Insurance enrollment coming (need y’all’s help)

[Mijudac79]

I think S.C.A.N. Insurance might be available to you in Texas. I’m in California, and it laid for EVERYTHING.. Are you old enough for social security? If so, don’t dawdle and look into it seriously!

[Rider1400]

My BCBS at first denied and then when I properly submitted the corrected codes they accepted with no issues. Was told by the girl I talked to at BCBS that there are literally thousands of plans under BCBS and that companies that provide the insurance to their employees can pick and choose what they want covered for their employees when setting it up. So you would need to pick one and then specifically find out if it’s covered.. I hope my existing implant will take me til I’m retired and Medicare will definitely cover it and I’ll have a supplemental coverage to pick up what’s left.

[tobenormalagain]

I have the BCBS Anthem for federal employees and they covered my entire surgery, all but $2000 ($36,000 total). What I did last. year, was obtained the CPT code for whatever device (insertion of inflatable penile prosthesis/insertion of non-inflatable penile prosthesis) and called each insurance carrier that I was eligible to enroll in. Believe me, this can literally save you thousands of dollars in the long run. I'm sure you know already but I was shocked to learn that even Blue Cross Blue Shield had varying coverages and exclusions and they aren't always in direct correlation to their premiums.

[Pamen116]

I have the BCBS Anthem for federal employees and they covered my entire surgery, all but $2000 ($36,000 total). What I did last. year, was obtained the CPT code for whatever device (insertion of inflatable penile prosthesis/insertion of non-inflatable penile prosthesis) and called each insurance carrier that I was eligible to enroll in. Believe me, this can literally save you thousands of dollars in the long run. I'm sure you know already but I was shocked to learn that even Blue Cross Blue Shield had varying coverages and exclusions and they aren't always in direct correlation to their premiums.

Sorry I’m new to the CPT code but are they all the same or different?

[Pamen116]

I have the BCBS Anthem for federal employees and they covered my entire surgery, all but $2000 ($36,000 total). What I did last. year, was obtained the CPT code for whatever device (insertion of inflatable penile prosthesis/insertion of non-inflatable penile prosthesis) and called each insurance carrier that I was eligible to enroll in. Believe me, this can literally save you thousands of dollars in the long run. I'm sure you know already but I was shocked to learn that even Blue Cross Blue Shield had varying coverages and exclusions and they aren't always in direct correlation to their premiums.

Sorry I’m new to the CPT code but are the penile implant codes all the same or different?

[jwdetails]

Agree with above posters - recommend you look up the CPT codes and see if a plan exclusion for implant. Aetna and Cigna suck. BC depends on the state since I know in California will approve implant, but in other states (like texas) certain plans have plan exclusion. If you have Medicare (or qualify) that will cover the cost.

[dgraham]

The best information would come from your surgeon's office, even if you're still in the thinking-about-it process.

I sat with Dr. Hakky's billing coordinator and she went through a list of insurers that do business in Georgia and ranked them based on her experience with them. I was able to get a policy with one of her higher percentage ones (Ambetter) and Dr. Hakky still had to have a peer-to-peer conversation before I was approved.

Call the office and ask to speak with someone who works with their insurance claims. Insurance is regulated on the state level so what would be covered in Georgia may not be in Texas.

[HikerMan]

I simply looked down the list of things that are covered and Penile Implants WAS one of them.
My plan goes thru Motion Picture and they are regarded as the Cadillac health plan.

On your health plan you should be able to see the list that YOU'RE covered with.
If you are Blue Cross, you should be covered.

Brilliant, thank you. Any advice on finding that document myself? I scoured my plan's website but didn't find anything. Is it like a 100-page insurance policy document that you ask someone in customer service for and they email it to you? Or would it instead make sense to ask the representative for a "list of treatments that are covered"

Whoever you are insured by should have an index file of what they do and don't insure.
I had a 70 page book that MPHPIP (Motion picture health and Pension plan) gave me that told me of the choices I had in getting insurance (Kaiser, COBRA, Blue Cross) and what they covered.

I'm surprised they didn't give you anything as a reference??

I believe a simple phone call to Blue Cross or whoever is insuring you will get you the answer you're looking for.

Good Luck.

[semi45]

If you're a vet the VA pays 100%. I'm getting an AMS day after tomorrow.