Biker60 wrote:Well post op 3 weeks. Dr billed 6000, was paid 3000k. Implants insertion paid zero. Plan does not pay for sexual dysfunction. But pays 40k for xiaflex. Plan did pay for penis plastic surgery ? Which was the plication. Hospital Bill was 76K and still processing. My diagnosis is Peyronie’s so appeal will be the next thing to do. The plication would require the same stay and or use as the implants. So I am guessing they won’t pay for the implants. My plan does not require pre authorization. They will not accept a appeal until there is a claim. I knew this was going to happen. But also aware if it was Medicare they will get maybe 17k tops. Can’t worry about it. But men need a federal mandate as women have for breast reconstruction. The sad part is that the denial is based on one diagnostic criteria. Question any guys on FT won on appeal?
I agree with you biker60. The men do need a federal mandate as women have for breast reconstruction. This is ridiculous, seems like there is a problem with every insurance company covering an implant unless you have medicare. Something needs to be done! Sick of paying for an insurance that finds ways to get out of paying for medically necessary procedures! I feel for you having to pay that much but I’m sure you may be able to come up with some type of payment agreement with them for a reduced amount. I got a damn busted implant that I’m stuck with until I can figure out how to come up with the funds or get coverage to pay for a revision. The damn insurance won’t pay and the hospital won’t budge without it being paid in full. I hope I can come up with something soon and it not take years. My fire for life is slowly becoming a shimmering glint of shit!