Insurance status

The final frontier. Deciding when, if and how.
Lost Sheep
Posts: 6162
Joined: Mon Jul 04, 2016 11:16 pm

Re: Insurance status

Postby Lost Sheep » Mon Dec 07, 2020 7:21 pm

deepanvee wrote:
mike123 wrote:
deepanvee wrote:Unfortunately I dont have any medical reasons for this implant.


Can you expand on that a bit further? You have ED, but no medical reason to explain it? Phycological ED? Or can you get a normal erection but are just looking for an enhancement?


Yes that is correct. I always had ED even when I was 20 years old but couldnt explain why. I can never get 100% erection maybe 25%-50% hard not good enough to penetrate. When the doctor injected me with trimix(for ultrasound) I had real good erection- He said the blood flow is very good and there are no leaks. I am not sure if its psychological because I would assume there would be no erection at all rather than partial erection but get good erection when I have cialis(~75%) or trimix(100%)?

Ultrasound shows good blood flow (I assume this is arterial inflow) and no leaks (this must be venous outflow). And you got a good erection with that trimix injection.

Does that 100% rule out ALL possible physical causes?

Can you get erections through masturbation or while you are asleep? (There are tests for "nocturnal penile tumescence" which generally bypasses all psychological causes of E.D.) If your urologist will not or cannot discuss potential causes or treatments with you further, find another for a second opinion.

ANY solution short of implant is better than an implant. I am thrilled with my implant, but the operation destroys pretty much all hope of ever finding an actual cure. Implant is a treatment. Not a cure. Get one only as a last resort of a desperate man.
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
READ OLD THREADS-ask better questions -better understand answers
Be part of your medical team
Document pre-op size-photos and written records
Pre-op VED therapy helps. Post-op is another matter

gercoa
Posts: 66
Joined: Fri May 10, 2019 12:45 pm

Re: Insurance status

Postby gercoa » Tue Dec 08, 2020 6:50 pm

Insurance denied me as well. ED just was not enough. My doctor and his department wrote them and got it approved based on pyrones and the medical need associated with it. If you have that avenue maybe try again? the whole process of going back and forth with the insurance took almost 6 weeks!
52 Been on every pill, done Trimix/Bimix In line for a Titan pump. Married, wife involved with this whole process. :) Implanted 12/9/19 Titan 20 with 1.6 rear tips.

bionicbrother
Posts: 335
Joined: Thu Oct 22, 2020 1:53 am
Location: San Francisco bay area

Re: Insurance status

Postby bionicbrother » Wed Dec 09, 2020 3:58 pm

gercoa wrote:Insurance denied me as well. ED just was not enough. My doctor and his department wrote them and got it approved based on pyrones and the medical need associated with it. If you have that avenue maybe try again? the whole process of going back and forth with the insurance took almost 6 weeks!


Thats good that you were able to get it approved. The issue is not proving the "need" the issue is there is no coverage at all no matter the reasons for doing it. Its completely excluded no matter what is what my insurance company told me so its sucks

I guess I have few options to pursue 1) Trimix which is really working for me but not an ideal solution especially while flying(which will not happen for me for quite sometime I guess 2) Soundwave theraphy which I havent tried so far( thinking of purchasing Phoenix when it goes on sale again) 3) Continue manage with Cialis. Not sure if P shot would help me.. Need to check with my doctor.
40 yrs old. Have ED and PE all my life. Never had penetrative sex all my life. Tried almost all kinds of options( pills, injections, natural therapies etc. Turned Bionic on May 17'22 with Titan by Dr.Karpman infrapubic approach.16cm+2 RTE

Lost Sheep
Posts: 6162
Joined: Mon Jul 04, 2016 11:16 pm

Re: Insurance status

Postby Lost Sheep » Wed Dec 09, 2020 4:12 pm

deepanvee wrote:
gercoa wrote:Insurance denied me as well. ED just was not enough. My doctor and his department wrote them and got it approved based on pyrones and the medical need associated with it. If you have that avenue maybe try again? the whole process of going back and forth with the insurance took almost 6 weeks!


Thats good that you were able to get it approved. The issue is not proving the "need" the issue is there is no coverage at all no matter the reasons for doing it. Its completely excluded no matter what is what my insurance company told me so its sucks

I guess I have few options to pursue 1) Trimix which is really working for me but not an ideal solution especially while flying(which will not happen for me for quite sometime I guess 2) Soundwave theraphy which I havent tried so far( thinking of purchasing Phoenix when it goes on sale again) 3) Continue manage with Cialis. Not sure if P shot would help me.. Need to check with my doctor.

Changing insurance companies/policy is an option right now, maybe. Also, could a rider be added to your policy to cover ED/implant issues? Since Cialis and injections still work, you might be able to wait out a "pre-existing condition" exclusion period. Read the fine print before committing any money.
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
READ OLD THREADS-ask better questions -better understand answers
Be part of your medical team
Document pre-op size-photos and written records
Pre-op VED therapy helps. Post-op is another matter

bionicbrother
Posts: 335
Joined: Thu Oct 22, 2020 1:53 am
Location: San Francisco bay area

Re: Insurance status

Postby bionicbrother » Thu Dec 10, 2020 6:51 pm

[/quote]
Changing insurance companies/policy is an option right now, maybe. Also, could a rider be added to your policy to cover ED/implant issues? Since Cialis and injections still work, you might be able to wait out a "pre-existing condition" exclusion period. Read the fine print before committing any money.[/quote]

