Cigna declined me

[GoodWood]

I’m sorry this has happened. That’s awful.

When you are ready to look at next steps, research if you have any other options for healthcare plans. Contact them and ask for a copy of the policy. Then check the exclusions page.
Ask your surgeon’s office staff which insurance policy they have good luck getting coverage.

Then switch to a better plan if that’s an option for you.

[jdsatx1977]

I’m sorry this has happened. That’s awful.

When you are ready to look at next steps, research if you have any other options for healthcare plans. Contact them and ask for a copy of the policy. Then check the exclusions page.
Ask your surgeon’s office staff which insurance policy they have good luck getting coverage.

Then switch to a better plan if that’s an option for you.

We are an open enrollment at my work and they refuse to address the disparity and coverage. So between my employer and Cigna they really have screwed a whole bunch of people over including me and it sucks. I’ve tried federal complaints because of the situation but due to the current climate, nothing is gonna get done so I’m either left with being incomplete in a manner of speaking or hoping some Rich relative just dumped some money on me so I can pay out-of-pocket and give my employer the finger.


I’m about five seconds away from starting to go fund me, but I don’t want that many people know in my business this is terribly depressing

[GoodWood]

If you are in open enrollment, contact the different insurance companies and ask them to email a copy of the policy with its coverage and exclusions. They will do this. It’s common to ask for this so employees can decide which coverage is best for them.

Then look at the coverage and particularly the exclusion page. The exclusion page is very important. If they won’t cover penile implant this is probably where you will find that info.

I have BCBS and assumed I would be denied coverage because I had previously seen a clause that said they don’t cover treatment for sexual function. But when I closely read the exclusion page it said they don’t cover treatment for sexual function EXCEPT surgical implantation of penile prosthesis for erectile dysfunction.

I had to pay a percentage which ended up being around $6000 but that’s beater than nothing.


And a call to your surgeons office about which I sirance companies that have good luck with may be helpful.

Hopefully you will have an insurance option that will provide coverage. Check it out and see.

[Jgoody]

Man I'm sorry to read this. I can certainly sympathize. I have Cigna as well. They verbally approved the procedure on the phone with me a month before my surgery appointment. A few days after the phone approval they then denied it- even with a letter of medical necessity stating that I've exhausted all other treatments & had Peyronie's + arterial insufficiency. Luckily the peyronie's was only beginning and it was due to injections but that was not stated in the letter.

I ended up having to pay out of pocket- 17k. I got two different credit cards to cover it & a little cash. I have now appealed the decision. They made it incredibly hard to do. They couldn't get record of the surgery even happening & kept claiming the codes were wrong, etc. I believe they have finally accepted that the surgery happened & that I paid for it, to actually review it now. In other words, they have finally accepted my appeal, with tremendous resistance & not even being able to talk to the same "representative" every time we'd call.

I'm not holding my breath & I'll report back if something comes of it. But I hate insurance companies now & understand Luigi a bit tbh lol