Insurance Excludes Penile Implant - Not Sure What to Do

[Cnidium]

Funny9097 is right,

I spoke to Eid about a week ago. We discussed premature revisions. He said it would still cost ~$12,000 for a revision with the 10 year guarantee. He can't guarantee the hospital bill and the anesthesia costs because they are separate entities. But, you will not pay for an actual new device (you basically own the rights to one) and he will not charge you for his surgical costs. So basically you pay about half the bill for a revision that is needed before the 10 year period.

Also,

Another thing us younger guys have to contemplate is time off of work. 2 weeks isn't a small amount of time in the eyes of most employers. Too many 2 weeks because of needed revisions in a period of a few years isn't good for you career either. And there goes your vacation too.

[alibaba]

The 10 year warranty is nice considering how many of these things we read go bad here. I doubt the warranty covers if you are dissatisfied with the installation.Never asked. I know Perito has replaced several in the last 6 months that were less than 2 years old and leaked. Care Credit usually is free if paid in 6 months. After that 21% or more. I put my implant at Vanderbilt on Care Credit and Visa but then ended up did not have to finance it when the insurance agreed to pay.

[David_R]

Back when I got an implant in 2002, my insurance told me that it was covered because it was caused by a physical problem (ultimately, prostate cancer, causing my surgery in 2000 that left me mostly soft down there). If it were caused by a psychological problem, they told me, it would not have been covered. (They gotta be careful and not spend too much of those premiums we pay every month.)

[TANGERINE]

sounds like you should consider paying the 25,000 cash price.

If that is not workable for you, and if you are buying your own insurance as an individual, remember that "open enrollment" happens in november, and possibly you can change insurance plans to something that might cover the implant..

When I looked into this, the key question to ask the insurance carrier is "is xyz procedure code excluded or xyc diagnosis code excluded ? You can get the relevant codes from your urologist.

I am so sorry that this is an issue, many insurance carriers place implant into the same category as "cosmetic surgery" such as breast implant. I know, I know, it is a medical condition that leads to depression, but the insurance carriers can decide which "procedure codes" and which "diagnoses" are excluded.

[alibaba]

At one point I used the tactic that state law requires breast implants for both sides in case of breast cancer but no coverage for men's penis is discriminatory. Claim fibrosis causing intercourse pain and severe curvature, buckling due to lack of engorgement. An experienced doctor knows ways to do that I am sure. ...experienced and gives a damn. A lot of doctors don't want to waste any time trying to help.

[strongagain]

Just a thought: I got my Coloplast Titan in Germany - medical aid paid every cents. Should I need a revision I would like to have it done by Dr. Eid.

In my opinion Coloplast will cover the costs of a new implant resp. parts of it, no matter where the operation will be done. I only would have to pay the doctor. Am I right? OR must I see my German doctor in case of a revision?

[Cnidium]

strongagain,

You would need to pay for the doctor's surgery, the anesthesia, and the hospital bill. These 3 things make up the majority of the bill.

[Cnidium]

The 10 year warranty is nice considering how many of these things we read go bad here. I doubt the warranty covers if you are dissatisfied with the installation.Never asked. I know Perito has replaced several in the last 6 months that were less than 2 years old and leaked. Care Credit usually is free if paid in 6 months. After that 21% or more. I put my implant at Vanderbilt on Care Credit and Visa but then ended up did not have to finance it when the insurance agreed to pay.

Alibaba,

Can someone get insurance just for their implant? It would be like car insurance... just dick insurance.

[mouseco]

Smallbutsure,
You might also want to consider a Semi-Rigid implant. It will do the trick and I don't believe you will be limited by the 10 year fear of mechanical failure. Also,there is probably even less of a chance of infection occurring.
You could use it until your circumstances change and then replace it with a 3 piece product or whatever is the latest and greatest at that time.

[Piddlin]

I had my implant at the end of March. All out of pocket. Do a search for Surgeo. I used them, they offer sweet deals, beyond excellent service and reasonable prices with top surgeons. They even allow me to purchase of to $50k in complications insurance since my insurance would not cover any issued related to the IP surgery. Never saw a bill they took care of everything. Without the extra $25K more that comes with the package, I would have come in under $20K. My surgeon was in Houston and service was excellent from him and the hospital was also excellent.