Medicare Part B Sucks

The final frontier. Deciding when, if and how.
Dogface
Posts: 44
Joined: Tue Mar 05, 2013 11:58 am

Medicare Part B Sucks

Postby Dogface » Tue Dec 18, 2018 10:45 am

Getting ready to pull the trigger and schedule implant surgery. Since turning 65 Medicare A and B has become primary and they are a pain in the ass. Don't want to cover ongoing prostate cancer blood work and question about every medical procedure which is not very much. Dr. Kramer's office requires some expensive pre-surgical test (EKG, and comprehensive blood work etc.). Has anybody had issues with Medicare A and B covering implant (pre and post surgical) expenses? Does medicare require advance authorization prior to implant surgery? I can see myself getting stuck with a $20,000 bill. Medicare has already denied $800 in blood work which I recently appealed.

On a positive note seniors are allowed to cancel Part B anytime. Can't receive a refund ($130 a month for me) however my Cigna insurance would become primary with a $300 deductible and 100% coverage on blood work.
RP surgery for PCa March 2011, rising PSA 2013, remission since 2014. Chronic ED since 2011 tried pills, VED, and injections. Implanted LGX 4/17/19 Dr. Kramer. On scale of 1-10 I'd give it an 8. That's due to a slight curve.

UTVOLS
Posts: 22
Joined: Fri Oct 20, 2017 10:15 pm
Location: BG KY

Re: Medicare Part B Sucks

Postby UTVOLS » Tue Dec 18, 2018 3:20 pm

Dogface, I don't think you will fine a better insurance than medicare for the price. I suggest you do a lot of research before you cancel. JUST MY 2 CENTS
70 y/o married 51 yrs. pills quit working. Implanted 5/21/18 in Nashville by ( Dr. Lowe now retired) AMS 700 LGX 21CM+2CM, RTE's

Dave52
Posts: 206
Joined: Sat Oct 13, 2018 4:28 am

Re: Medicare Part B Sucks

Postby Dave52 » Tue Dec 18, 2018 4:28 pm

My implant cost me $0.00 for the whole thing Medicare and my BCBS supplemental covered every penny
Dave
Born 52
Prostatectomy 6/1/18
Viagra worked before RRP
Trimix painful Bimix both Ineffective
Titan 20CM 1CM RTE
10/26/18 Dr.Eid

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

Re: Medicare Part B Sucks

Postby LMCatman » Tue Dec 18, 2018 4:29 pm

Did you have a prostatectomy? My first implant and revisions (pre-Medicare) were through Humana and had something to do with "making me whole" after RP, a concept similar to breast reconstruction for women. My second revision was through Medicare with no "issues".

Not approving the bloodwork seems strange. I've done blood (PSA) tests every 3 or 4 months for the past 8 years. Again no issues HOWEVER...with my most recent physical, my Primary did NOT order a PSA test. When I asked, he said 'you've reached the age (67) where you are very unlikely to get an aggressive cancer'. I was surprised (and pleased).

It's also possible that the surgeon's office might know "tricks" about getting these through Medicare.

Yes, UTVOLS, more research!

Good luck, man!
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

Xomanow
Posts: 403
Joined: Mon Dec 14, 2015 9:03 pm

Re: Medicare Part B Sucks

Postby Xomanow » Tue Dec 18, 2018 4:47 pm

Dave52 wrote:My implant cost me $0.00 for the whole thing Medicare and my BCBS supplemental covered every penny
Dave


Same here......Medicare & supplemental covered the entire thing.......that's almost enough to give me an erection right there......
Implanted Jan 4 2017 by Dr. Eid - 70 yo and single...ED gradually over 15 yrs...tired of pills, injections, cock rings....happy with my choice and results. Titan OTR - one 20cm cylinder - one 20cm+1 RTE...."got a rocket in my pocket"....

DougAnd
Posts: 1536
Joined: Sun Jul 08, 2018 5:10 pm
Location: Melbourne, Florida

Re: Medicare Part B Sucks

Postby DougAnd » Tue Dec 18, 2018 7:53 pm

Medicare B did not cover certain types of things. For example my doc did an injection before my venous leakage test they did not pay for and a few other things, They would not pay for an MRI or CAT scan to see if you have scarring but will pay for ultrasound. They only accept the bare min testing.
LGX 18cm+3cmRTE 8 / 8/18 by Docs Saracino , Prody of FL Disfigured by Implant. Married 31 years, Functionally impotent 2+ years. 4" day of surgery now 7" inflated after VED 6.5" without. Pump moved 12/4/18 by Dr Kata

David_R
Posts: 2145
Joined: Mon Nov 02, 2015 1:03 pm

Re: Medicare Part B Sucks

Postby David_R » Tue Dec 18, 2018 9:51 pm

Dave52 wrote:My implant cost me $0.00 for the whole thing Medicare and my BCBS supplemental covered every penny

Same for me.

David_R
Posts: 2145
Joined: Mon Nov 02, 2015 1:03 pm

Re: Medicare Part B Sucks

Postby David_R » Tue Dec 18, 2018 9:52 pm

Xomanow wrote:that's almost enough to give me an erection right there......

:lol:

CTR5000
Posts: 170
Joined: Wed Apr 01, 2015 9:51 pm

Re: Medicare Part B Sucks

Postby CTR5000 » Tue Dec 18, 2018 10:02 pm

Dave52 wrote:My implant cost me $0.00 for the whole thing Medicare and my BCBS supplemental covered every penny
Dave


Same for me... $0.00 with Medicare primary and Aetna secondary. I was 61 when I got my implant... 2015.

Larry10625

Re: Medicare Part B Sucks

Postby Larry10625 » Wed Dec 19, 2018 6:36 am

Dogface wrote:Getting ready to pull the trigger and schedule implant surgery. Since turning 65 Medicare A and B has become primary and they are a pain in the ass. Don't want to cover ongoing prostate cancer blood work and question about every medical procedure which is not very much. Dr. Kramer's office requires some expensive pre-surgical test (EKG, and comprehensive blood work etc.). Has anybody had issues with Medicare A and B covering implant (pre and post surgical) expenses? Does medicare require advance authorization prior to implant surgery? I can see myself getting stuck with a $20,000 bill. Medicare has already denied $800 in blood work which I recently appealed.

On a positive note seniors are allowed to cancel Part B anytime. Can't receive a refund ($130 a month for me) however my Cigna insurance would become primary with a $300 deductible and 100% coverage on blood work.



I would like to suggest to you that you look at the "other stuff" that might come up i.e.. blood test meter, needles lancets and test strips if you become diabetes, physiotherapy etc. :)

Larry


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