Insurance coverage

[Naples]

I have Blue Cross Blue Shield insurance and was scheduled for an implant on December 11 but just received notice that my insurance has an exclusion for this procedure has anyone else had the same issue and have you been able to get it approved. I was told if I had cancer that caused ED then it would cover it also was told if I had Medicare it would cover it however I’m way too young for Medicare which seems ironic.

[Genesis]

Naples Florida? Yeah... I currently have Molina, scheduled surgery for December 15th after they agreed to pay over the phone, and a week later they fax my urologist and say they won't pay because the implant falls under infertility and they do not cover any infertility.
I was looking to switch to BCBS next year...This is a nightmare. Oh, I called around to some high volume office looking for advice, they told me to claim the implant is to fix the erectile dysfunction not infertility, I would just have to call insurance provider and ask if they have any exclusions to ED. So I did and they do...including the implant.
Let me know if you find a way through, I will do the same.

Check my post history for more information.

[Anonymous3]

Going thru the bullshit right now. Thank Obhama Care. Medicare paid their portion mt secondary does not cover anything ED. But by law are mandated to pay for a fucking sex change

[Naples]

That figures a sex change is medically necessary? But a man’s ability to have sex is not. My insurance policy has an exclusion that says “sexual dysfunction caused by other than organic disease. I’m hoping the fact that I have type two diabetes and had quintuple bypass ( heart disease) that I can get qualified through appeal.

[Anonymous3]

That figures a sex change is medically necessary? But a man’s ability to have sex is not. My insurance policy has an exclusion that says “sexual dysfunction caused by other than organic disease. I’m hoping the fact that I have type two diabetes and had quintuple bypass ( heart disease) that I can get qualified through appeal.

If they code it secondary to the diabetes it should. It still a fucked up situation. Maybe we need to start filing discrimantion cases against the asholes

[rdnkbiker]

Hey Naples,
I ran into the same thing they were nice enough to let me know 3 days before surgery lol and called the doc they said no its been pre approved we have the conf # so they called and yes said it was denied not covered I asked what to do they said they would fix it called hospital they said if it came to that they would help out to,so had it done which I'm still glad I did but had complications really racked up the bill all said and done I still owe 56k on mine yep payment plan all I could do sorry to hear insurance is getting worse all the time my suggestion is go to a place that only does implant Krammer Eid Ect... if you have to pay a lot cheaper than going to local hospital if I had know that's what I would have done a third the cost of mine
hopefully you will get it worked out
Jim