Implant Cost without Insurance Coverage

The final frontier. Deciding when, if and how.
rlm1818
Posts: 380
Joined: Tue Sep 06, 2011 10:33 pm
Location: Midwest USA

Implant Cost without Insurance Coverage

Postby rlm1818 » Wed Nov 02, 2011 11:48 am

I'm looking forward to my first meeting with an implant surgeon next week. I have Anthem BCBS insurance. While I will try to get them to cover the implant cost once I select a surgeon, I think they won't, since it appears to be an exclusion in the policy and since they haven't covered any of my previous ED medical costs.

So I'm trying to get a handle on the likely cost of the procedure assuming I pay fully out of pocket. I feel the most important decision is finding the right surgeon, and that cost is a very secondary consideration, but I'm still interested in what others have experienced. Here's what I've found so far.

1) Dr Dan Williams, Madison WI did Blacke's implant for $15,000, all in cost for outpatient, in August this year.

2) Illuminist states that Dr Karpman, in CA, will do it for about $20,000 (all in I think?)

3) Others have indicated, as of about one year ago, that Dr. Milam will do it outpatient for $19,000 to $20,000 (all in also?).

4) I talked to Dr Francois Eids office recently, and they indicated there was a recent price increase and that it would be $29,000-30,000. However, that was not a final quote.

5) I have been told in a private message that someone got a quote from the Mayo Clinic for $42,000, but they didn't go this route.

Does anyone have other data points for uninsured costs?
22cm Coloplast Titan OTR implanted Feb 2012 by Dr Francois Eid in NYC.
Initial implant experience here: viewtopic.php?f=6&t=1308

Illuminist
Posts: 60
Joined: Sat Jan 22, 2011 3:48 pm

Re: Implant Cost without Insurance Coverage

Postby Illuminist » Wed Nov 02, 2011 4:40 pm

Dr. Karpman's bill is as follows:

SURGEON’S FEE $ 2000.

ANESTHESIA $ 810.

HOSPITAL $ 16,150.


TOTAL $ 18,960

rlm1818
Posts: 380
Joined: Tue Sep 06, 2011 10:33 pm
Location: Midwest USA

Re: Implant Cost without Insurance Coverage

Postby rlm1818 » Wed Nov 02, 2011 4:46 pm

I thought the implant device itself was around $8-9,000? Is that included in "hospital" or is that additional?
22cm Coloplast Titan OTR implanted Feb 2012 by Dr Francois Eid in NYC.
Initial implant experience here: viewtopic.php?f=6&t=1308

Illuminist
Posts: 60
Joined: Sat Jan 22, 2011 3:48 pm

Re: Implant Cost without Insurance Coverage

Postby Illuminist » Wed Nov 02, 2011 7:42 pm

rlm1818 wrote:I thought the implant device itself was around $8-9,000? Is that included in "hospital" or is that additional?


Included in the hospital bill.

bill1200
Posts: 38
Joined: Fri Jun 17, 2011 5:24 pm

Re: Implant Cost without Insurance Coverage

Postby bill1200 » Fri Nov 04, 2011 10:44 am

Yep, also have BS (and the BS doesn't really stand for Blue Shield),implant also not covered under my plan. Karpman's charges to me were exactly as stated above. Just glad we were in a position to cover it. My wife and I were calculating how much money we have paid into BS over the years and it is well over $100,000.00 Great plan!
59 y/o, Good health, dealing with ED since age 40, pills worked for awhile, shots work but are getting less effective and a hassle.
IPP AMS CX 10-11-11, Dr Karpman

infinite19
Posts: 58
Joined: Fri Sep 02, 2011 4:00 pm

Re: Implant Cost without Insurance Coverage

Postby infinite19 » Sun Nov 06, 2011 1:15 pm

I just got my bill last week and it was $39,000 ,but I had insurance.
My Dr told me it would be about $15,000 guess he isn't onn touch with the Hospital.
It took 35 minutes for the operation and I spent one night i the hospital.
I am stil haveing pain around the base but it does seem to be getting better down there,I was 6 weeks post last friday and it will be several more weeks before I can use it ,but if everthing works it will be worth it.
I have mt fingers crossed hopeing that I am over the worst part.

