Cash or Finance

[Rider1400]

I really appreciate all the replies. These help give some context.

I just found out my insurance has a specific exclusion for this operation. LMAO. i mean fuck - go figure. So now Im just trying to figure out if I want to shell out the cash or look for financing.
I am typically the kind of person that weighs the interest rate of the loan against what my money can make if its invested.

Anyway, i'm just bummed with this news and trying to figure out what I want to do.

Thanks everyone.

At first I was told by my insurance that it would not be covered… but, after many hours on phone with Dr office to get the actual codes you submit for the actual procedure, I got back with insurance and found it was covered! I had a shoulder surgery earlier the month before so my deductible and max out of pocket was reached. Only cost a couple hundred dollars.

[CHIEF3]

My experience and opinion. When I had BCBS they did not want to pay for my first implant. They claimed I did not try all treatment options. And I had a very bad experience with the agent reviewing my claim. I believe that person was let go and I was assigned to another agent. In my case, I explained to the agent (on the phone not by email) that I had tried multiple different things (pills, injections, rings, herbs). Nothing was working long enough to make to ejaculation. At the time we wanted to have a baby. It was a very pleading testimony to the agent, a woman. I feel she might have had some compassion for me and believed all our efforts. My surgery was approved and my copay was insignificant compared to full payment and the benefits from the results. I was also very lucky in having one of the best surgeons, Dr. Karpman. At the time I didn’t know his experience and all the possible complications with this surgery. In closing, continue to work with your insurance agent directly and choose the best doctor within your means.
All the best to everyone.

[TexasMax]

I really appreciate all the replies. These help give some context.

I just found out my insurance has a specific exclusion for this operation. LMAO. i mean fuck - go figure. So now Im just trying to figure out if I want to shell out the cash or look for financing.
I am typically the kind of person that weighs the interest rate of the loan against what my money can make if its invested.

Anyway, i'm just bummed with this news and trying to figure out what I want to do.

Thanks everyone.

That stinks. How specific is the exclusion? Sometimes a doctors billing office can manipulate insurance with a different code.
My co-pay was about $3,500 through UHC. Denied at first, billing office sent another request. Approved!

They got me good on this policy. Specifically - " no implantable devices " lol. So they have just leaned on that.

[TexasMax]

I really appreciate all the replies. These help give some context.

I just found out my insurance has a specific exclusion for this operation. LMAO. i mean fuck - go figure. So now Im just trying to figure out if I want to shell out the cash or look for financing.
I am typically the kind of person that weighs the interest rate of the loan against what my money can make if its invested.

Anyway, i'm just bummed with this news and trying to figure out what I want to do.

Thanks everyone.

Could be worse, I called my insurance to see if I was covered, was told on not once but three times that both the operation and device were covered. After the surgery I get a "explanation of benefits" letter saying it's not covered because it's in my exclusions ( which I didn't know anything about because we didn't have exclusions when we first signed up or weren't notified about any.) And to top it off I had to have the device replaced because it was defective about 2 months later. So my first EOB said I owed around $92000 about $50000 was the device. Just waiting for the other shoe to drop with a EOB from the second surgery, probably another $92000 but should get a credit for the bad device... The insurance sucks because they told me, my Dr, and the hospital that it was covered, then balk when it's time to pay.... Still have no idea how I'm going to be able to pay that bill....

Jesus christ brother. Wow. I would definitely be raising some serious hell. Is there not a way to ahold of the proof and remind them what they said then tell them to get fucked. lol. Maybe i've watched to much Suits.

[Old Guy]

They got me good on this policy. Specifically - " no implantable devices " lol. So they have just leaned on that.

What if you blew out a knee? Are they going to make you an invalid if they won't implant a knee?
See if they allow female breast enhancements. If they do call them for discrimination!

[Bigdave]

They got me good on this policy. Specifically - " no implantable devices " lol. So they have just leaned on that.

What if you blew out a knee? Are they going to make you an invalid if they won't implant a knee?
See if they allow female breast enhancements. If they do call them for discrimination!

Seriously, WTF?
I just had an ankle replacement. I guess they would exclude that as well?
You really need to look into your insurance options.
Good luck.

[rdnkbiker]

sorry to hear your issues had the same got my first implant at 55 to young i guess and shitty doc a lot of docs can write it as a necessary medical issue which mine was any way no budging insurance wise so i got stuck with the bill and was large on my second one July 10th 2023.. had them check all options good doc still couldn't get it covered had to pay cash up front before surgery a lot cheaper to pay upfront in my case


good luck
jim

[TexasMax]

They got me good on this policy. Specifically - " no implantable devices " lol. So they have just leaned on that.

What if you blew out a knee? Are they going to make you an invalid if they won't implant a knee?
See if they allow female breast enhancements. If they do call them for discrimination!

Seriously, WTF?
I just had an ankle replacement. I guess they would exclude that as well?
You really need to look into your insurance options.
Good luck.

Without getting into all the details of the shitty policy i have. Their exclusions have a few inclusions for things like that. but in a sub section paragraph of this section they double down on the exclusions with " any surgical or non surgical services for the treatment of impotence, infertility, or testosterone .........

[Old Guy]

Without getting into all the details of the shitty policy i have. Their exclusions have a few inclusions for things like that. but in a sub section paragraph of this section they double down on the exclusions with " any surgical or non surgical services for the treatment of impotence, infertility, or testosterone .........

Damn, sorry. Insurance should pay for all things medical. But I guess that keeps folks from abusing it.
Before my implant a rep lady called me from our insurance. She started asking questions about what I've used, what worked and what didn't. Then she started naming all the bad things that could go wrong during the implant surgery, and the possibility of infections after and/or problems to the point I could end up with a worthless penis to possible amputation. When I told her if my penis was worthless it wouldn't be any different than what I had. Asked her if she was married and would she be happy not having any physical intimacy with her spouse if he had ED. I got approved.