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Does anyone have independent ins. that covers implants

Posted: Wed Apr 25, 2018 6:14 pm
by treetop
My next step is to maybe get independent insurance and pay for it myself.
Go see an in network uro, and get a referral to Dr. EID.

I will go on the web. Janice thinks Blue Cross. I am not sure if I can get independent ins. with them but I will check.

Anyone here paying for insurance that covered their implant, can you give me info?

Thanks
TT

Re: Does anyone have independent ins. that covers implants

Posted: Wed Apr 25, 2018 6:23 pm
by ED2013
That’s a tough one. Many insurers do not pay for existing conditions. I hope you do find one tho. Another option is to get a part time job with medical benefits. Make a lil extra money and insurance to boot.

Re: Does anyone have independent ins. that covers implants

Posted: Wed Apr 25, 2018 7:17 pm
by Anonymous3
deleted by user

Re: Does anyone have independent ins. that covers implants

Posted: Wed Apr 25, 2018 8:15 pm
by treetop
hturner12 wrote:Tree
You cid mention your age but Medicare pays. To check your insurance lo9k in the section labeled not covered. Last year for GEHA it was on page 45 and said ED not covered. This year it was page 96 and was worded sexual inadequacy or impotence


I am 58. So if I remember, Medicare starts at 65.
So that would mean waiting 6 years.
But I am happy it covers it.
Thanks for the info.
TT

Re: Does anyone have independent ins. that covers implants

Posted: Thu Apr 26, 2018 7:31 am
by LMCatman
Humana paid for my first two implants. I'd had a Radical Prostatectomy and an implant "made me whole", similar to breathing reconstruction for a woman after breast cancer. Medicare paid for my third one..... Good luck!

Re: Does anyone have independent ins. that covers implants

Posted: Thu Apr 26, 2018 7:07 pm
by antman90
treetop wrote:My next step is to maybe get independent insurance and pay for it myself.
Go see an in network uro, and get a referral to Dr. EID.

I will go on the web. Janice thinks Blue Cross. I am not sure if I can get independent ins. with them but I will check.

Anyone here paying for insurance that covered their implant, can you give me info?

Thanks
TT

Treetop you can buy blue cross.... but their enrollment period is only twice a year. The plans with very little or no deductible ... are between 350-600 a month. I do know that they partially cover implants under "prosthetic devices." If you were to go directly to EID with blue cross it would probably be more ... idk if he is in network and he is also out of state. I have 30k saved up... but it would hurt me to spend that much on this procedure. If I do decide to go the implant route I will try to figure out this insurance thing first.

Re: Does anyone have independent ins. that covers implants

Posted: Thu Apr 26, 2018 9:29 pm
by newbie443
I have ACA (Obamacare) compliant BCBS. It is a Gold plan and cost me $945.00 a month. It has coverage for part of implant surgery (I would pay deductibles, copays, non covered items, some of those would be above my 3500 out of pocket). If the cause is physical injury or illness. It does not cover for psychological causes.

I have no out of net work coverage. BCBS said I had to stay local for anything as long as there was a provider in my area for them to pay anything.

Insurance is state to state though so your states BCBS may be different than mine. And I have seen advertisements for non compliant policies now that the tax or penalty for not having ACA compliant health insurance was lifted for 2019. It was my understanding that ACA did away with pre-existing conditions. But they might have a waiting period.

I hope this was of some help. Good luck with this.

Re: Does anyone have independent ins. that covers implants

Posted: Fri Apr 27, 2018 11:42 am
by treetop
antman90 wrote:
treetop wrote:My next step is to maybe get independent insurance and pay for it myself.
Go see an in network uro, and get a referral to Dr. EID.

I will go on the web. Janice thinks Blue Cross. I am not sure if I can get independent ins. with them but I will check.

Anyone here paying for insurance that covered their implant, can you give me info?

Thanks
TT

Treetop you can buy blue cross.... but their enrollment period is only twice a year. The plans with very little or no deductible ... are between 350-600 a month. I do know that they partially cover implants under "prosthetic devices." If you were to go directly to EID with blue cross it would probably be more ... idk if he is in network and he is also out of state. I have 30k saved up... but it would hurt me to spend that much on this procedure. If I do decide to go the implant route I will try to figure out this insurance thing first.


Thanks for that information. Please update me if you find an ins company that you like.
Also see newbie443's response regarding BD/BS. If they won't allow out of network then they won't work for me as I will only see one doctor (EID).

I am not in a hurry. Open enrollment for my company is in October, so I may look at my options at that time to see what is available.
If I do find independent ins then I can opt out of company ins and get the independent.
I am 6 years from Medicare, although I don't want to wait for that long....
TT

Re: Does anyone have independent ins. that covers implants

Posted: Fri Apr 27, 2018 11:44 am
by treetop
newbie443 wrote:I have ACA (Obamacare) compliant BCBS. It is a Gold plan and cost me $945.00 a month. It has coverage for part of implant surgery (I would pay deductibles, copays, non covered items, some of those would be above my 3500 out of pocket). If the cause is physical injury or illness. It does not cover for psychological causes.

I have no out of net work coverage. BCBS said I had to stay local for anything as long as there was a provider in my area for them to pay anything.

Insurance is state to state though so your states BCBS may be different than mine. And I have seen advertisements for non compliant policies now that the tax or penalty for not having ACA compliant health insurance was lifted for 2019. It was my understanding that ACA did away with pre-existing conditions. But they might have a waiting period.

I hope this was of some help. Good luck with this.


Yes, this information does help.
$945 is a lot, but out of pocket is more if I get a loan to pay off.
I may check into BC/BS plans, but would need some out of network coverage as I am sure Dr. EID is out of network.
Everything else may be in network, hospital, etc.

I will continue my research, and this does help.
Thank you
TT

Re: Does anyone have independent ins. that covers implants

Posted: Fri Apr 27, 2018 12:15 pm
by newbie443
Many doctors are in network for my state insurance and if I were out of area or state and had a medical emergency I could go to them and would be covered. But this is what is considered as a covered elective surgery in my state. That means BCBS can choose who I will go to for this surgery. As I said your state may be different. And if your states BCBS policy has out of network coverage you need to make sure you can file under that. Might not be able to as that it is may be considered elective. And out of network in all the policies I have seen have seperate higher deductible's, and out of pocket. Your Doctors office may be able to help with this and work it in reverse so to speak or know first hand.

Having traveled for this I can say 1000% that if there was a really good surgeon in my area I would gone to him. One of the surgeons I was considering contacting for this is in southern California. If he had been in KS I would have gone to him. As would one from Texas, Atlanta, Florida, and New York. And many others.