Insurance that covers Implants

[Pamen116]

Anyone know what monthly insurance I can purchase that will cover my revision?

Thanks guys

[KeithC]

Any individual policy would cost you probably $8k out of pocket if they cover it at all.

How did you get the other 3 paid for?

Guys your age are really at a disadvantage unless you have excellent insurance through your job or make really good money.

If you were old like me (66) it would be easier. I only paid $200 for my implant total with no deductible to meet. The doctor of my choice came highly recommend by other urologists. BCBS is my Medicare Advantage Plan.

Healthcare in this country is so screwed up it’s ridiculous. As a business owner I always had to have individual plans that cost a fortune with really high deductibles.

[Old Guy]

Any insurance will probably have a waiting period before they pay for a big surgery. For coverage you'll have to read what exclusions are written into the policy.

[newbie443]

Anyone know what monthly insurance I can purchase that will cover my revision?

Thanks guys

As the marketplace (Obamacare) is a federal program all policies should have coverage. But it is expensive and will require prior approval. At least mine did. My policy was 12 to 13k a year and was the best policy BCBS offered. I had a 1500 deductible and 4K max out of pocket. And a very small coverage area and they told me who I could go to for the surgery. The business office of the uro group that was approved said that my cost would be 4K + as insurance did not cover all of what they charged and many men that received the implant by the doctors in the group ended up having them removed due to poor results. The doctors did not do repairs or replacements. Just one and done and the only other surgery was removal. They seemed almost even happy to tell me I would have size loss from the surgery. Pretty sure BCBS is powerful in my state government and controls health care in the state to a point. And also the doctors and BCBS seemed to hate to pay for the device. There was another insurance offered that had out of network coverage but it was twice the cost. and twice the deductible and max out of pocket. I just paid out of pocket. Insurance did pay for my repair surgery but would not pay for a replacement device that all the well-known doctors wanted to use in the repair surgery. They instead had me go to a doctor in my state that removed and then put back in the original device. I had meet a lot of my deductible and some of my max out of pocket and it still cost me 2.5K. I would think your best luck in getting coverage for this would be a federal or maybe state job.

Good luck going forward with this.

[Livingstonguy]

Any insurance will probably have a waiting period before they pay for a big surgery. For coverage you'll have to read what exclusions are written into the policy.

My insurance did not have a waiting plan. BCBS of TN

[TuffDadSF]

My insurance at work (Aetna) covers the surgery and revisions BUT my job does not allow it because it falls under plastic surgery and thought to be cosmetic. It totally sucked because I had my surgery all lined up in September 2022 and the day before was told it would NOT be covered. I could have fought it but I didn't really want to sue and be the face of IMPLANTS FOR ALL! in my small town.

I then looked into getting a second insurance policy. Since it was right around the time of open enrollment I was able to jump on MVP which covers the surgery AND had a platinum plan with no deductible and $2000 out of pocket max for the year.

It went into effect in January 2023 and I had my surgery on January 17th. I paid $1300 a month in premiums for January and February. I had 2 copays of $100 (one for the facility and one for the surgeon).

I cancelled my secondary insurance to end at the end of this (Feb 2023) month.

So $2800 spent for a 45K surgery was well worth it!

[Old Guy]

It went into effect in January 2023 and I had my surgery on January 17th. I paid $1300 a month in premiums for January and February. I had 2 copays of $100 (one for the facility and one for the surgeon).

I cancelled my secondary insurance to end at the end of this (Feb 2023) month.

So $2800 spent for a 45K surgery was well worth it!

Sweet. You figured out the system!

[Pamen116]

My insurance at work (Aetna) covers the surgery and revisions BUT my job does not allow it because it falls under plastic surgery and thought to be cosmetic. It totally sucked because I had my surgery all lined up in September 2022 and the day before was told it would NOT be covered. I could have fought it but I didn't really want to sue and be the face of IMPLANTS FOR ALL! in my small town.

I then looked into getting a second insurance policy. Since it was right around the time of open enrollment I was able to jump on MVP which covers the surgery AND had a platinum plan with no deductible and $2000 out of pocket max for the year.

It went into effect in January 2023 and I had my surgery on January 17th. I paid $1300 a month in premiums for January and February. I had 2 copays of $100 (one for the facility and one for the surgeon).

I cancelled my secondary insurance to end at the end of this (Feb 2023) month.

So $2800 spent for a 45K surgery was well worth it!

my luck always fails- MVP doesn’t provide service for those in Texas

[sswinsfba]

So $2800 spent for a 45K surgery was well worth it!

Glad you were about to make the insurance system work for you but the current rate among high volume surgeons who do penile implants for "out of pocket" patients is around $20k.

What they bill & collect from the insurers for it is another matter.

Fortunately, for us OGs 65 & over, Medicare pays for almost all of it.