How much did your IPP cost out of pocket?

[Jgoody]

17k

No insurance, correct? Thanks for sharing.

No problem. But correct no insurance. Well we have Cigna but they denied coverage after initially approving it. So I paid out of pocket & am in the process of appealing still. The estimate they sent to my insurance company was 74k

[QuestionGuy]

17k

No insurance, correct? Thanks for sharing.

No problem. But correct no insurance. Well we have Cigna but they denied coverage after initially approving it. So I paid out of pocket & am in the process of appealing still. The estimate they sent to my insurance company was 74k

I am also researching CIGNA and they have assured me that this procedure is covered. What rationale did they give for the denial ? I'm looking at a revison....but for new surgery they seemed only to want evidence that one has tried pills, injections etc.... first , before opting for surgery. Did they ask for that paper trail?

As far as cash prices: I have seen $35K for surgery center $10K for doctor $2K for anesthesiologist (i think the implant itself is part of the surgery center cost)

[niall4473]

Speaking personally, my direct expenses for my two major surgeries were about £16.80, roughly $22.80, for some off-site car parking while I was being implanted.

[Jgoody]

No insurance, correct? Thanks for sharing.

No problem. But correct no insurance. Well we have Cigna but they denied coverage after initially approving it. So I paid out of pocket & am in the process of appealing still. The estimate they sent to my insurance company was 74k

I am also researching CIGNA and they have assured me that this procedure is covered. What rationale did they give for the denial ? I'm looking at a revison....but for new surgery they seemed only to want evidence that one has tried pills, injections etc.... first , before opting for surgery. Did they ask for that paper trail?

As far as cash prices: I have seen $35K for surgery center $10K for doctor $2K for anesthesiologist (i think the implant itself is part of the surgery center cost)

I think what happened was I just called them to get pre authorization after I met with surgeon. On the phone I was verbally told that it would be covered in my plan. I was excited. 2 days later I found out they were denying coverage. Apparently our plan does not cover ED treatments. I had recently began to develop some scar tissue from injections so urologist listed Peyronie's & wrote a letter of medical necessity & stated I exhausted all other modes of treatment.

They have made the process very challenging to even appeal. After some ups and downs, I think the appeal has finally been accepted to review recently. So my fingers are crossed to get reimbursement.

However, if you have been pre-authorized, I wouldn't worry much. I sort of rushed the whole thing once implant was on my radar.

[LGXDownunder]

I'm getting mine done in Australia. I'm travelling there from New Zealand.
I've been quoted $27500 AUD. Adding in flights and accommodation it comes to $32000 AUD.
That's about $21000 USD.

Looks to be in the ball park. Coming here from NZ I'm assuming you will have to pay everything out of pocket?
Yes, the extras with flights and accommodation also adds up, more so if you are bringing a support person/s.

After I received a final statement from the private hospital where my surgery was done I was able to calculate the full cost of my procedure, with some limitations. They itemised everything as follows and the amounts are all in AUD.
Some item numbers are Australian Medicare (I think, without checking) and the "BS" ones I'm assuming are Boston Scientific.

ASO ADV SURG PR 1-14 DAYS $1,120.00 (this would be private room accommodation)
Item Code 37429 PENIS artificial ERECTION $2,149.00
Item Code 37426 PENIS artificial ERECTION $485.76
Item Code BS423 AMS 700 Series Inflatable $655.00
Item Code BS414 AMS 700 Series Inflatable $1,881.00
Item Code BS413 AMS 700 Series Inflatable $8,070.00
Total $14,360.76 (this was all paid by my private health insurance except for a $200 co payment)

Adding the upfront costs that I paid of approx. $7,800.00 for surgeon's fee etc the overall would be around $22,000 AUD.
Converting at today's exchange rate = $14,523.52 USD

p.s. An unknown is the full anaethetist's fee. He only billed me for the $600 gap.

[Colby-jack__]

Right now the hospital where i had my implant done a month ago has an open "in process" claim for $158k.

Im sure this will not be the final bill. Has anyone else seen claims like this?

[charlie]

I have insurance, so my out of pocket was $400.

[Desperado]

I have insurance…

Charlie, Thanks. Mind sharing what kind of insurance?

[GoodWood]

Insurance coverage can be challenging.

I’m 57, in the USA, and my insurance doesn’t cover ED treatments.

But once I really ready the exceptions page closely it say that they don’t cover treatments for sexual function EXCEPT surgical implantation of penile implant for ED.




And it turned out they covered my surgery. I still had to pay a percentage and the total ended up being between $5000-$6000. Not an insignificant amount of money, but better than I expected.


So it’s definitely worth reading your policy closely. I also think it’s a plus if a high volume surgeon. Their office staff know ALL the insurance policies and which codes will get a yes from which companies.

[LGXDownunder]

I have insurance, so my out of pocket was $400.

Charlie, your profile states that you are in Australia.
In which case I'm very keen to know how you were able to get an out of pocket of only 400 bucks.
And which insurer? I think I really need to change insurers!
My total out of pocket was approx. $8,000-00 AUD after I exhausted all insurance claims, both private and Medicare.
My experience seems fairly typical, based on the costs other Aussie guys have reported on franktalk from time to time.
To my knowledge the only way to get such a low cost (or free) implant would be to go through Medicare as an uninsured public patient.
And potentially be on a waiting list for years, assuming they deemed the surgery necessary.