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Cost
Posted: Wed Oct 02, 2019 10:47 am
by JTB121249
Will insurance or medicare pay for an implant ? I am currently using a Tri-mix type of injection- from a compounding pharmacy. There is a doctor in the area "installing" implants, but he seems very eager to do this procedure. I am wondering the costs - and will insurance pay or medicare ???
Re: Cost
Posted: Wed Oct 02, 2019 1:12 pm
by dg_moore
Medicare does cover implants. Private insurance varies from carrier to carrier, and if employer-provided, depends on whether the employer supports coverage for implants. So if Insurer A provides implant coverage for Company B - which itself approves implant coverage, Insurer A will not provide implant coverage for Company C if that company excludes implant coverage.
Re: Cost
Posted: Wed Oct 02, 2019 1:53 pm
by WhiteCane
OK, I’m a weird case… I’m 32… I’m blind and I’m within three years of double organ transplants… I qualify “for now“ for Medicare and Pennsylvania state Medicaid… I am seeing a surgeon because of his experience that is a state or two away… Total cost of surgery is 20,000… Medicaid “because it is out of state“ is not picking up any of it… Medicare is taking care of all except an estimated 2900… I hope that helps maybe even a little bit… Best of luck, brother!
Re: Cost
Posted: Wed Oct 02, 2019 6:13 pm
by LMCatman
My first implant was paid by Humana (less my deductible). My second implant was paid by Humana (less my deductible) although I paid Dr. Perito myself, as he was not in Humana's network. The hospital, implant etc was paid by Humana. My third implant was paid by Medicare (less my deductible).
I think it was first covered by Humana as it was to "make me whole after prostate cancer", much as breast augmentation is to make women whole after breast cancer. Emphasis on 'I think'!
Good luck man!