Some Good Insurance News For a Change

[ElbowRoom]

Yeah BC/BS of Georgia changed their language too. It used to say treatments for sexual dysfunction aren't covered.

Now it says they're not covered (except for organic male erectile dysfunction). And when I called them they said "coverage is based on medical necessity" which is insurance speak for "we'll cover it if you make a good case that it's needed".

[ElbowRoom]

I just logged into the BC/BS portal to check on my pre-auth request. It was APPROVED! I’m over the moon, the surgery is pre-authorized between now and December 31.

This is fantastic news for me, it means I’ll have the procedure in the hospital instead of in Hakky’s office (which is a much easier drive to my home, and preferred in case of complications). I’ll have an out-of-pocket cost of $3k to $4k instead of $22.5k.

I’m relieved and getting excited to join the brotherhood!

[LastHope]

Good luck, ElbowRoom! Please keep us posted on your journey with BCBS. If I can establish a home address in a neighboring state, I’ll qualify for BCBS of Texas through my employer. With my current address, I’m stuck with Aetna, which proved to be useless for any implant procedures.

Clavells office told me specifically that BCBS of Texas is no good. I currently have the foreign service aetna plan and it's completely out of the question with them.

Thank you edjohn for sharing this. This is great to know. No BCBS of Texas, then. Aetna was acquired by CVS ...go figure!

[ElbowRoom]

Thank you edjohn for sharing this. This is great to know. No BCBS of Texas, then. Aetna was acquired by CVS ...go figure!

My plan that just approved is BC/BS of Georgia, but they have several plans that certainly have different coverage.

[LastHope]

My plan that just approved is BC/BS of Georgia, but they have several plans that certainly have different coverage.

You're right. Congratulations! Glad it was PA approved for you.

[duke_cicero]

I just logged into the BC/BS portal to check on my pre-auth request. It was APPROVED! I’m over the moon, the surgery is pre-authorized between now and December 31.

This is fantastic news for me, it means I’ll have the procedure in the hospital instead of in Hakky’s office (which is a much easier drive to my home, and preferred in case of complications). I’ll have an out-of-pocket cost of $3k to $4k instead of $22.5k.

I’m relieved and getting excited to join the brotherhood!

That's great news!! Congratulations!!

[ElbowRoom]

Thanks guys, I'm pretty stoked. Surgery is scheduled for Oct. 21.

[Rider1400]

I have had BCBS of Illinois for over 13 years. At the time of my implant they originally told me it would not be covered. Eventually I got some codes from my Dr office and requested coverage for these specific codes and they said it would be covered. So a few months later I started the process thru Dr office and received a pretty quick approval. Only cost me about 2 k which is my out of pocket expected cost. Now 3 years in and going strong. Hope that whenever I need a revision they will still be covering it. I was told on the phone with BCBs that large. Companies like I work for can make make exclusions by their lawyers when they set up the plans and they can change from year to year so BCBS means very little as a covering insurance.