Dr. Karpman...Insurance Issues

The final frontier. Deciding when, if and how.
alibaba
Posts: 3027
Joined: Sun Oct 12, 2014 8:04 pm

Re: Dr. Karpman...Insurance Issues

Postby alibaba » Thu Jan 01, 2015 8:48 pm

I have a private health plan plus have a secondary of medicaid. Medicaid will not pay one cent toward an implant. The insurance will pay for it after the deductible is met. It is another matter for finding a network doctor on an ever changing list a network doctors, being able to get a surgery scheduled when my deductible is met and before the insurance rolls over for a new deductible period. Find a network doctor one week, finally have the appointment date 3 months later and they tell you they are no-longer a network provider. That has happened several times. top that with finding a doc that does not have a phobia against people with HIV. Out of network docs cost 9 times to me what an in network doc surgery costs. Yes I have spent several entire days trying to find another plan that will make things easier. I have yet to find a new plan that is on the market today that will cover an implant. Brokers all tell me I should go the medicare route. Cannot seem to get through their heads that I have 10 more years come tomorrow to be old enough to apply for medicare. Nothing but blockades. After 26 months trying to get this done I pretty well have given up. I have a health insurance broker meeting tomorrow that I will attend only because I previously agreed to the date so he could try to find me a plan that took care of this, otherwise I would not waste another day on it. You can't borrow your way out of debt and when you have already exhausted all resources including maxing out your debt to pay medical bills, you plain old can't go borrow another $20k to get the job done. Top that off, I don't know where you can get the job done for $20k. Every scheduling person at the hospitals I have talked to says you have to deposit anywhere from $27k to $30k to even get on the schedule.
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.

KMeister
Posts: 446
Joined: Sun Aug 28, 2011 5:43 pm

Re: Dr. Karpman...Insurance Issues

Postby KMeister » Fri Jan 02, 2015 1:06 am

NickNickNick wrote:Hi KM,
I forgot to mention I'm keeping both options on the table for now. I have an appointment with my own Urologist on the 15th and we're going to talk about the implant surgery. Like you said, it doesn't hurt to take a look. But the reason I'm so skeptical is because of how much bad stuff I've read about low volume doctors both on FT and on the web. Higher infection rates, botched surgeries, shorter penis lengths, floppy head issues, longer recovery time...some of this scares the shit out of me. I've heard nothing but good about Karpman.

But I will see what my uro says after I have my appointment. But either way I'm in a tough position...Pay 20k but have the complete reassurance that one of the best implant doctors in the country is going to do my surgery. Or pay nothing, and take my chances with one of the local surgeons in my medical network. God why can't this be easy hahaha


I think your approach of keeping your options open is a good one. Also, you don't have to be locked into your uro. I recommend checking out the AMS and Coloplast websites to see which uro in your area does the implant. Here are their websites.

http://americanmedicalsystems.com/en/pa ... alist.html

http://www.coloplastmenshealth.com/find-a-physician/

Also, you can call both customer service liaison and ask which doctor in the area performs a bunch of implants.

AMS is (800) 328-3881

Coloplast is (800) 525-8161

When it comes to surgery, anything can happen. My uro--who's been doing this for 30 years--did a fine job putting in my implant but one of the cylinders was defective, so just last week back I went...

KM

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

Re: Dr. Karpman...Insurance Issues

Postby alibaba » Fri Jan 02, 2015 3:38 am

Thanks for the link. I already talked to AMS. It is against the law to reccomend doctors here in Missouri just like it is against the law for them to help us with copay assistance.

Maybe coloplast has someone who is not a jerk still learning and don't follow that rule..
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.


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