cost of procedure

[quigleyt57]

If this is covered in the threads already .... I apologize.
I have a major insurance company and as it turns out the implant procedure (ED treatments, are) is "Excluded" ... "for any reason". its not fair .... I was diagnosed in early 2011 with prostate cancer. a year later i underwent a radical prostatectamy. My doc attempted the nerve sparing robotic procedure, but low and behold, afterward things aren't working for me in the erection department. I had mild to moderate ED before the surgery (that was manageable with medication), and was regretfully, left with nothing afterward. Ive tried daily cialis, high dose cialis, viagra, trimix and bimix injections, muse, and just recently a pump. there's been no financial help with any of this from my insurance company. I held up hope that they might assist with an implant after trying all other options with no success. but nooooo.

After all this is said .. my question .... does anyone have a rough idea as to the possible cost to receive an implant with no insurance? The thought of its cost is scary, but the thought of having to live this way is terrible.

Your thoughts would really be appreciated .... Many Thanks
Quig

[billylee]

q,
I do not know from first hand experience, but from what I have read, cash negotiations can be made in the $18-20K figure. Hope this helps.
b

[rlm1818]

Use the advanced search function (upper right on the page) and search for 'implant cost without insurance' in the implant forum.

[Bigtime071]

Hey Brother. Go get Blue Cross and Blue Shield. Tell them you dont have any health problems. And wait about 3 months and then get your implant. You will be very pleased and satisfied with the outcome. Take Care Bri

[ED2013]

Personally, I paid about 19k

[stringerbell]

The cost when paying out of pocket varies wildly. I researched it- looks like the cheapest is a guy at Cleveland clinic (Montague) who was around $12,000. It seems cheap considering the implant alone costs around that much. A few guys are clustered around $20,000, including Garber, Goldstein, and even Kramer who's one of the more high profile/high volume guys. Perito and Eid, also huge volumes, seem to be 25k-30k, I'm sure it's just the overhead of their practices. All the top guys take insurance, if you are near open enrollment for your job and can switch, or get some coverage, you can go to one of the best in the world (eid, kramer, perito) and pay nothing. Only in the U.S….
.

[Bigtime071]

I paid only 4000.00 my insurance paid almost 17000.00. So you do the math. It was a very good experience. I hope you will take some good advice. Take Care. Nobody will give you any better advice.

[Bionic_by_AMS]

Quig,
The "exclusion" is determined by the employer nor the Insurance company. You can appeal their decision ... you'll need to make sure that the URO used the proper medical "codes" for the process. If they just submitted the code for an Implant without the corresponding codes for your prostrate surgery ... then this may be an issue.

Others will cover if it is in their contract and depending on cause of ED: Vascular (Diabetes, Hypertension, Hypercholesterolemia, Tobacco, Coronary artery disease) or related to cancer surgery/treatment (prostate, colon, bladder, etc...).
http://www.urologicalcare.com/patient_information/faq-ipp/

In order to assist you with the cost determination, we will provide you with a letter of Medical Necessity, which includes the Procedure codes so that you are able to contact the carrier to determine the exact cost and expense.
http://www.urologicalcare.com/patient_information/ipp-details/

[quigleyt57]

Thanks all
I appreciate the advice sounds pretty daunting, but worth it.
Bigtime ... its actually bcbs of tn thatni have coverage with being very difficult I had bcbs in ny and they were totally different

bionic... will discuss your advi e with my doc.

THANK YOU

[jryancey44]

Mine at Duke Hospital was $50K.

Jim