Did your insurance pay for your revision/new implant after the implant wore out or malfunctioned

[GJGordon]

Just curious if your insurance paid for a revision/new implant after it failed so to speak. I see a lot of guys get only about 4 years out of their first implant. Thank you in advance.

[newbie443]

Just curious if your insurance paid for a revision/new implant after it failed so to speak. I see a lot of guys get only about 4 years out of their first implant. Thank you in advance.

My insurance would only pay for local doctors with results so poor a large number of men ended up having the device removed. I did self pay for my first. For my repair I was able to go out of network using a clause in my policy that permitted me to do so if the service I needed was not performed by network doctors. My device was not replaced. My left cylinder was just removed then put back in with the repair.

I have all my original parts and they still work for over 6 years.

[LastHope]

I see a lot of guys get only about 4 years out of their first implant.

I met an individual who is in his 20th year with an implant but doesn't have a FrankTalk account. The users represented here may only reflect a subset of the implanted individuals, and therefore, the observations made here are not statistically comprehensive, though anecdotally helpful for the wider community.

I hope the following statistic provides some reassurance.

7% of implants fail by the first year
9% of implants fail within three years
13% of implants fail within five years
23% of implants fail within ten years
36% of implants fail within 15 years
48% of implants fail within 20 years

Source:
Long-Term Survival Rates of Inflatable Penile Prostheses: Systematic Review and Meta-Analysis
Larry E Miller et al. Urology. 2022 Aug.
https://pubmed.ncbi.nlm.nih.gov/35421510/

[JohnHC]

I had mine implanted 4-12-23 it failed the first week. I had revision in 6-22-23 it failed Jan this year ( 2024 ). Insurance said implant covered, called about revision told again it's covered. Then after revision insurance said nope we aren't covering either surgery. Been fighting them over it and was finally told they would pay 7-5-24. Saw on insurance website that they sent payment to the hospital for both surgeries on 7-17-24. But they haven't paid the Drs or anthesia yet. So if insurance tells you it's covered fight it, appeal it, and hopefully it'll get resolved. Now I just gotta get this second revision done ( to fully remove and replace the second implant )

[newhope]

I had mine implanted 4-12-23 it failed the first week. I had revision in 6-22-23 it failed Jan this year ( 2024 ). Insurance said implant covered, called about revision told again it's covered. Then after revision insurance said nope we aren't covering either surgery. Been fighting them over it and was finally told they would pay 7-5-24. Saw on insurance website that they sent payment to the hospital for both surgeries on 7-17-24. But they haven't paid the Drs or anthesia yet. So if insurance tells you it's covered fight it, appeal it, and hopefully it'll get resolved. Now I just gotta get this second revision done ( to fully remove and replace the second implant )

I hope you are not going to the same doctor. Just my 2 cents

[JohnHC]

I had mine implanted 4-12-23 it failed the first week. I had revision in 6-22-23 it failed Jan this year ( 2024 ). Insurance said implant covered, called about revision told again it's covered. Then after revision insurance said nope we aren't covering either surgery. Been fighting them over it and was finally told they would pay 7-5-24. Saw on insurance website that they sent payment to the hospital for both surgeries on 7-17-24. But they haven't paid the Drs or anthesia yet. So if insurance tells you it's covered fight it, appeal it, and hopefully it'll get resolved. Now I just gotta get this second revision done ( to fully remove and replace the second implant )

I hope you are not going to the same doctor. Just my 2 cents

Yes I am. My first implant failure I would bet was caused by a nurse in recovery giving me one of those long acting pain shots. The second one is a issue with the connector ( either connector broke, tubing broke, or tubing pulled free from the connector ). The second failure I'm just guessing at but that's what I feel when I feel around down there. I have talked to the AMS rep who was in the surgical suite and present for the whole procedure both times. She has assured me that everything was done by the book and had she seen anything out of place she would have spoken up. That I believe because I don't think Boston Scientific would want someone having two failures so close together since they replace them under warranty at no cost for the device. And the bad word of mouth would hurt them. So yeah having talked to both the Dr and rep I have full confidence in him doing the surgery, now if it fails again in a short amount of time ( 1 year or less ) then yeah I would probably schedule with Dr Hakky in Atlanta.

[wilsonmill]

My insurance paid for the first, I think my out of pocket was around 2500, that was 5 years ago, just had revision in June, my out of pocket was 3200, so far I believe they have covered about 35k of the bill. Total bill was 63k, but we know how the billing goes.