Insurance vs Self Pay

[Musson]

I think it be interesting to see how many implantees went the self pay route

[bionicbrother]

I had the ability to self pay but when insurance can pay for it why not?? For my doctor it was $18k cash but went with insurance. My out of pocket was like $300 or so( since I paid all my deductibles before)

[DougAnd]

I think that's a good point. I mean it's not as if the doctor is going to give you a better job right? He still gets the same money. My situation was that I could use insurance and pay less than $100 out of pocket and go locally or I could use insurance and have to pay for hotel airline tickets travel Etc and use Dr Kramer in Baltimore. So it was kind of insurance / plus self pay. But I couldn't afford it so I went local and pay for that dearly every day. So I think the point here is that if you can get the best job paying out of pocket and you have the money to do it you'd be stupid to use insurance and get a Half Baked job locally

[Diligent]

I had to selfpay. My insurance kept declining me. I couldn't wait any longer. Im in my 15th day since surgery. How many pumps till it becomes like squeezing a walnut.
? I'm only up to five? I'm happy so far.

[DougAnd]

At 6 weeks the best I could do was seven pumps. Now years later 30 or more is not uncommon

[newbie443]

I had to selfpay. My insurance kept declining me. I couldn't wait any longer. Im in my 15th day since surgery. How many pumps till it becomes like squeezing a walnut.
? I'm only up to five? I'm happy so far.

I found heat helped. I was not released for baths when I was activated and do not take them anyway so I used a heating pad. That softens the tissue and cylinders and the pump and makes everything easier.

I think that's a good point. I mean it's not as if the doctor is going to give you a better job right? He still gets the same money. My situation was that I could use insurance and pay less than $100 out of pocket and go locally or I could use insurance and have to pay for hotel airline tickets travel Etc and use Dr Kramer in Baltimore. So it was kind of insurance / plus self pay. But I couldn't afford it so I went local and pay for that dearly every day. So I think the point here is that if you can get the best job paying out of pocket and you have the money to do it you'd be stupid to use insurance and get a Half Baked job locally

I have done both and I can't check both boxes. My first I paid out of pocket due to super poor results from local doctors. But I was unlucky and could not afford to pay to fix a proximal perforation for my second. Even well known doctors have problems and the doctor that did my first was not of much help for some reason. Insurance paid for the repair as there was a clause that if the service was not offered, I could travel for the service. They would not approve a 2nd well known doctor for the repair with a full replacement and I still had to travel for the repair. I still have pain using it just not as often as I had before the repair.

Another option I have considered many times is to move to a location with better doctors. Not just for this but for everything. So put me down for one self pay and one insurance and 2 travels outside my home area.

[DougAnd]

I had to selfpay. My insurance kept declining me. I couldn't wait any longer. Im in my 15th day since surgery. How many pumps till it becomes like squeezing a walnut.
? I'm only up to five? I'm happy so far.

I found heat helped. I was not released for baths when I was activated and do not take them anyway so I used a heating pad. That softens the tissue and cylinders and the pump and makes everything easier.

I think that's a good point. I mean it's not as if the doctor is going to give you a better job right? He still gets the same money. My situation was that I could use insurance and pay less than $100 out of pocket and go locally or I could use insurance and have to pay for hotel airline tickets travel Etc and use Dr Kramer in Baltimore. So it was kind of insurance / plus self pay. But I couldn't afford it so I went local and pay for that dearly every day. So I think the point here is that if you can get the best job paying out of pocket and you have the money to do it you'd be stupid to use insurance and get a Half Baked job locally

I have done both and I can't check both boxes. My first I paid out of pocket due to super poor results from local doctors. But I was unlucky and could not afford to pay to fix a proximal perforation for my second. Even well known doctors have problems and the doctor that did my first was not of much help for some reason. Insurance paid for the repair as there was a clause that if the service was not offered, I could travel for the service. They would not approve a 2nd well known doctor for the repair with a full replacement and I still had to travel for the repair. I still have pain using it just not as often as I had before the repair.

Another option I have considered many times is to move to a location with better doctors. Not just for this but for everything. So put me down for one self pay and one insurance and 2 travels outside my home area.

WOW. Proximal perforation is almost the same as distal crossover but in the opposite direction. How did that happen? Did you have peyronies or something?

[newbie443]

WOW. Proximal perforation is almost the same as distal crossover but in the opposite direction. How did that happen? Did you have peyronies or something?

That is a long story and I do not wish to start the mess that seems to occur with this or any other man that had problems with this doctor. It would highjack this thread to something not intended. If you would like to talk about this I would be willing to do so just send me a PM.

[OregonStrong]

It was an emphatic NO from my terrible work sponsored insurance plan that doesn't seem to cover crap, and has such a high deductible I don't even know why we carry it. I guess for catastrophic coverage.

[SquadCaptain74]

It was an emphatic NO from my terrible work sponsored insurance plan that doesn't seem to cover crap, and has such a high deductible I don't even know why we carry it. I guess for catastrophic coverage.

BSCI has a great insurance liaison team that will work between the practice and the insurance companies to attain approval. I found their help to be of incredible worth - and once approved (it did take a while and a lot of paperwork to show treatments) only paid $300 for the co-pay for the outpatient center. Be persistent - but also leverage the resources of the staff at the urology clinics and Boston Scientific (if you are considering their AMS implants). PM if you have any questions. Happy to share my journey in this realm.