Cigna said "No"

The final frontier. Deciding when, if and how.
newbie443
Posts: 1827
Joined: Fri Dec 01, 2017 9:41 pm
Location: Sedgwick county, Kansas USA

Re: Cigna said "No"

Postby newbie443 » Wed Jul 18, 2018 2:42 pm

My insurance covers this but only after everything else fails. I had no luck with pills and injections. That may be why you were turned down. Could be you need documentation from a doc that pills and injections do not work. They may pay after that.

As far as paying out of pocket, that varies. The surgeon that did mine charges 24k. If you decide to pay out of pocket then you just need to contact the surgeon you want to do this and ask.
Injections failed. Implanted 3-21-18 AMS 700 LGX 21 + 1 RTE 100 cc reservoir 6.5" L 5" G Dr. Kramer.

Proximal Perforation Sling Repair 4/13/21 Dr. Broghammer

66 years young.

Will show and tell and talk with others.

Tsanchez12369
Posts: 227
Joined: Fri Dec 23, 2016 7:52 pm
Location: SAN Francisco

Re: Cigna said "No"

Postby Tsanchez12369 » Wed Jul 18, 2018 8:19 pm

Just be sure to try all the ED treatments and report back to the doc they are NIT working for you (unless of course you hit the jackpot and one works great for you). Then you can apply again.
Sept 11, 2018: excision, grafting (human cadever tissue) and implant. Doc is Dr Edward Karpman in Mountain View, surgery at El Camino Hospital, LOS Gatos CA. AMS 700 CX infrapubic 18 cm + 3 cm RTE. http://www.peyroniesforum.net/index.php

MK1965
Posts: 625
Joined: Thu May 24, 2018 5:32 pm

Re: Cigna said "No"

Postby MK1965 » Wed Jul 18, 2018 9:33 pm

I am so sorry to hear about your denial by Cigna.
I am in the same process waiting to hear from Aetna.
It is discouraging but do not give up!

MK
IPP 9/5/18; TITAN OTR 18 +1cm RTE,Prostate Ca at 51 y/o; RARP 11/2/16, ED Post RP, Cialis, Viagra, VED,TRIMIX painful, BIMIX ineffective,lost 2+ inches of length after RP. Revision 12/2/20 by Dr Clavell, AMS 700 CX, L 21 R 21+1.5 RTE.

oldbeek
Posts: 2454
Joined: Sun Sep 10, 2017 1:46 pm
Location: Los Angeles area

Re: Cigna said "No"

Postby oldbeek » Wed Jul 18, 2018 11:18 pm

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



Sex was better with injections anyway for me. No orgasms so far with implant. Trimix gave my minor pyronies. You have to prove injections do not work for you before Cigna will approve IP. Give injections an honest try.
82, good health, RP 7-2017, all nerves taken , PSA 0.05, 4-18,, .07 1/19,.05 4/19, .03 11-21, .04 11-23, implanted 4-1-18, Infra-pubic, AMS lgx 15 cm with 5cm rte. Implant at USC Keck. Dr Boyd and Dr Loh Doyle 6.5 x 5, 800 AUS 7-21-20

Lost Sheep
Posts: 6133
Joined: Mon Jul 04, 2016 11:16 pm

Re: Cigna said "No"

Postby Lost Sheep » Wed Jul 18, 2018 11:35 pm

Mikestap and Alibaba have posts worth re-reading.

Many Doctors' offices know how to do the coding on their billing correctly (to the mind of the bean counters at the insurance companies). A billing code for a given procedure might trigger a denial, but the same procedure coded differently (perhaps broken up into discrete functions, or more likely, bundled with your prostate treatment) may pass. The Doctor's billing office may be of GREAT help. Extablish a relationship with womeone there by way of your doctor and try.

Alibaba's advice to speak to AMS is worth it's weigh in gold. or platinum or truffles. Whatever.

Restoration of a lost function IS A VERY VALID POINT OF INSURANCE COVERAGE!!!

Unless it is SPECIFICALLY disallowed in your policy (and remember the Prostate issues may invalidate the disallowance) NEVER GIVE UP!

