Did Insurance Cover the Procedure?

The final frontier. Deciding when, if and how.
Kiawahgolf
Posts: 85
Joined: Sat Dec 17, 2022 9:56 am

Did Insurance Cover the Procedure?

Postby Kiawahgolf » Sun Dec 18, 2022 10:09 am

Hello,

Just curious if insurance covered the expenses of your implant procedure? Obviously, testing must be performed to deem the implant necessary but just curious how much trouble it was to have the surgery covered.

As an aside, how long does it take to fully pump the implant to erect?

Thanks!

BearsWin
Posts: 51
Joined: Thu May 12, 2022 11:37 pm

Re: Did Insurance Cover the Procedure?

Postby BearsWin » Sun Dec 18, 2022 10:33 am

Anthem Blue Cross covered mine without issue. No testing. I did have a long history of oral meds and failed injectable therapy/urologist visits so they certainly had an adequate history of other treatments, don’t know if that was important.

Inflation time to something useable under a minute. I’m still in early cycling so I can work if for over 10 more minutes to get more pumps into it.

Haven’t been able to use it yet 7 weeks postop but that’s another story.
Born 1966. PDE-5s since age 40. Decreasing efficacy age 50. Started on Trimix 2022 - variable response even at high doses. Coloplast Titan 11/1/22 Dr. Yafi UCI, submuscular/ectopic reservoir. History of hypertension. Married, Nevada.

Flounder
Posts: 271
Joined: Mon Jul 23, 2018 3:17 pm
Location: PA

Re: Did Insurance Cover the Procedure?

Postby Flounder » Sun Dec 18, 2022 10:48 am

So far Medicare and my plan G supplement are paying 100% of the surgery costs. (My annual deductible was previously met)

However Medicare did decline the pre-assessment office visit plus injection and sonogram. That pre-surgery visit totals a little over $2k. I’m in the process of appealing that claim. Wondering if anyone else on Medicare had trouble getting the pre-surgery tests paid?

Same situation as BearsWin, still in the early stages of cycling. Not always getting full pumps so can’t really say yet.
A-69, M-44, Battling ED since partial NS-Prostatectomy 2012 plus SRT for PCa return 2016
Pills & injections ran their course. Implant 11/11/22 by Dr. Eid.
Titan Classic 22cm, LH cylinder trimmed, Ectopic reservoir placement.

KeithC
Posts: 151
Joined: Thu Dec 01, 2022 2:00 pm

Re: Did Insurance Cover the Procedure?

Postby KeithC » Sun Dec 18, 2022 11:50 am

Mine cost just $200 with BlueCross BlueShield of Texas Medicare advantage. I had no deductible to meet. I was shocked frankly. I thought surely it would cost me thousands. Oh yeah and I had to pay $18 for the meds at the hospital to take home which I though was very reasonable and very convenient. No need to wait all day on a pharmacy then drive to pick it up. $218 total!

There was no "testing" at all. The PA asked me a list of questions and then said I was qualified. I didn't have to prove anything.

If you're on regular insurance and not Medicare, who knows, it could cost a lot.

Old Guy
Posts: 2700
Joined: Tue Mar 31, 2020 4:31 pm
Location: Ohio

Re: Did Insurance Cover the Procedure?

Postby Old Guy » Sun Dec 18, 2022 1:32 pm

My insurance covered 80% of the surgery leaving me with a $3,400 co-pay. If I would have had Part B at the time my cost would have been Zero.
Inflating takes me maybe 30 seconds.
Nov. 8, 2019
4+ years, Coloplast Titan OTR
Married 36 years to my beautiful young bride
Always here to answer questions if you PM me

crazyjoe
Posts: 563
Joined: Thu Feb 18, 2021 4:22 pm

Re: Did Insurance Cover the Procedure?

Postby crazyjoe » Sun Dec 18, 2022 2:01 pm

I have a Blue Cross rider over Medicare -- they paid every cent. Pumping to rock hard about 2 mins.
75, used pills, injections -- all lost effectiveness. Titan implanted by Eid in Feb '22.

robcb1
Posts: 30
Joined: Sat Jul 16, 2022 6:48 am

Re: Did Insurance Cover the Procedure?

