Devastated

[alibaba]

You cannot know how excited I was that a dick implant was in the works. 6 days to go. Hospital just called. United Healthcare says they will not pay for any part of it for any reason and need a deposit or guarantee of $30,000 to continue if uncomplicated. I am a pretty tough cookie but this time I feel like crying. Thanks for all the support and encouragement. It was truly uplifting. Only 13 more years till I am old enough for Medicare. maybe then. d

[ED2013]

My insurance didn't cover it either. I took out a personal loan to pay for it. To me it was well worth it. I'd rather be in debt for a few years than deal with the living hell Ed causes.

[dg_moore]

You cannot know how excited I was that a dick implant was in the works. 6 days to go. Hospital just called. United Healthcare says they will not pay for any part of it for any reason and need a deposit or guarantee of $30,000 to continue if uncomplicated. I am a pretty tough cookie but this time I feel like crying. Thanks for all the support and encouragement. It was truly uplifting. Only 13 more years till I am old enough for Medicare. maybe then. d

Sorry to hear that. UHC covered my implant 100% (except for a copay of about $1100) in 2008. Most likely it's not UHC making the decision - it's probably your company's coverage decision, which UHC is bound to follow.I had a similar situation with Blue Cross for my late wife - her oncologists recommended a bone marrow transplant, but my company didn't want them to pay for it. After a lot of scrambling around the company finally relented and paid for it - it was over $200K and unfortunately was not successful. But the point is that, if you're part of a group plan, the coverage decisions are made by your employer and executed by the insurance company.

[wavygravy]

man that really blows!

Hang in there.

[alibaba]

Dave, sorry about your wife. I almost lost mine and it tore me up. I would take care of her then walk to the back of the place to cry where she would not see me, then come back to the house to tend things some more. Can't imagine losing here completely. I have a private policy that covers only me. Premium is now $1816.54 post pca . Hugs.

I called UH. They told me they have not had any request for coverage authorization since April when I had a CT. Do not know what kind of hinky $#it is going on but several more calls confirmed that the doctor nor the hospital ever contacted the insurance. Insurance said it was covered as long as it was not for conception. Nurse at the doc office told me they will only put the code for impotence 607.84 on the request for coverage and WILL NOT put, high blood pressure, 607.85 peyronies, 185 and 233.4 prostate cancer or the prostatectomy on it. The insurance paperwork says you must have 1 of those listed plus failure of injections, pills, vacuum pump, and constriction rings. Guess what ladies? I ring all the bells. Not one but all. 2 days ago I got a letter advising me that federal law requires insurance companies to cover breast reconstruction for one or both breast to insure balanced symmetry for all women that have a mastectomy. There is no law that they have to fix your junk when it does not work after a prostatectomy. I called Sen. McCaskill (d) and Sen Blunt (R) offices to ask them to sponsor a bill to require such work for we guys. McCaskill's office was a brush off. This brush off has come from several offices in the last 4 years. Blunt's D.C. office sent me to the Columbia office where I was told it will NEVER happen in many years time. I told her that it only took 30 minutes to declare war on Germany and 20 to declare war on Japan but you say that in several years time you will not get this done? Senate and Congress are mostly men. I cannot wait till their junk no-longer works and the insurance company says pay it yourself. I told them all it is "gender discrimination" to have a law that requires you put women in working order but not men.
ED2013, my wife and I live on a total of $1086 a month total both of us combined SS and disability. A loan is out of the question. 10 years ago I would would have paid and gone on.
Thanks for the support. I wish there was a way to do a petition to make penile implants an insurance requirement like women's boobs. Do not knock women's boobs one bit, but this is not right. d

[JDavid]

It sounds like you need a different doctor. If the office is this sloppy in attempting to get the authorization, do you really want him doing surgery? It seems you do have coverage. This may have been a blessing in disguise.

[RogerM]

I agree with JDavid. I suggest you find an experienced surgeon, preferably one that does a lot of implant operations & has been recommended by people in this site. I also had United Healthcare at the time of my operation & they covered it. Good luck. Please keep us posted & don't give up!
RogerM

[dg_moore]

It sounds like you need a different doctor. If the office is this sloppy in attempting to get the authorization, do you really want him doing surgery? It seems you do have coverage. This may have been a blessing in disguise.

I agree. Find another doctor who does lots of transplants. They know all of the ins and outs of insurance and know how to code their paperwork so the insurance will cover it. I think your doc's "policy" is ridiculous.

Good luck!
Dave

[oldgoat]

I question how an insurance company can deny covering a procedure that medicare will cover.

[alibaba]

urologist is a Georgetown grad and supposedly one of the best in Central U.S. I checked other docs in the St. Louis area and was shocked how few do implants and how many are credentialed about the same as a mail carrier. Cannot believe the other medical schools doc list. $30k if it is an uncomplicated procedure seems steep too but Barnes prices have gone nuts since they bought their new adminstrator in. I figure would be at least $50 k at that rate because I have had several complicated surgeries that did not go as planned so why figure this one would be issue free if we are running numbers?
The comment that this blows was right on the mark!
This is the 5th time I have had an issue like this since 2007. I wish they would be honest and say I do not want to treat you rather than these rats ass games.
Guess we'll see what shakes out of the trees next week.
Cheers everybody. Reading how well things are going with the recent surgeries is awesome.