Good luck
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
READ OLD THREADS-ask better questions -better understand answers
Be part of your medical team
Document pre-op size-photos and written records
Pre-op VED therapy helps. Post-op is another matter

Urz14me
Posts: 43
Joined: Fri Mar 30, 2018 11:24 am
Location: Atlanta(ish)

Re: Cigna said "No"

Postby Urz14me » Fri Jul 20, 2018 10:18 am

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



Bummer Cigna approved me however instead of doing it in my Doctors Surgery Center it had to be scheduled in a hospital. (which actually cost Cigna more money)
52 year old. Diagnosed with Venous Leak. Trimix was hit and miss. opt'd for implant Titan 22cm 3.5cm RTE by Dr. Hakky on March 27, 2018 ...Remember they never complaint how small your penis is when it is in their ass... just sayin' :o

Larry10625

Re: Cigna said "No"

Postby Larry10625 » Fri Jul 20, 2018 10:43 am

oldbeek wrote:
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



Sex was better with injections anyway for me. No orgasms so far with implant. Trimix gave my minor pyronies. You have to prove injections do not work for you before Cigna will approve IP. Give injections an honest try.



Are you sure you don't just need to "continue" longer? I was pleasantly surprised that it takes me a lot more time now (at least 20 minutes and up to 55 minutes). I hope things get better for you... the orgasms are freakin AWESOME. :)

Larry

oldbeek
Posts: 2454
Joined: Sun Sep 10, 2017 1:46 pm
Location: Los Angeles area

Re: Cigna said "No"

Postby oldbeek » Fri Jul 20, 2018 12:08 pm

Larry10625 wrote:
oldbeek wrote:
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



Sex was better with injections anyway for me. No orgasms so far with implant. Trimix gave my minor pyronies. You have to prove injections do not work for you before Cigna will approve IP. Give injections an honest try.



Are you sure you don't just need to "continue" longer? I was pleasantly surprised that it takes me a lot more time now (at least 20 minutes and up to 55 minutes). I hope things get better for you... the orgasms are freakin AWESOME. :)

Larry


It does come eventually. We banged for 45 minutes last week and I got close, but didn't get there. My wife got a urinary tract infection from it :( So now I am banned from the happy place. Yesterday I finally get off using porn, vibrator, hot tub, a gallon of oil and my Fleshlight. 40 minutes. today my dick is sore but happy:D My wife says to come and see her when I get feeling back into that thing.
82, good health, RP 7-2017, all nerves taken , PSA 0.05, 4-18,, .07 1/19,.05 4/19, .03 11-21, .04 11-23, implanted 4-1-18, Infra-pubic, AMS lgx 15 cm with 5cm rte. Implant at USC Keck. Dr Boyd and Dr Loh Doyle 6.5 x 5, 800 AUS 7-21-20

Larry10625

Re: Cigna said "No"

Postby Larry10625 » Fri Jul 20, 2018 12:40 pm

oldbeek wrote:
Larry10625 wrote:
oldbeek wrote:

Sex was better with injections anyway for me. No orgasms so far with implant. Trimix gave my minor pyronies. You have to prove injections do not work for you before Cigna will approve IP. Give injections an honest try.



Are you sure you don't just need to "continue" longer? I was pleasantly surprised that it takes me a lot more time now (at least 20 minutes and up to 55 minutes). I hope things get better for you... the orgasms are freakin AWESOME. :)

Larry


It does come eventually. We banged for 45 minutes last week and I got close, but didn't get there. My wife got a urinary tract infection from it :( So now I am banned from the happy place. Yesterday I finally get off using porn, vibrator, hot tub, a gallon of oil and my Fleshlight. 40 minutes. today my dick is sore but happy:D My wife says to come and see her when I get feeling back into that thing.



It does get better, honest. :)

Larry

Bigjohnjr
Posts: 6
Joined: Tue Jul 17, 2018 1:31 pm

Re: Cigna said "No"

Postby Bigjohnjr » Sat Jul 21, 2018 12:13 pm

So now I have been diagnosed with peyronies, never had that before.

So did the caverjet or the trimix cause that?

I have no idea, If cigna would pay for the implant none of this would be an issue.

They approved the caverjet, which will cost them about 18K a year for the med.

The xiaflex to treat the peyronies with cost them more money, now well exceeding the cost of the implant.

I just don't get it. The implant is so much cheaper, one and done.
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.


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