dmikesaw
Posts: 163
Joined: Wed Sep 07, 2011 5:23 pm

Re: Implant Cost without Insurance Coverage

Postby dmikesaw » Mon Nov 07, 2011 3:19 am

mine was $19,600 at Vanderbilt Cool Springs Clinic, Doug Milam, MD, doing the surgery - outpatient, no overnight stay

hockey
Posts: 125
Joined: Tue Apr 26, 2011 8:35 am
Location: New Haven, IN

Re: Implant Cost without Insurance Coverage

Postby hockey » Mon Nov 07, 2011 8:47 am

My total cost was approx. $18,000 before insurance discounts.
Outpatient surgery center $14,000
Surgeon $3,000
Anesthesia $895.00
I went in the surgery center at 6:30 am. in surgery at 7:30 am.
back in recovery at 8:30 am. discharged at 11:00 am.
I am insured with Aetna.
Out of pocket:
Surgery Center $595.00
Anesthesia Dr. $49.60
Surgeon covered 100%

Would I do it again? PRICELESS

Week-end with icebag made everything very comfortable.
Pain level rating on a 1 to 10 scale: 1.5 at the very highest.
67 yr's young. Loving wife and 4 children 7 grandchildren. Type II diabetic for 9 years. Could retire but love my job and the people I work for. Pills, Pumps & Injections all failed. Implanted on 9/2/11. I am now "Bionic":)

Techman52
Posts: 96
Joined: Mon Aug 16, 2010 10:49 am
Location: Ballwin, MO 63021
Contact:

Re: Implant Cost without Insurance Coverage

Postby Techman52 » Thu Nov 10, 2011 11:09 am

Just received pre-op insurance costs from Vanderbilt's insurance office:

Total procedure costs, before insurance: $51,014.41

Total out of pocket: BCBS / Anthem: $205.59

Think I will go ahead and get it done on 11/22 8-)
Elevated PSA July 2009, Biopsy (postive) August 2009
Robotic surgery Sept 2009, Gleason 8-6, ED
VED, Cialis, Bi-mix unsuccessful
LGX Implant 11/22/11
Activation January 4, 2012

askew1971
Posts: 2
Joined: Wed Nov 09, 2011 11:03 pm

Re: Implant Cost without Insurance Coverage

Postby askew1971 » Thu Nov 10, 2011 2:20 pm

Hi there every one... I'm new to this forum and am 2nd day post op........ not sure if i made the right decision because unlike i've been reading from ( obviously ego driven men ) on how there was no/not much pain i'm here to keep it real.... This shit hurts..... Not only that, it has to stay inflated till next Tuesday ( my first post op visit )... It's very difficult walking around with a full on hard on all day n night... The worse was the first time i had to take a shit... Had to piss standing up first then sit with my cock hanging over the seat... From the pain meds i was constipated and afraid to push to hard ( didnt want to rip the stitches inside ya know ) So ... i suggest a laxative the day of surgery.... Also a few pairs of tight boxer briefs because it has to stay inflated for 6-7 days after..... ( walking around w a hard on is not cool at all ) And after going into op at 12 noon didnt awake till 5:30...By the time i got released it was to late to go to the pharmacy to script for percocet filled... Last night was okay bcause the surgery meds were still working it was waking up this morning that i had the first thoughts of regret... Unbelievable pain and stiffness everywhere down there..In time i only hope all is well cuz theres no going back now... Finally this afternoon i got to the pharmacy n got the pain meds so now a few hours later im nice and cumfy... However, it feels like i have a large brick hanging between my legs... Swelling is crazy and stiffness ( pardon the pun ) is all through my abdomin... ( i did have the 3 piece wereapon they have to do extra cutting to place the resivior under the addomin ) This in itself ands a few more weeks of recovery im told by the Dr but the 3 piece is the best way to go if your gonna do it... Dont waste your time with any other implant... Anyway, i'll re post in a day or two and let all know how i'm coming along... If any one has some advise/insight for me please email me at bmoreksw@yahoo.com ........


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