Costs, Travel and Recovery

[etj4588]

Hello all,

Long time lurker, first time poster. I've suffered from ED for about 5 years now... a complication from Type 2 diabetes. It started with getting weaker erections and has progressed to being unable to penetrate. Consequently, I've run through the protocols of Viagra, Cialis, Levitra. Then it was on to Bi-mix, Tri-Mix, and now Quad-mix. And although some of these brought temporary solutions, the effectiveness has tended to fade quickly. I am now seriously considering the implants and I am in the beginning stages of gathering information.

I understand that many insurance companies cover the cost of the surgery for the most part. But for those plans that don't, can anyone tell me what the surgery might cost? I've seen ranges from $25k to over $100k. I'm not sure if my plan covers it, so I want to be sure I can afford it before going down the path and getting excited about it and then being let down if I can't afford it.

For those that have traveled to see a non-local surgeon, how does that work? Do you stay in a hotel during recovery? Are you able to travel back home? If so, at what point?

Lastly, I was wondering if anyone could tell me what the recovery time would be before resuming normal activities? By normal activities, I mean going back to work. I am an accountant and may only have 2 to 3 weeks for recovery before I am required to be back at my desk. Is this even possible?

Thanks in advance.

[Nebraska64]

I had the implant done by Dr. Hakky six weeks ago and his total cost was $19,000. This covers the procedure in his in-clinic surgery room. If a patient has any major health issues that would make it necessary to have him do the procedure in the hospital, I imagine that the cost would be considerably higher.

I had a pre-op appointment on a Wednesday, the procedure the next day (Thursday), had an office visit on Monday to have the wound drain removed, met with Dr. Hakky and the Coloplast rep that Tuesday (day 5) and started cycling that same day that I saw the rep. I stayed til Thursday just to make sure I had the hang of inflating and deflating.

[newbie443]

Hello, and welcome to the site. This has been discussed many times and you can do a search to find a lot of information. Short answer is things very a lot. And cash price is way different from insurance charged or paid price. There was a thread a member made that listed self-pay amounts for different doctors if you can find it. Another thing to consider is travel costs and cost for a repair or revision if something goes wrong. Some doctors have a partial warranty but I'm not sure about that so another thing to look into. There is a company Surgeo that has self-pay packages with some really good doctors and it includes a 3rd party 25k insurance for the first year. But you'd deal with an insurance company that of course dose not want to pay. But the web site will give you some prices to look at and if you are considering one of the doctors be sure to do a search on the doctor on this site.

2-3 weeks should be good to go back to work. But check activation waits with your doctor. You are inflated during surgery and left that way for a certain amount of time then deflated and start inflating and deflating called cycling. Activation is when you start cycling. My local docs were 8 weeks 5 years ago and last year they moved up to 6 weeks. My surgeon was just under 3 weeks just over 4 years ago. You can still go back to work inflated but it would be less fun than if you were already activated.

As you can see men fly across the US and from all over the world to well-known doctors in the US. Doctors are set up for this and they vary a bit but most have information to give you on transportation and hotels along with when you will be released to travel back home.

Good luck with this.

Hello all,

Long time lurker, first time poster. I've suffered from ED for about 5 years now... a complication from Type 2 diabetes. It started with getting weaker erections and has progressed to being unable to penetrate. Consequently, I've run through the protocols of Viagra, Cialis, Levitra. Then it was on to Bi-mix, Tri-Mix, and now Quad-mix. And although some of these brought temporary solutions, the effectiveness has tended to fade quickly. I am now seriously considering the implants and I am in the beginning stages of gathering information.

I understand that many insurance companies cover the cost of the surgery for the most part. But for those plans that don't, can anyone tell me what the surgery might cost? I've seen ranges from $25k to over $100k. I'm not sure if my plan covers it, so I want to be sure I can afford it before going down the path and getting excited about it and then being let down if I can't afford it.

For those that have traveled to see a non-local surgeon, how does that work? Do you stay in a hotel during recovery? Are you able to travel back home? If so, at what point?

Lastly, I was wondering if anyone could tell me what the recovery time would be before resuming normal activities? By normal activities, I mean going back to work. I am an accountant and may only have 2 to 3 weeks for recovery before I am required to be back at my desk. Is this even possible?

Thanks in advance.

[Time2Change]

My insurance did cover my surgery. I saw the bill--55k.

I had surgery an hour's drive from home. I spent the rest of the day and the night in the hospital. My wife drove me home the next day.

My first follow-up appointment was two weeks and two days after the surgery. My doctor deflated me then and gave me the okay to go back to work. I would think you might like to have the options of both a sitting desk and a standing desk when you go back to work. I found having both options helpful for a while because it was uncomfortable to just sit or just stand for long at first.

[Flounder]

First things first, call your insurance company and ask if your benefits cover a CPT procedure code of 54405 (implantation of a two or three piece penile prosthesis) with either a diagnosis code of N52.9 (erectile dysfunction, other cause). Or N52.03 (erectile dysfunction, organic cause). The cause code can be important.

You shouldn’t have to tell them it’s for a penile implant or anything, just ask them to look up the codes by number. They can tell you if it’s covered benefit, if there is a cap or network restrictions, and what the co-payment might be. BTW, Medicare does pay for it if your getting close to that age group.

As for travel, it would be helpful if you state where your located. While some do travel far, it’s not a given that you must travel and stay in hotels. Many have reported excellent results with a driver and back home the same day. Just depends on your location and choice of doctor.