Does anyone have independent ins. that covers implants

The final frontier. Deciding when, if and how.
treetop
Posts: 276
Joined: Mon Mar 14, 2011 12:28 pm
Location: Southern California

Does anyone have independent ins. that covers implants

Postby treetop » Wed Apr 25, 2018 6:14 pm

My next step is to maybe get independent insurance and pay for it myself.
Go see an in network uro, and get a referral to Dr. EID.

I will go on the web. Janice thinks Blue Cross. I am not sure if I can get independent ins. with them but I will check.

Anyone here paying for insurance that covered their implant, can you give me info?

Thanks
TT
Treetop -- (TT)
Implant - Pending Medicare in 2024 (I turn 65) -- I am now in planning stages.
My Introduction - http://www.franktalk.org/phpBB3/viewtop ... =14&t=7775

ED2013
Posts: 1231
Joined: Tue Mar 05, 2013 8:15 pm

Re: Does anyone have independent ins. that covers implants

Postby ED2013 » Wed Apr 25, 2018 6:23 pm

That’s a tough one. Many insurers do not pay for existing conditions. I hope you do find one tho. Another option is to get a part time job with medical benefits. Make a lil extra money and insurance to boot.

Anonymous3
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Joined: Thu Aug 03, 2017 9:43 pm

Re: Does anyone have independent ins. that covers implants

Postby Anonymous3 » Wed Apr 25, 2018 7:17 pm

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Last edited by Anonymous3 on Sat May 12, 2018 1:41 pm, edited 1 time in total.

treetop
Posts: 276
Joined: Mon Mar 14, 2011 12:28 pm
Location: Southern California

Re: Does anyone have independent ins. that covers implants

Postby treetop » Wed Apr 25, 2018 8:15 pm

hturner12 wrote:Tree
You cid mention your age but Medicare pays. To check your insurance lo9k in the section labeled not covered. Last year for GEHA it was on page 45 and said ED not covered. This year it was page 96 and was worded sexual inadequacy or impotence


I am 58. So if I remember, Medicare starts at 65.
So that would mean waiting 6 years.
But I am happy it covers it.
Thanks for the info.
TT
Treetop -- (TT)
Implant - Pending Medicare in 2024 (I turn 65) -- I am now in planning stages.
My Introduction - http://www.franktalk.org/phpBB3/viewtop ... =14&t=7775

LMCatman
Posts: 1006
Joined: Wed May 08, 2013 11:11 am
Location: South Florida, USA

Re: Does anyone have independent ins. that covers implants

Postby LMCatman » Thu Apr 26, 2018 7:31 am

Humana paid for my first two implants. I'd had a Radical Prostatectomy and an implant "made me whole", similar to breathing reconstruction for a woman after breast cancer. Medicare paid for my third one..... Good luck!
73 Years old. RP Oct 2010, No erections after, Botched Titan implant April, 2013, Successful Titan revision, April , 2014 by Dr. Paul Perito, Miami. Titan failure Feb 2017. Rev. by Dr Perito March 1st, 2017. Titan failure Nov 2020. New Titan January 2021

antman90
Posts: 60
Joined: Tue Mar 27, 2018 5:45 am

Re: Does anyone have independent ins. that covers implants

Postby antman90 » Thu Apr 26, 2018 7:07 pm

treetop wrote:My next step is to maybe get independent insurance and pay for it myself.
Go see an in network uro, and get a referral to Dr. EID.

I will go on the web. Janice thinks Blue Cross. I am not sure if I can get independent ins. with them but I will check.

Anyone here paying for insurance that covered their implant, can you give me info?

Thanks
TT

Treetop you can buy blue cross.... but their enrollment period is only twice a year. The plans with very little or no deductible ... are between 350-600 a month. I do know that they partially cover implants under "prosthetic devices." If you were to go directly to EID with blue cross it would probably be more ... idk if he is in network and he is also out of state. I have 30k saved up... but it would hurt me to spend that much on this procedure. If I do decide to go the implant route I will try to figure out this insurance thing first.
27, divorced no kids, ED since as long as I can remember, don't know the cause. Pills work but hate the sides/planning. Leaning towards an implant.

newbie443
Posts: 1837
Joined: Fri Dec 01, 2017 9:41 pm
Location: Sedgwick county, Kansas USA

Re: Does anyone have independent ins. that covers implants

Postby newbie443 » Thu Apr 26, 2018 9:29 pm

I have ACA (Obamacare) compliant BCBS. It is a Gold plan and cost me $945.00 a month. It has coverage for part of implant surgery (I would pay deductibles, copays, non covered items, some of those would be above my 3500 out of pocket). If the cause is physical injury or illness. It does not cover for psychological causes.

I have no out of net work coverage. BCBS said I had to stay local for anything as long as there was a provider in my area for them to pay anything.

