Insurance Woes

The final frontier. Deciding when, if and how.
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Joined: Mon Aug 14, 2017 11:11 pm

Re: Insurance Woes

Postby TheProfessor » Fri Sep 01, 2017 11:53 pm

Apparently it's my employer that has the exclusion for this procedure. BCBS would cover it were it not for my employer's policy, which has a grandfather clause that excludes this, regardless of any federal laws.

Since our insurance is changing in January, I'll take a look at my options during the open enrollment period.
The Professor

RP July 2016
Gleason 3+4=7

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Joined: Thu Aug 03, 2017 9:43 pm

Re: Insurance Woes

Postby Anonymous3 » Sat Sep 02, 2017 12:20 am

By chance are you a veteran? The VA will pay

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Joined: Wed Jul 05, 2017 7:57 pm

Re: Insurance Woes

Postby Dustyknox » Sat Sep 02, 2017 9:03 am

Be sure to also find out specifically why they wouldn't cover it. Initially my insurance company said it wasn't covered when I gave them the diagnosis code for erectile dysfunction. This is a common exclusion. When I tried again using the code for hypogonadism it was covered. So you may want to try the code for diabetes.
Age & staus: mid 30s and single
Implant date: September 8, 2017
Implant model: Coloplast Titan 24cm (no RTE)
Doctor: Eid
ED cause: Propecia (10 years plus of ED)
My story thread: viewtopic.php?f=6&t=8775

phillip brooks
Posts: 3
Joined: Sat Jul 01, 2017 10:24 am
Location: Dallas TX

Re: Insurance Woes

Postby phillip brooks » Wed Sep 13, 2017 12:56 pm

All of you, thank you so much for your advice.

I will update everyone as things unfold

The best to all,


Posts: 523
Joined: Fri Aug 31, 2012 2:52 pm
Location: Portland, TN

Re: Insurance Woes

Postby radiodec » Wed Sep 13, 2017 1:27 pm

From somebody that was in more or less the same boat. I initially was approved for an implant because the AFCA had just come out and my company's plan had not been fully grandfathered. Surgery and implant paid for. Now 5 years later plan is fully grandfathered so no go. The plan specifically excludes penile implants and is fully grandfathered.

I am old enough to qualify, so I picked up Medicare as secondary coverage and they will pay quite a bit of it. Also, my company funded BCBS (Arkansas) covered everything but my surgeon and the implant charge. Still a quite large number. Medicare should get quite a bit of that but neither my surgeon nor the hospital have filed with Medicare yet. I am also lucky in that this second go round has some warranty coverage from AMS.

The women got their coverage by screaming long and loud; for some reason I can't see that many men that need ED intervention wanting to admit it and screaming long and loud.

70 - married 47 years: RP - 2000, injections till 2012, AMS700LGX with 21cm tubes 2cm extenders 11/7/2012, failed 6/5/2017 --- Re-implanted 8/18/2017 with AMS 700CX -- Implants by Dr. David Morris, Hendersonville,TN

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Location: Ontario, CANADA

Re: Insurance Woes

Postby Larry10625 » Wed Sep 13, 2017 3:49 pm

phillip brooks wrote:All of you, thank you so much for your advice.

I will update everyone as things unfold

The best to all,


You should create a "Signature" so that we may be able to offer you some advice.
To add your signature.... look in the upper right hand corner where get your notification and Private messages. Your Profile name is there too, just click on your name. Another window will open, then click on the "User Control panel" tab, then on the left side in that box you will see "Edit Signature".. click on it and then you will be able to add what ever type of information you wish to's easy.

Include things like date implanted, doctors name, Make - Titan or AMS, size of implant, rte's? any story you wish to share - like ED for 15 years, or whatever, any medical info - like diabetes, or high blood pressure, etc. or 33 years old, single gay man with ED for 10 years, thinking about getting an implant. Here is mine:

AMS 700 (18 + 2). Implanted March 30, 2017 by Dr. Brock of London, Ont, CANADA. Great surgeon. Went in to septic shock and had to have implant removed April 29, 2017. Appt. for consult for second attempt is on November 6, 2017... I can't wait.

Feel free to contact me if you need assistance or advice on anything. :)

51 years old, married 29 years. Implanted Mar 30/17 by Dr. Brock of London, Ont, CANADA. (AMS 700 CX 18 + 2). Had implant removed Apr 29/17 due to Septic Shock. Liposuction By Dr. Gan and re-implant by Dr. Brock (AMS LGX 15 + 2) Dec 14/17.

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