insurance

[tarheel]

Just got a call from Dr. Milam's office.They said my insurance wouldn't cover any of the cost of the implant because of an exclusion clause in my insurance.Called my insurance company to inquire,and was told it wouldn't pay because Peyronies wasn't considered a "medical condition".I asked Dr. to submit a letter and all corresponding information to see if that would help.Has anyone had any similiar problems?Looks like it will be about $20,000 if it is all out of pocket.Will probably take about a month to hear back.Surgery was scheduled for June 9th but is now postponed till we hear back from insurance co.Sort'a bummed:(

[rdhill]

I THINK THAT'S BULLSHIT!!!!!! THE FINANCIAL/BILLING PERSON AT UNC MEDICAL CENTER TOLD ME THAT PEYRONIE'S WAS NOT QUESTIONED. MAYBE YOU SHOULD LOOK ELSEWHERE!
GOOD LUCK,
ROBIN

[regain-is-the-aim]

Tarheel:

Dam. That kind of crap from insc companies is another reason we needed health care reform and when it is fully implemented this should not happen. First, appeal this decision to a higher level in the insc company. In my opinion Dr. Milam's office should be very aggressive about this. You also might check with the Insurance Dept of your state for possible assistance.

Some insc. companies have their coverage reviews done by outside vendors and their payments can be based on how much they can save the company. Hence, they say no whenever they can or want to. Fight this with a vengeance. I am dumbstruck with this determination.

Check with the agent or workplace which has your coverage for assistance; they may be able to help.

Who is the insc company- we all should know and perhaps check our own policies as peyronie's can happen to anyone. wow, this is a bummer for you

Just keep fighting and perhaps we can straighten them out also. . .

My best,

Dick

[Cajun Jeff]

tarheel: I got the same response from BCBS of LA. IPP not covered under my policy. So it looks like I'm going to continue with injections till I hit 65 in 5 years.

Cajun Jeff

[steven]

my ins. co. never batted an eye. my implant was due to peyronies but I also had a prostatectomy a year earlier for pc but I know the urology office had to submitt peyronies as the primary reason tho. Does your co. pay for breast reconstruction or prosthesis? I hope you can successfully appeal. bs is right.

and how can the price vary so much? mine was over $80k.