Postby robcb1 » Sun Dec 18, 2022 2:30 pm

Insurance covered my implant procedure. I paid $460 for the entire thing, and I am not yet on Medicare. That $460 went toward satisfying my deductible. My use of other options was well documented by my doctor, so it was no problem getting the implant approved. I can’t believe the freedom this implant has brought. No more meds! No more, “Is this stuff going to work?” It works 100%!
Implanted 8/23/22. Coloplast Titan 20cm, no RTE’s, infrapubic. Married 40 years.

newbie443
Posts: 1930
Joined: Fri Dec 01, 2017 9:41 pm
Location: Sedgwick county, Kansas USA

Re: Did Insurance Cover the Procedure?

Postby newbie443 » Sun Dec 18, 2022 11:29 pm

Kiawahgolf wrote:Hello,

Just curious if insurance covered the expenses of your implant procedure? Obviously, testing must be performed to deem the implant necessary but just curious how much trouble it was to have the surgery covered.

As an aside, how long does it take to fully pump the implant to erect?

Thanks!


Welcome to the site. Some things to clear up a bit. First I have had no testing for my ED ever. Some places do testing some do not. Just treatment. Pills then injections. VED is in there also but as I am single that was not an issue. I have had testing for surgery certification. I paid out of pocket for my first implant surgery. For my repair my share of the testing for surgery certification, travel, and hospital and doctors visits was around 3k.

Time to pump is going to depend on a number of things. How big the cylinders are that need to be inflated, what pump you have, hand strength, how fully deflated or partially deflated you keep the device. It takes me under 2 minutes to have mine inflated enough for sex.
Injections failed. Implanted 3-21-18 AMS 700 LGX 21 + 1 RTE 100 cc reservoir 6.5" L 5" G Dr. Kramer.

Proximal Perforation Sling Repair 4/13/21 Dr. Broghammer

66 years young.

Will show and tell and talk with others.

Kiawahgolf
Posts: 85
Joined: Sat Dec 17, 2022 9:56 am

Re: Did Insurance Cover the Procedure?

Postby Kiawahgolf » Mon Dec 19, 2022 2:10 pm

I appreciate everyone’s replies. I have had ED since I was in high school and have spent countless hours googling conditions trying to figure out why I have to be that guy. It has gotten to a point where 100 mg of Viagra will provide a 75% erection that does not last. I am only 39 years old but I’ve been dealing with this for over 20 years and I really don’t want to start injecting. Unfortunately, me and my high school sweetheart got divorced in January and the comfort level is not there with new women and that’s made things even worse. I don’t want to come across the wrong way but I am a fit, good looking guy, that works out five days a week.. I have been able to talk to and get just about any lady I want but after two-three weeks I start backpedaling out of performance anxiety. I honestly don’t want to get an implant due to my age and the fact that I’m afraid it won’t be spontaneous/the girl will be turned off, and maybe even cause more anxiety by making my feel like less of a man. Does this make sense? I’m also worried about the time I’ll have to take off of work for the procedure and I don’t want to tell my family or coworkers what’s going on. I really appreciate everyone here and your experiences and words of advice.

Flounder
Posts: 271
Joined: Mon Jul 23, 2018 3:17 pm
Location: PA

Re: Did Insurance Cover the Procedure?

Postby Flounder » Mon Dec 19, 2022 5:37 pm

Kiawahgolf wrote:…………. I have been able to talk to and get just about any lady I want but after two-three weeks I start backpedaling out of performance anxiety. I honestly don’t want to get an implant due to my age and the fact that I’m afraid it won’t be spontaneous/the girl will be turned off, and maybe even cause more anxiety by making my feel like less of a man. Does this make sense? ……..


Honestly, No. IMO it doesn’t make sense
Seems like backpedaling and terminating relationships due to performance anxiety is more damaging than occasional bedding a girl that might be turned off by the implant.
Heck, even when my natural erections were good and strong, not every hookup ended with great sex. Seems like you’re favoring your current 100% fail rate over a chance for some wonderful date nights and a chance to meet Mrs. Right.
Last edited by Flounder on Mon Dec 19, 2022 7:40 pm, edited 1 time in total.
A-69, M-44, Battling ED since partial NS-Prostatectomy 2012 plus SRT for PCa return 2016
Pills & injections ran their course. Implant 11/11/22 by Dr. Eid.
Titan Classic 22cm, LH cylinder trimmed, Ectopic reservoir placement.


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