Can Medicare Pay for an Implant?

The final frontier. Deciding when, if and how.
JimStars
Posts: 844
Joined: Sun Jan 24, 2010 2:41 pm

Re: Can Medicare Pay for an Implant?

Postby JimStars » Fri Mar 30, 2018 12:26 pm

What my dr billed for everything was over 70k. Medicare assignment was 13k. They paid 10k. My secondary paid zero. So I owe 3k


70k... and another was 80k?!! Wow! Gives new meaning to Rocket Surgery!! ;-0
RP 2008 ... MUSE 2008-9 .. TriMix Gel 2009 .. Trimix 2009-2015 ... PGE-1 2016-2019 ..Misoprostal 2019 Onward. All worked.

RayChez
Posts: 347
Joined: Sat Mar 17, 2018 11:25 pm

Re: Can Medicare Pay for an Implant?

Postby RayChez » Fri Mar 30, 2018 1:35 pm

Something does not sound right on the cost. I had the revision done around fourteen months ago in Ca. and I have a medicare advantage with Anthem blue cross. It did not cost me a cent. I do not remember what they paid the hospital and the doctor, but it was less then 10K. I was an out patient. Surgery took something like two hours. Great work by the surgeon.

IF the surgeon belongs to a group within the zone of your insurance, they will have to take the contracted pay with medicare. They might charge a large amount, but when it comes down to what the agreement was with medicare and the group of doctors within the zone, that is what they are going to get. Patient IF he has a medicare advantage will not be responsible for the difference. My cost was zero.
age: 75 First implant around 2001, 59 at the time. AMS 700 Ultrex
revision Dec 2016. 2ND implant 21CM, 1rte AMS 700 LGX MS pump

steveb1
Posts: 8
Joined: Mon Jul 22, 2013 7:08 am

Re: Can Medicare Pay for an Implant?

Postby steveb1 » Fri Mar 30, 2018 10:11 pm

This is my 1st post. I have been on Frank Talk since 2013. After much investigation I have decided to have Dr. Karpman do my Surgery. I recently called Anna, Dr. Karpman's scheduling Nurse. She was very helpful. I have Medicare with Anthem Blue Cross. She informed me that Medicare will pay for 80% and Anthem Blue Cross will pay the remaining 20% with no out of pocket cost. :)
Age 70, married 50 yrs. Implant on Oct. 29, 2018 by Dr. Karpman, No known Physical problems except ED for 20 yrs. On Frank Talk since 2013.

David_R
Posts: 2145
Joined: Mon Nov 02, 2015 1:03 pm

Re: Can Medicare Pay for an Implant?

Postby David_R » Sat Mar 31, 2018 4:31 pm

steveb1 wrote:Medicare will pay for 80% and Anthem Blue Cross will pay the remaining 20% with no out of pocket cost.

Same for me; CareFirst Blue Cross paid the remaining 20%.


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