Insurance process?

The final frontier. Deciding when, if and how.
Nestor
Posts: 48
Joined: Tue Oct 16, 2018 6:13 pm

Insurance process?

Postby Nestor » Sun Oct 21, 2018 8:29 am

So my insurance DOES cover implants, of course I have a 20% co-pay after my high deductible is met. (So it will still be a bit pricey)

I will need pre-approval. I'm not sure though how that works. I've seen endos over the years, and even originally a local uro. Over the ~15 years I've dealt with this, I've even seen two of the USA's best known men's health specialists.

For an implant, I'd go to one of the best known implant doctor's. So in other words, someone that has no real history with me. How typically do these Dr's handle insurance approval if they don't have that history?
47; Considering an implant. ED for over a decade. Tested a decade ago for VL, negative. Not hormonal; may be dopamine reward dysfunction.

Floppy
Posts: 77
Joined: Thu Jun 28, 2018 9:03 am

Re: Insurance process?

Postby Floppy » Sun Oct 21, 2018 9:04 am

Dr.Eid's office will I know provide you with the information you need, total cost, insurance part, your copay the only thing that they can't tell you is your deductible. They will answer your questions promptly even if you choose to go elsewhere.
Born 1952,
RRP 6/1/18 Viagra worked prior to RRP
Trimix painful didn't work Bimix didn't work either
Implanted Titan 20CM 1CM rte
10/26/18 Dr. Eid
Great experience

Bigred
Posts: 186
Joined: Sun Mar 12, 2017 7:47 am
Location: SC, GA

Re: Insurance process?

Postby Bigred » Sun Oct 21, 2018 5:13 pm

Your physician’s office should handle all the pre-approval from your insurance. They know the proper codes. Be sure to request a copy of the approval from the doctor before the procedure.
66 YO, Implant 6/7/2017 at University of Maryland by Dr. Andrew Kramer, High Volume Implant And world class surgeon. AMS 700. Great expierence with zero complications.

Nestor
Posts: 48
Joined: Tue Oct 16, 2018 6:13 pm

Re: Insurance process?

Postby Nestor » Sun Oct 21, 2018 8:24 pm

Thank you for your replies.

You're suggesting though a physician that specializes in these surgeries (Dr's Eid and Kramer for instance)... Who haven't treated a patient through other solutions (PDE5's, hormones, etc...) is able to still convince an insurance company that there's a need for surgery?
47; Considering an implant. ED for over a decade. Tested a decade ago for VL, negative. Not hormonal; may be dopamine reward dysfunction.

LMCatman
Posts: 1007
Joined: Wed May 08, 2013 11:11 am
Location: South Florida, USA

Re: Insurance process?

Postby LMCatman » Mon Oct 22, 2018 1:41 pm

for my first revision (2nd implant), Humana cancelled my authorization the afternoon before surgery. What they finally worked out was an approval for the procedure and hospital with the doctor's name left blank. Dr Perito did not take my insurance. All else was paid by Humana (less deductibles and copays) and I paid Dr Perito myself.....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

Bigred
Posts: 186
Joined: Sun Mar 12, 2017 7:47 am
Location: SC, GA

Re: Insurance process?

Postby Bigred » Mon Oct 22, 2018 4:13 pm

Nestor wrote:Thank you for your replies.

You're suggesting though a physician that specializes in these surgeries (Dr's Eid and Kramer for instance)... Who haven't treated a patient through other solutions (PDE5's, hormones, etc...) is able to still convince an insurance company that there's a need for surgery?


With Kramer, I had to provide medical history showing that I had been prescribed E.D. Meds in the past and had been diagnosed with E.D. His office took care of the rest.
66 YO, Implant 6/7/2017 at University of Maryland by Dr. Andrew Kramer, High Volume Implant And world class surgeon. AMS 700. Great expierence with zero complications.


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