Non-Medicare Insurance

[Redsteel]

Hey guys, just found out my employer is switching from an insurance company with 80% coverage of treatments and implants to an insurance that **explicitly** does not cover sexual dysfunction treatment of any kind, be it pills, pumps, injections, or implants (unitedhealthcare).

I am beside myself with anger and disgust at the greed of both my employer and this insurance company.

Regardless, I need an IPP in the relatively near future. I’m about half the age required for Medicare, so that isn’t an option. Do I have any options here? I can’t afford to pay for this treatment anywhere near out of pocket, so I need some kind of insurance. Is there some kind of private insurance that I can get outside of my employer that you all recommend? Do I just need to quit my job and try to find somewhere with better insurance (and a big pay cut)? I’m really starting to panic here.

[ragingbull]

If I don't have health insurance for an IPP, I'd be forced to settle for the so-called "inferior and widely hated" malleable option. However, if I'm dissatisfied with it, I'll switch back to an IPP once I have access to better insurance.

[newbie443]

Hey guys, just found out my employer is switching from an insurance company with 80% coverage of treatments and implants to an insurance that **explicitly** does not cover sexual dysfunction treatment of any kind, be it pills, pumps, injections, or implants (unitedhealthcare).

I am beside myself with anger and disgust at the greed of both my employer and this insurance company.

Regardless, I need an IPP in the relatively near future. I’m about half the age required for Medicare, so that isn’t an option. Do I have any options here? I can’t afford to pay for this treatment anywhere near out of pocket, so I need some kind of insurance. Is there some kind of private insurance that I can get outside of my employer that you all recommend? Do I just need to quit my job and try to find somewhere with better insurance (and a big pay cut)? I’m really starting to panic here.

The thing is that insurance with IPP coverage is really expensive. The insurance I bought from my states exchange was well over a thousand dollars a month. It has been 3 years since I bought it so I have no idea how much it is now. That insurance had a max 4k out of pocket and 1500 deductible. So when you add that 4k to the amount I was paying it came very close to the out-of-pocket cost of an implant. Best thing to do is to cut back on things you don't need. I ditched cable and had an antenna put up for TV. Then I have internet with some free other tv. Like Roku, Tubi, and others. YouTube has a lot and that is free also. Cut back everything you can and start saving. If you have loans work to pay those of as fast as you can. The thing is though that you need to also prepare for a problem. Even the best doctors have infection rates. And other causes for a reoperation. Surgeo self-pay medical https://surgeo.com/penile-implant has a number of doctors around the US and the fee includes a 3rd party 20k insurance policy if you need a reoperation in the first year. I have no information on anyone dealing with Surgeo or the 3rd party insurance. It is just an option I wanted to let you know about. I did not wait to save up the self-pay amount. I just used the equity in my home for a loan for my first surgery. Just some ideas on how to go about this. If you want to change jobs I would think a federal job would have the full coverage insurance. Some local government jobs may also but then again they may not.

Good luck with this

[Redsteel]

Hey guys, just found out my employer is switching from an insurance company with 80% coverage of treatments and implants to an insurance that **explicitly** does not cover sexual dysfunction treatment of any kind, be it pills, pumps, injections, or implants (unitedhealthcare).

I am beside myself with anger and disgust at the greed of both my employer and this insurance company.

Regardless, I need an IPP in the relatively near future. I’m about half the age required for Medicare, so that isn’t an option. Do I have any options here? I can’t afford to pay for this treatment anywhere near out of pocket, so I need some kind of insurance. Is there some kind of private insurance that I can get outside of my employer that you all recommend? Do I just need to quit my job and try to find somewhere with better insurance (and a big pay cut)? I’m really starting to panic here.

The thing is that insurance with IPP coverage is really expensive. The insurance I bought from my states exchange was well over a thousand dollars a month. It has been 3 years since I bought it so I have no idea how much it is now. That insurance had a max 4k out of pocket and 1500 deductible. So when you add that 4k to the amount I was paying it came very close to the out-of-pocket cost of an implant. Best thing to do is to cut back on things you don't need. I ditched cable and had an antenna put up for TV. Then I have internet with some free other tv. Like Roku, Tubi, and others. YouTube has a lot and that is free also. Cut back everything you can and start saving. If you have loans work to pay those of as fast as you can. The thing is though that you need to also prepare for a problem. Even the best doctors have infection rates. And other causes for a reoperation. Surgeo self-pay medical https://surgeo.com/penile-implant has a number of doctors around the US and the fee includes a 3rd party 20k insurance policy if you need a reoperation in the first year. I have no information on anyone dealing with Surgeo or the 3rd party insurance. It is just an option I wanted to let you know about. I did not wait to save up the self-pay amount. I just used the equity in my home for a loan for my first surgery. Just some ideas on how to go about this. If you want to change jobs I would think a federal job would have the full coverage insurance. Some local government jobs may also but then again they may not.

Good luck with this

Ideas are good right now, I’ll take as many as I can get. Replies like this mean a lot right now, thank you

[ViaSwiss]

Typically a company has to choose to not accept sexual dysfunction coverage... its a checkbox they have to check to exclude it. I know this because I was the one to sign my company up and I 100% made sure I did not check that box.

If you are unlucky enough to fall into this category, then you will want to look into self pay. Surgeo.com is a good option. Self pay is an option but you are talking 20-30k out of pocket.

[wilsonmill]

Another to think about is overseas, I have read on FT that there are some turkish physicians that are excellent and the cost there is way less expensive than what we have here, which included airline, hotel stay for quite a number of days and the hospital and surgeon. Just a thought.. Good luck..

[LastHope]

If a job ain't got no BCBS, Humana, or UHC, I ain't takin' that dadgum offer, no sir!

[Redsteel]

If a job ain't got no BCBS, Humana, or UHC, I ain't takin' that dadgum offer, no sir!

We’re going to unitedhealthcare in January. From googling it it looks like they just categorically don’t cover sexual dysfunction treatment. The articles I saw said that they believed the vast majority of men going in for ED treatment didn’t actually need it, so they don’t cover it. (Words can’t described how fucked up that is by the way). I saw that and went on their website under the Options PPO plan we are supposedly getting and I can’t find a single thing about erectile dysfunction or any penis related medical care.

Am I wrong and UHC aren’t awful? We haven’t seen our specific plans to sign up yet, but the company saying outright that sexual dysfunction treatment is overprescribed and therefore they don’t cover it is pretty damn bleak

[LastHope]

I was under the impression that UHC is the best commercial insurance for penile prosthesis going by this study:

Percentage of insurance approvals in Miami region for submitted claims for men seeking IPP between January 2016 and December 2017:

Medicare: 100.0%
Coventry: 100.0%
United Healthcare: 70.0%
Molina: 65.5%
Humana: 62.5%
Sunshine Health: 50.0%
Blue Cross Blue Shield: 56.3%
Aetna: 36.4%
AvMed: 15.8%
Cigna: 14.3%
Magellan: 0.0%
Medicaid: 0.0%

Commercial Insurance Overall: 52.0%

Source:
Commercial Insurance Coverage for Inflatable Penile Prosthesis at a Tertiary Care Center
Published in 2019
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6675033/

[LastHope]

Kaiser also seems to offer great coverage, but the key question is whether Kaiser affiliated surgeons are high-volume, with at least 45+ surgeries per year (atleast one per week!).