Plea for help

[jerseyhulk]

My implant busted a week ago. I’m having some pain, most likely where it has blown out inside my penis. I’m a 37 yo college student and have no means to pay out of pocket. The hospital and AMS reps have been ignoring my calls because I’ve been pleading for help and financial assistance. My current insurance will not cover it. My doctor agreed to do the revision for free. AMS would provide the implant under warrantee but the hospital wants all the money upfront. I really need advice because I can’t keep living in pain or risk damaging my penis because of their greed. Should I get a lawyer? Anybody know any insurance company that would cover a revision for a 37 yo. I really need advice.

[krh9999]

Hey man.

I am really sorry to hear your predicament. Why is your insurance denying you if I may ask?

[Txagq8]

I've never been in your position so I don't know that I can offer much in the way of advice.

If you are looking at AMS waiving any charged due to warranty and the surgeon waiving his fee, there will be some costs left but I would think they wouldnt be astronomical.

They might even be less astronomical if you enlisted the help of your surgeon's practice and they quote you a fixed, cash price.

I understand budgets are tight for college students. But if you had only to raise a small portion of what the hospital's full book price is, assuming they would take less if paid in cash in advance, you might be able to swing it.

If you qualify for student loans a medical loan for a deal like this seems like one avenue to investigate.

I see surgeons in the US offering the whole deal for self-pay patients for around 18-20K. Take away what the surgeon wants, what AMS gets......the hospital is getting some...but it might be less bad than you imagine.

I'd talk to the doc. You dont want to cut corners. But there are places you can economize and still get a good result. Maybe a nurse anesthetist instead of a doctor. Maybe a epidural with conscious sedation instead of general anesthesia. Definitely day surgery in lieu of an overnight stay. Maybe an ambulatory surgical center instead of the hospital.

It's got to get fixed, and not strictly for sex. Its not likely to be long term healthy to carry around a damaged device in tour innards.

[Waynetho]

Dr. Eid told me that if the insurance covered the first implant, they should cover revisions that are *NEEDED*. Since this is a health issue, being you are broken and need to be fixed, plus you are in pain due to the damaged implant, this should warrant coverage. The doctor needs to submit a preauthorization form to your insurance with medical reason codes to warrant the replacement on grounds of the health of the insured.

[jerseyhulk]

Hey man.

I am really sorry to hear your predicament. Why is your insurance denying you if I may ask?

It is an exclusion to the policy. The original insurance I had was UHC and they covered my initial implant. My implant only lasted 4 years and now I have a different job and goto school. My insurance sucks! It is BCBS and my doctor told me they will not cover it. My doctor has been the only person who has tried to help but he is limited by the hospital. I’m totally screwed because I don’t know how I’ll be able to pay for this. The pain I’m having worries me that it may cause scarring on the inside over time if it is scraping against the tissue. I had a bad venous leak and after years and years of every treatment (meds, injections, VED) nothing worked after time. My only option was the IPP. Now I’m wondering if I can at least use a VED with a busted implant to prevent atrophy. I’m so screwed.

[jerseyhulk]

I might just keep getting on the hospitals ass! They just seem to be blowing me off. I really don’t think they tried to file anything with my current insurance.

[TANGERINE]

call BCBS phone number on your insurance card and tell them that you would like to appeal the claim. If you are really persistent with your current insurance, then there might be a chance. If insurance , after several appeals, still does not authorize your revision, then try to cut a deal with your local surgeon and hospital (the surgeon's fromt desk might be willing to help you -- or at least steer you in the direction regarding who to present your case with).

If all this fails, get a medical loan.

[jerseyhulk]

I guess worst case I’ll have to wait until open enrollment...

[jerseyhulk]

Unfortunately I don’t qualify for loans at this time due to a divorce that resulted in a bankruptcy. It’s been one let down after another...

[Waynetho]

Exclusion possibly for enhancement or even for reproductive surgery to make you functional when you're healthy, but this is not healthy. You said it yourself, it hurts. This means it is INJURING YOU and it needs to be fixed. At the very least you need to be EXPLANTED to remove the damaged and injurious implant but since AMS and the doctor are already offering their products and services for free, the same hospital operating room would be needed to EXPLANT or to REPLACE/REIMPLANT.

You really are injured and need emergency surgery. Whether they remove one or remove and reinstall another that's freely offered, there's little difference when the operating room is already in use.