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Insurance Setback

Posted: Fri Mar 02, 2018 11:24 pm
by Fundle
I was eagerly looking forward to my penile implant surgery, originally scheduled for yesterday in Philadelphia, PA. I jumped through all the hoops, had clearance from my family doctor and my cardiologist, thought I was ready to go. But three weeks ago I got a call from my surgeon's office saying my medical insurance had declined authorization. Needless to say, that was a blow. So for the time being I had to cancel my presurgery admission testing and drop off the surgeon's schedule.

The good news, however, is that it should be covered under Medicare. And I'm in the process of switching from private insurance to Medicare, so I'll be contacting the surgeon as soon as Medicare is fully active, and get back on the schedule. I'm not sure how long that will take, but hopefully not more than a month or two.

Have any of you (in the US) had this surgery under Medicare? Any issues I should be aware of?

Re: Insurance Setback

Posted: Sat Mar 03, 2018 3:20 am
by Anonymous3
My secondary insurance fucked me over. They (GEHA) does not cover sexual impotence or inadequacy or anything related to it. But by law they have to pay for a fucking sex change. My Dr is good for all the testing and surgery I owe 300. Hecwrote a bunch of stuff off. I think Medicare authorised 13k and paid 10k.

I have a post about it

viewtopic.php?f=6&t=9049&p=71264&hilit=Insurance#p71264


I think all of that this has happen to should file a discrimination law suite. The law says you can not discriminate because of sex. But it would not would not work since we are men and no what gender we are and want to stay that way. You can thank Congress for it. They are the ones that loved The fucked up Affordable Care Act, that does not apply to them

Re: Insurance Setback

Posted: Sat Mar 03, 2018 8:30 am
by DonDon
Medicare and Advantage plan through Humana paid all but my $200 co-pay.

Re: Insurance Setback

Posted: Sat Mar 03, 2018 9:10 am
by nudist
hturner12 wrote: You can thank Congress for it. They are the ones that loved The fucked up Affordable Care Act, that does not apply to them


my roommate has had 2 different types of cancer. without the affordable care act, she would have no insurance. is that what you find preferable?

Re: Insurance Setback

Posted: Sat Mar 03, 2018 10:24 am
by David_R
Sometimes a doctor's office will go to bat for you with the insurance company, saying that if they cover breast reconstruction after a mastectomy (the reconstruction being a procedure that is not to prevent death but instead is to improve life), then they should also cover a penile implant. Hope someone goes out to confront them on this (most insurance covers breast reconstruction, I understand).

Re: Insurance Setback

Posted: Sat Mar 03, 2018 11:45 am
by Anonymous3
nudist wrote:
hturner12 wrote: You can thank Congress for it. They are the ones that loved The fucked up Affordable Care Act, that does not apply to them


my roommate has had 2 different types of cancer. without the affordable care act, she would have no insurance. is that what you find preferable?



That is the exception Congress is the ones that determined tha sexual dysfunction d8d not gave to be covered

Re: Insurance Setback

Posted: Sat Mar 03, 2018 12:01 pm
by Xomanow
Medicare A&B paid for my entire implant......that was almost enough to give me an erection right there......

Re: Insurance Setback

Posted: Sun Mar 04, 2018 6:05 am
by ocitgo
Kaiser and medicare covered 100%.

Re: Insurance Setback

Posted: Mon Mar 05, 2018 12:17 pm
by Tsanchez12369
Hugh, I’m sorry for your predicament. Fortunately, Medicare pays. Affordable care act has decreased the number of conditions that insurance companies can exclude...we need more of that not less. Also, please don’t let the profit driven corporations divide and conquer...our brothers and sisters that need a sex change operation are certainly entitled to one as are those of us that need an implant.

Re: Insurance Setback

Posted: Mon Mar 05, 2018 5:19 pm
by Anonymous3
Tsanchez12369 wrote:Hugh, I’m sorry for your predicament. Fortunately, Medicare pays. Affordable care act has decreased the number of conditions that insurance companies can exclude...we need more of that not less. Also, please don’t let the profit driven corporations divide and conquer...our brothers and sisters that need a sex change operation are certainly entitled to one as are those of us that need an implant.

That not what I am saying. If they are required to pay for that operation then they should also be required to pay for our operations. We are being discriminated against because we are men.