Insurance is state to state though so your states BCBS may be different than mine. And I have seen advertisements for non compliant policies now that the tax or penalty for not having ACA compliant health insurance was lifted for 2019. It was my understanding that ACA did away with pre-existing conditions. But they might have a waiting period.

I hope this was of some help. Good luck with this.
Injections failed. Implanted 3-21-18 AMS 700 LGX 21 + 1 RTE 100 cc reservoir 6.5" L 5" G Dr. Kramer.

Proximal Perforation Sling Repair 4/13/21 Dr. Broghammer

66 years young.

Will show and tell and talk with others.

treetop
Posts: 276
Joined: Mon Mar 14, 2011 12:28 pm
Location: Southern California

Re: Does anyone have independent ins. that covers implants

Postby treetop » Fri Apr 27, 2018 11:42 am

antman90 wrote:
treetop wrote:My next step is to maybe get independent insurance and pay for it myself.
Go see an in network uro, and get a referral to Dr. EID.

I will go on the web. Janice thinks Blue Cross. I am not sure if I can get independent ins. with them but I will check.

Anyone here paying for insurance that covered their implant, can you give me info?

Thanks
TT

Treetop you can buy blue cross.... but their enrollment period is only twice a year. The plans with very little or no deductible ... are between 350-600 a month. I do know that they partially cover implants under "prosthetic devices." If you were to go directly to EID with blue cross it would probably be more ... idk if he is in network and he is also out of state. I have 30k saved up... but it would hurt me to spend that much on this procedure. If I do decide to go the implant route I will try to figure out this insurance thing first.


Thanks for that information. Please update me if you find an ins company that you like.
Also see newbie443's response regarding BD/BS. If they won't allow out of network then they won't work for me as I will only see one doctor (EID).

I am not in a hurry. Open enrollment for my company is in October, so I may look at my options at that time to see what is available.
If I do find independent ins then I can opt out of company ins and get the independent.
I am 6 years from Medicare, although I don't want to wait for that long....
TT
Treetop -- (TT)
Implant - Pending Medicare in 2024 (I turn 65) -- I am now in planning stages.
My Introduction - http://www.franktalk.org/phpBB3/viewtop ... =14&t=7775

treetop
Posts: 276
Joined: Mon Mar 14, 2011 12:28 pm
Location: Southern California

Re: Does anyone have independent ins. that covers implants

Postby treetop » Fri Apr 27, 2018 11:44 am

newbie443 wrote:I have ACA (Obamacare) compliant BCBS. It is a Gold plan and cost me $945.00 a month. It has coverage for part of implant surgery (I would pay deductibles, copays, non covered items, some of those would be above my 3500 out of pocket). If the cause is physical injury or illness. It does not cover for psychological causes.

I have no out of net work coverage. BCBS said I had to stay local for anything as long as there was a provider in my area for them to pay anything.

Insurance is state to state though so your states BCBS may be different than mine. And I have seen advertisements for non compliant policies now that the tax or penalty for not having ACA compliant health insurance was lifted for 2019. It was my understanding that ACA did away with pre-existing conditions. But they might have a waiting period.

I hope this was of some help. Good luck with this.


Yes, this information does help.
$945 is a lot, but out of pocket is more if I get a loan to pay off.
I may check into BC/BS plans, but would need some out of network coverage as I am sure Dr. EID is out of network.
Everything else may be in network, hospital, etc.

I will continue my research, and this does help.
Thank you
TT
Treetop -- (TT)
Implant - Pending Medicare in 2024 (I turn 65) -- I am now in planning stages.
My Introduction - http://www.franktalk.org/phpBB3/viewtop ... =14&t=7775

newbie443
Posts: 1837
Joined: Fri Dec 01, 2017 9:41 pm
Location: Sedgwick county, Kansas USA

Re: Does anyone have independent ins. that covers implants

Postby newbie443 » Fri Apr 27, 2018 12:15 pm

Many doctors are in network for my state insurance and if I were out of area or state and had a medical emergency I could go to them and would be covered. But this is what is considered as a covered elective surgery in my state. That means BCBS can choose who I will go to for this surgery. As I said your state may be different. And if your states BCBS policy has out of network coverage you need to make sure you can file under that. Might not be able to as that it is may be considered elective. And out of network in all the policies I have seen have seperate higher deductible's, and out of pocket. Your Doctors office may be able to help with this and work it in reverse so to speak or know first hand.

Having traveled for this I can say 1000% that if there was a really good surgeon in my area I would gone to him. One of the surgeons I was considering contacting for this is in southern California. If he had been in KS I would have gone to him. As would one from Texas, Atlanta, Florida, and New York. And many others.
Injections failed. Implanted 3-21-18 AMS 700 LGX 21 + 1 RTE 100 cc reservoir 6.5" L 5" G Dr. Kramer.

Proximal Perforation Sling Repair 4/13/21 Dr. Broghammer

66 years young.

Will show and tell and talk with others.


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