Some Good Insurance News For a Change

The final frontier. Deciding when, if and how.



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ElbowRoom
Posts: 403
Joined: Mon Mar 17, 2025 1:58 pm

Re: Some Good Insurance News For a Change

Postby ElbowRoom » Tue Aug 05, 2025 9:53 am

Yeah BC/BS of Georgia changed their language too. It used to say treatments for sexual dysfunction aren't covered.

Now it says they're not covered (except for organic male erectile dysfunction). And when I called them they said "coverage is based on medical necessity" which is insurance speak for "we'll cover it if you make a good case that it's needed".
58yo Coloplast Titan implant scheduled for 10/23/2025 with Dr. Hakky. Pre-op erect measurements:
8.5"L and 6.5"C

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ElbowRoom
Posts: 403
Joined: Mon Mar 17, 2025 1:58 pm

Re: Some Good Insurance News For a Change

Postby ElbowRoom » Tue Aug 19, 2025 11:10 am

I just logged into the BC/BS portal to check on my pre-auth request. It was APPROVED! I’m over the moon, the surgery is pre-authorized between now and December 31.

This is fantastic news for me, it means I’ll have the procedure in the hospital instead of in Hakky’s office (which is a much easier drive to my home, and preferred in case of complications). I’ll have an out-of-pocket cost of $3k to $4k instead of $22.5k.

I’m relieved and getting excited to join the brotherhood!
58yo Coloplast Titan implant scheduled for 10/23/2025 with Dr. Hakky. Pre-op erect measurements:
8.5"L and 6.5"C

LastHope
Posts: 1399
Joined: Sun Feb 18, 2024 1:26 am

Re: Some Good Insurance News For a Change

Postby LastHope » Tue Aug 19, 2025 2:11 pm

edjohn wrote:
LastHope wrote:Good luck, ElbowRoom! Please keep us posted on your journey with BCBS. If I can establish a home address in a neighboring state, I’ll qualify for BCBS of Texas through my employer. With my current address, I’m stuck with Aetna, which proved to be useless for any implant procedures.


Clavells office told me specifically that BCBS of Texas is no good. I currently have the foreign service aetna plan and it's completely out of the question with them.


Thank you edjohn for sharing this. This is great to know. No BCBS of Texas, then. Aetna was acquired by CVS ...go figure!
40, Jan 2025 - Coloplast Genesis 22-13

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ElbowRoom
Posts: 403
Joined: Mon Mar 17, 2025 1:58 pm

Re: Some Good Insurance News For a Change

Postby ElbowRoom » Tue Aug 19, 2025 2:17 pm

LastHope wrote:
Thank you edjohn for sharing this. This is great to know. No BCBS of Texas, then. Aetna was acquired by CVS ...go figure!


My plan that just approved is BC/BS of Georgia, but they have several plans that certainly have different coverage.
58yo Coloplast Titan implant scheduled for 10/23/2025 with Dr. Hakky. Pre-op erect measurements:
8.5"L and 6.5"C


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