultimately, I got a sympathetic customer service representative on the phone. She said it was a matter of the code that my doctor had submitted.
Within a couple of days, she called me back to tell me Cigna had approved my surgery. I still have her message saved on my phone.
Re: Denied by Insurance
Posted: Mon Feb 10, 2025 6:51 pm
by LastHope
Cigna and Aetna are POS. Funny that they also have plans that end with POS.
BCBS/Humana/Kaiser/UHC are generally good for this procedure. My Aetna didn't cover.
Re: Denied by Insurance
Posted: Mon Feb 10, 2025 7:03 pm
by richard_goes_bionic
If you don't get covered you can come to Europe. Good luck.
Re: Denied by Insurance
Posted: Tue Feb 11, 2025 12:24 am
by Tokyo_123
CarbonBurrito wrote:I have a policy with Anthem BCBS. They declined coverage of IPP. According to the policy's "What is Not Covered" section, "66. Sexual Dysfunction Services or supplies for male or female sexual problems."
This seems like something I won't be able to appeal.
I've had ED issues since 32. A couple years back, I told myself that I was just going to get an implent if my ED wasn't getting better at 45. Now that I'm 45 and ready to make the decision, I find out my insurance won't even cover it.
We just so happen to be switching insurance carriers at the end of the month. So I'll see what the new policy covers.
BUMMER!!
I just paid cash.