Cigna said "No"

The final frontier. Deciding when, if and how.
Bigjohnjr
Posts: 6
Joined: Tue Jul 17, 2018 1:31 pm

Cigna said "No"

Postby Bigjohnjr » Wed Jul 18, 2018 7:16 am

I am a prostrate cancer survivor, I have serious ED now.
Just dead wood.
Tried pills, trying injections now.
I wanted an implant, I figured just fix the dam thing.

Cigna said "no", I appealed and they said I don't need it.
I guess they know better than I do.

So am I just screwed? I have no idea how much it would cost if I paid for out of pocket, and I am not leaving the country to get it done.

So if I paid for it out of pocket any ideas on the cost?

What insurance companies pay for implants?

I am only 57, I like sex. I should not be denied because Cigna is being an ass.

John
Age 56, divorced twice ( I never learn ) Been fighting ED for the past 4 years, Had prostrate cancer (finished rad June 2017). Tried all the pills no good, just makes me sick. Now using trimix, still trying to find that sweet spot. It's hit or miss.

Cajun Jeff
Posts: 1202
Joined: Sat Aug 01, 2009 11:44 pm
Contact:

Re: Cigna said "No"

Postby Cajun Jeff » Wed Jul 18, 2018 7:37 am

I had the same problem with Blue Cross of Louisiana. The said would not cover even with appeal. I went with injections and have adjusted well to that. I am now 67 and Medicare will cover it but I am good at this point with injections. If or when they quit working I will consider implant. Best of luck. Insurance sucks. It all about them making $
68 years old, Married 48 years. Prostate Cancer surgery 11 years ago. Tried Pills, VED, moved to injections (EdEx) for past 6 years. Implanted with AMS 700 LGX by Dr Hellstrom in New Orleans at Tulane Medical. 1/13/20

justanotherdrumber
Posts: 242
Joined: Sun Mar 25, 2018 11:29 pm
Location: Erie, PA

Re: Cigna said "No"

Postby justanotherdrumber » Wed Jul 18, 2018 10:10 am

corvetteman3 wrote:I had the same problem with Blue Cross of Louisiana. The said would not cover even with appeal. I went with injections and have adjusted well to that. I am now 67 and Medicare will cover it but I am good at this point with injections. If or when they quit working I will consider implant. Best of luck. Insurance sucks. It all about them making $

Insurance is about the policy holder wanting to spend $10 to receive $20 in benefits, while the insurance company wannts to take your $10 and give you $5 worth of benefits.

If you think about it, they have to pay agents commission, employee wages & benefits, rent office buldings, purchase office equipment, pay utilities, lease a fleet of vehicles, sponsor sports teams build stadiums, hire advertising agencies and pay for ads on tv and in publications .....
.....make a profit and pay your claims !

Notice that you came last ?
Erie,PA
Age 64 - g/f 34
Implanted ams700 lgx, 18cm+1cm RTE
March 2018

dg_moore
Posts: 1885
Joined: Mon Apr 25, 2011 9:34 am

Re: Cigna said "No"

Postby dg_moore » Wed Jul 18, 2018 10:42 am

Also note that most, if not all, corporate plans are administered by the Ins companies, but terms of coverage are dictated by the companies. Sometimes you can appeal a rejection to the company and they will make an exception to their policy. This happened to me years ago when I worked for GTE. BC/BS was the plan administrator. My late wife was battling metastatic breast cancer and her last hope was a bone marrow transplant, which BC/BS refused to cover. I was able to appeal this to the GTE HR people, and eventually they relented and approved the procedure, so BC/BS did "cover" it (GTE actually paid for it, of course, which is how these arrangements work). My wife survived for a year after the procedure, so to call it a "success" would be a stretch. In any case, if yours is a corporate plan you might find out if coverage decisions can be appealed directly to your company.

Good luck.
Dave, 80, Maryland - Implant (Titan) 2008 by Dr. Andrew Kramer (failed Sept 2020) - never used due to a stroke that, among other things, ended my sex life.
Life is not the way it's supposed to be, it's the way it is.

Larry10625

Re: Cigna said "No"

Postby Larry10625 » Wed Jul 18, 2018 11:00 am

Bigjohnjr wrote:I am a prostrate cancer survivor, I have serious ED now.
Just dead wood.
Tried pills, trying injections now.
I wanted an implant, I figured just fix the dam thing.