Makes sense sir. I am checking with my HR on what options I have.
40 yrs old. Have ED and PE all my life. Never had penetrative sex all my life. Tried almost all kinds of options( pills, injections, natural therapies etc. Turned Bionic on May 17'22 with Titan by Dr.Karpman infrapubic approach.16cm+2 RTE

Gt1956
Posts: 3041
Joined: Fri Apr 05, 2019 2:47 pm

Re: Insurance status

Postby Gt1956 » Thu Dec 10, 2020 10:38 pm

deepanvee wrote:

Changing insurance companies/policy is an option right now, maybe. Also, could a rider be added to your policy to cover ED/implant issues? Since Cialis and injections still work, you might be able to wait out a "pre-existing condition" exclusion period. Read the fine print before committing any money.[/quote]
Makes sense sir. I am checking with my HR on what options I have.[/quote]

I think that LS's advice is good. You need to be your own best advocate. Prepare your talking points in advance. Anticipate their replies before they say them & have a well thought out reply already in your mind.
68yo, HBP at 40, high triglycerides at 45. Phimosis at 57. Type 2 at 60. Dr. William Brant May 1, 2023 CX 21cm w/no rte's penoscrotal 6" girth @ 6 months

implant1959
Posts: 190
Joined: Fri Dec 04, 2020 6:27 pm
Location: Nebrasska

Re: Insurance status

Postby implant1959 » Fri Dec 11, 2020 2:12 am

deepanvee wrote:I am sorry to say that my insurance rejected it because looks like my company has excluded this coverage in my plan :( I have asked what the cash options looks like but I am not sure if there is any discount available. They are saying cost is around $18k. Looks like they will be financing it too.. I havent made a decision on whether to move forward or not.. Cigna is my provider

Anyone else experienced such insurance declines? Did you end up paying for it?


Can you find an Obamacare Plan that would cover it, and double cover yourself. Then once surgery is over drop the Obama Plan? Just a thought.
I consider myself lucky, it is covered by my insurance and my portion is between $1500.-$2000,
Scott, member of Bionic Brotherhood since 12/2/2020 with activation on 12/17/2020.
Coloplast Titan Touch.
Feel free to PM me, we all need an ear now and then.

bionicbrother
Posts: 335
Joined: Thu Oct 22, 2020 1:53 am
Location: San Francisco bay area

Re: Insurance status

Postby bionicbrother » Fri Dec 11, 2020 2:46 pm

Can you find an Obamacare Plan that would cover it, and double cover yourself. Then once surgery is over drop the Obama Plan? Just a thought.
I consider myself lucky, it is covered by my insurance and my portion is between $1500.-$2000,[/quote]


I was thinking and wondering the same thing wow.. let me do some research.. Thank you. Glad it was covered for you. Lucky man :mrgreen:
40 yrs old. Have ED and PE all my life. Never had penetrative sex all my life. Tried almost all kinds of options( pills, injections, natural therapies etc. Turned Bionic on May 17'22 with Titan by Dr.Karpman infrapubic approach.16cm+2 RTE

bionicbrother
Posts: 335
Joined: Thu Oct 22, 2020 1:53 am
Location: San Francisco bay area

Re: Insurance status

Postby bionicbrother » Fri Dec 11, 2020 2:46 pm

I think that LS's advice is good. You need to be your own best advocate. Prepare your talking points in advance. Anticipate their replies before they say them & have a well thought out reply already in your mind.[/quote]

Sounds good sir. Will do
40 yrs old. Have ED and PE all my life. Never had penetrative sex all my life. Tried almost all kinds of options( pills, injections, natural therapies etc. Turned Bionic on May 17'22 with Titan by Dr.Karpman infrapubic approach.16cm+2 RTE

implant1959
Posts: 190
Joined: Fri Dec 04, 2020 6:27 pm
Location: Nebrasska

Re: Insurance status

Postby implant1959 » Fri Dec 11, 2020 5:52 pm

Lost Sheep wrote:
deepanvee wrote:
mike123 wrote:
Can you expand on that a bit further? You have ED, but no medical reason to explain it? Phycological ED? Or can you get a normal erection but are just looking for an enhancement?


Yes that is correct. I always had ED even when I was 20 years old but couldnt explain why. I can never get 100% erection maybe 25%-50% hard not good enough to penetrate. When the doctor injected me with trimix(for ultrasound) I had real good erection- He said the blood flow is very good and there are no leaks. I am not sure if its psychological because I would assume there would be no erection at all rather than partial erection but get good erection when I have cialis(~75%) or trimix(100%)?

Ultrasound shows good blood flow (I assume this is arterial inflow) and no leaks (this must be venous outflow). And you got a good erection with that trimix injection.

Does that 100% rule out ALL possible physical causes?

Can you get erections through masturbation or while you are asleep? (There are tests for "nocturnal penile tumescence" which generally bypasses all psychological causes of E.D.) If your urologist will not or cannot discuss potential causes or treatments with you further, find another for a second opinion.

ANY solution short of implant is better than an implant. I am thrilled with my implant, but the operation destroys pretty much all hope of ever finding an actual cure. Implant is a treatment. Not a cure. Get one only as a last resort of a desperate man.



I had great blood flow, no venous leakage, great erections with Trimix, and nocturnal erections, but no other erections. Dr said it was never damage related to hypertension and diabetes, so don't let someone tell you it is psychological even when n the test results look good.
Scott, member of Bionic Brotherhood since 12/2/2020 with activation on 12/17/2020.
Coloplast Titan Touch.
Feel free to PM me, we all need an ear now and then.


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