Insurance approval and cost

The final frontier. Deciding when, if and how.
SW0110
Posts: 648
Joined: Sun Sep 02, 2018 6:15 pm
Location: Central Kentucky

Insurance approval and cost

Postby SW0110 » Wed Feb 20, 2019 9:59 am

Talked to docs office this morning. Bcbs approved surgery and they also let me know what my out of pocket estimate will be. My part is 15 percent and is estimated at around 2700. That puts my total implant cost at around 18,000. Seems like a bit less than some others have quoted. Could be less I guess here in northern ky southern ohio area.

I just hope they are not putting seconds in. A little over 2 weeks to go. I think my wife is more nervous than I am.
18 cm plus 1 rte titan installed March 2019. Revision March 2020 by Dr. Andrew Todd, Richmond KY. He replaced the titan with an AMS 700 LGX 18 cm cylinder plus 2 rte for 20 cm total length.

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Lunatech
Posts: 141
Joined: Wed Nov 28, 2018 2:07 pm
Location: Foothills of NC

Re: Insurance approval and cost

Postby Lunatech » Wed Feb 20, 2019 1:55 pm

Congrats on the ins. approval. I found out mine was approved at my pre-op appt. on 2/13 and I was responsible for our plan max out of pocket ($4k). But hey, the hospital will let you "finance" your part interest free so why not. My surgery date is 2/28 so I've got about a week to go. Getting nervous but excited. FINALLY will have something besides a limp noodle to work with.
49 years old at time of implant, Suffering from ED 10+ years, Implant surgery 2/28/19 AMS 700 LGX 18cm with 4cm RTE by Dr. Terlecki at WFBMC in Winston Salem NC

needhelp
Posts: 210
Joined: Sun Jan 07, 2018 7:07 pm

Re: Insurance approval and cost

Postby needhelp » Fri Feb 22, 2019 9:28 am

SW0110 wrote:Talked to docs office this morning. Bcbs approved surgery and they also let me know what my out of pocket estimate will be. My part is 15 percent and is estimated at around 2700. That puts my total implant cost at around 18,000. Seems like a bit less than some others have quoted. Could be less I guess here in northern ky southern ohio area.

I just hope they are not putting seconds in. A little over 2 weeks to go. I think my wife is more nervous than I am.


Congratulation's on your insurance stepping up. Wish my employer would. My insurance (WellsFargo) sucks. I've been pricing them out because this may (?) be out of pocket for me. They range from 14K - 27K
61 years old, single, Charlotte NC, Had a penile fracture. Implant scheduled for April 17. Dr Terlecki Winston-Salem, NC

andrew1959nj
Posts: 271
Joined: Thu Jun 14, 2018 3:04 pm

Re: Insurance approval and cost

Postby andrew1959nj » Fri Feb 22, 2019 9:42 am

I have Aetna and they don't cover implants. I even went to an attorney to evaluate a potential Bad Faith case. Nada, it would cost more in legal fees than several implants. I have to save and pay for It myself but it will be the best money I ever spent! I'm looking forward to many returns. . .
60 years old. MS and Severe ED 10+ years. Pills and injections never worked well. Implanted 5/16/2019 by Dr. Sadeghi. Titan 20cm + 2cm RTE.

MK1965
Posts: 625
Joined: Thu May 24, 2018 5:32 pm

Re: Insurance approval and cost

Postby MK1965 » Fri Feb 22, 2019 10:08 am

andrew1959nj wrote:I have Aetna and they don't cover implants. I even went to an attorney to evaluate a potential Bad Faith case. Nada, it would cost more in legal fees than several implants. I have to save and pay for It myself but it will be the best money I ever spent! I'm looking forward to many returns. . .


Andrew,
I also have Aetna, employer sponsored insurance, and my insurance covered my implant last September.
It cost me about $1500 ( Co-Insurance $1350 plus rest of Annual deductible).
I had prostate cancer and RPwas cause of mine ED.
MK
IPP 9/5/18; TITAN OTR 18 +1cm RTE,Prostate Ca at 51 y/o; RARP 11/2/16, ED Post RP, Cialis, Viagra, VED,TRIMIX painful, BIMIX ineffective,lost 2+ inches of length after RP. Revision 12/2/20 by Dr Clavell, AMS 700 CX, L 21 R 21+1.5 RTE.

Maverick2dog
Posts: 139
Joined: Mon Apr 23, 2018 9:24 am

Re: Insurance approval and cost

Postby Maverick2dog » Fri Feb 22, 2019 5:58 pm

BCBS contracted rate, what they paid the hospital, was about the same around $18,000. The actual bill from the hospital was around $60,000. I have a max out of pocket of $3000.

Every insurance plan can be different even if it the same company.
59 years old. Forth revision 10/2021
Third revision 9/21 moved pump replaced one cylinder AMS CX 21+ 3. Second revision January 31st 2019 AMS CX 21,+2CM RTE. First revision November 15th, 2018 24CM CX .5RTE. Implanted 4/2018, Titian 22CM 2.5 RTE

Robert66
Posts: 688
Joined: Thu Dec 28, 2017 10:39 pm

Re: Insurance approval and cost

Postby Robert66 » Sat Feb 23, 2019 1:06 am

What if you havemedicare and va
edex and tri mix 45/1/27 26 units

ocitgo
Posts: 397
Joined: Wed Jan 01, 2014 8:48 pm
Contact:

Re: Insurance approval and cost

Postby ocitgo » Sat Feb 23, 2019 5:01 am

"What if you have medicare and va?"
Medicare was 100% for mine.
ocitgo (Bob F), Bremerton, WA
Implanted 11/13/2017 AMS 700LGX 15 cm, leak, 3 cm rear tip
Implanted 06/17/2019 AMS 700LGX 18 cm, 1.5 cm rear tip

andrew1959nj
Posts: 271
Joined: Thu Jun 14, 2018 3:04 pm

Re: Insurance approval and cost

Postby andrew1959nj » Sat Feb 23, 2019 1:24 pm

MK1965,

Thanks, Aetna as an insurance company will cover implants, unless the company that sponsors it, my employer excludes it. I'm halfway there!
60 years old. MS and Severe ED 10+ years. Pills and injections never worked well. Implanted 5/16/2019 by Dr. Sadeghi. Titan 20cm + 2cm RTE.

Opie52
Posts: 50
Joined: Fri Sep 21, 2018 9:44 pm

Re: Insurance approval and cost

Postby Opie52 » Mon Feb 25, 2019 2:20 am

How does it work if insurance won’t cover the initial surgery? Will the cover revisions since it is now a part of you?
AMS 700 cx implanted on 9/14/18 in Iowa city, Iowa
42 years old peyronies disease


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