Cigna said "no", I appealed and they said I don't need it.
I guess they know better than I do.

So am I just screwed? I have no idea how much it would cost if I paid for out of pocket, and I am not leaving the country to get it done.

So if I paid for it out of pocket any ideas on the cost?

What insurance companies pay for implants?

I am only 57, I like sex. I should not be denied because Cigna is being an ass.

John



Find out who does pay for it,. sign up for it, then have it, then dump them. Insurance companies screw us all the time, I don't feel sorry for them. :)

Larry

Vagabond127
Posts: 737
Joined: Sun Aug 08, 2010 9:37 pm

Re: Cigna said "No"

Postby Vagabond127 » Wed Jul 18, 2018 11:09 am

That's why health insurance should not be for profit. I'm on Medicare and love the socialized form of medicine. Is it perfect? No. Am I getting an implant out of it? Yes. While insurance companies are denying you an implant or a baby a heart transplant these same CEOs are negotiating 100 million dollar exit packages. Oh well the newer generation seems to be more open to socialized medicine. A kinder gentler generation.
Implanted with Titan 1/15/19 with Dr. Eid.
6-length 4.5-girth.

mikestap
Posts: 172
Joined: Sat Sep 01, 2012 12:19 pm
Location: Atlanta, GA

Re: Cigna said "No"

Postby mikestap » Wed Jul 18, 2018 12:46 pm

Many docs have self-pay cash plans available. Expect to see numbers around $16 - 18k.
64 Years. RALP 2013. Received 22cm Titan Dec 20, 2017 by Dr Hakky. See results at download/file.php?id=5320 and download/file.php?id=4754
Revision 3-25-21 24 cm XL No RTE

alibaba
Posts: 3027
Joined: Sun Oct 12, 2014 8:04 pm

Re: Cigna said "No"

Postby alibaba » Wed Jul 18, 2018 2:02 pm

Call the AMS help line. They will get on the phone in a conference call with you and the insurance company and sort this out. I think it is the best product AMS has to offer, getting the insurance approved. Cheers man and DO NOT give up and do not accept the line they do not pay for procedures that promote conception. Your PC treatment likely ruined that prospect so they cannot use that as an excuse which my insurance company used on me for years to deny injections, office visits, vacuum pumps and more till I wisened up and figured out why they denied me and read the policy. In court one time a couple years ago an attorney testified about the commissions paid to reduce claim costs (deny). Even the judge asked more about it. We knew it was true but nobody ever admitted it. Cheers. DO NOT GIVE UP. Read your policy. Every word. use it to your advantage.
LGX 21cm .Milam 01/13/16. Horror; both service and surgical outcome. hated infrapubic installation. Kramer revision 03/01/17. 22cm Titan +1.5cm extender. Those who think their opinion is the only one that matters are a danger to themselves and others.

alibaba
Posts: 3027
Joined: Sun Oct 12, 2014 8:04 pm

Re: Cigna said "No"

Postby alibaba » Wed Jul 18, 2018 2:06 pm

E.D. is a side effect of prostate cancer treatment. It is known. If they pay for new boobs for breast cancer then they have a double standard not making you whole after the common male cancer. I've tried to get our state representative to introduce law to the effect but no luck. It is state law they have to pay for reconstruction on women, both sides if necessary to get symmetry.
LGX 21cm .Milam 01/13/16. Horror; both service and surgical outcome. hated infrapubic installation. Kramer revision 03/01/17. 22cm Titan +1.5cm extender. Those who think their opinion is the only one that matters are a danger to themselves and others.

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

Re: Cigna said "No"

Postby David_R » Wed Jul 18, 2018 2:08 pm

alibaba wrote:Call the AMS help line. They will get on the phone in a conference call with you and the insurance company and sort this out. I think it is the best product AMS has to offer, getting the insurance approved. Cheers man and DO NOT give up and do not accept the line they do not pay for procedures that promote conception. Your PC treatment likely ruined that prospect so they cannot use that as an excuse which my insurance company used on me for years to deny injections, office visits, vacuum pumps and more till I wisened up and figured out why they denied me and read the policy. In court one time a couple years ago an attorney testified about the commissions paid to reduce claim costs (deny). Even the judge asked more about it. We knew it was true but nobody ever admitted it. Cheers. DO NOT GIVE UP. Read your policy. Every word. use it to your advantage.

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