Affordable Self-Pay Options

The final frontier. Deciding when, if and how.
trevbalser
Posts: 4
Joined: Fri Jun 18, 2021 10:16 pm

Affordable Self-Pay Options

Postby trevbalser » Tue Jul 20, 2021 9:46 pm

I've been perusing this forum for some time and find all the comments very helpful. After years of contemplating it, I finally decided earlier this year to go for an implant. I met with the surgeon in May and scheduled it for 7/22/21. All summer I've been a nervous wreck, it seemed like the date would never come. Then, yesterday I found out that my insurance company, Cigna, is refusing to cover it all, even if it is proven to be medically necessary. It's simply not an included benefit in the plan. What a let down! HR rep at my company is looking into whether anything can be done but I'm not holding my breath. Hospital told me the self-pay cost for the surgery would be 40 Grand and that's not including the anesthesiologist! I know the going rate is $16 - 25K so I canceled the surgery and am shopping around. Does anyone have experience going the self-pay route? Where did you go and what was the cost? I'm in Columbus, OH but willing to travel.
51 years old. Venous leakage since my 20s. Have tried viagra, cialis, levitra, trimix (briefly). Viagra worked best but finally decided to go for an implant. Implanted with AMS 700 9/29/22.

ViaSwiss
Posts: 602
Joined: Fri May 24, 2019 9:09 am

Re: Affordable Self-Pay Options

Postby ViaSwiss » Tue Jul 20, 2021 10:00 pm

Anthem denied my operation 3x this year stating it was not medically necessary, my doc had to have 2 peer-to-peers with them before they approved.

If the plan has an exclusion, AMS will work with your HR to try to get you a one off. Michelle can help: Richelle.OReilly@bsci.com

If none of those options work, Dr. Tatem's self pay is $17,000 in Indianapolis. Dr Hakky is around $17,000 in Atlanta.
Age 35. Venous Leakage & Post Finasteride Syndrome (PFS) since age 18.
Original Implant | June 25, 2021 | 20cm Titan w 1.5cm & 1cm RTEs
Revision | November 16, 2021 | 26cm | Dr. Hakky

rayhay
Posts: 49
Joined: Sun Nov 01, 2020 2:52 pm

Re: Affordable Self-Pay Options

Postby rayhay » Tue Jul 20, 2021 10:55 pm

I did self pay in NYC with Dr EID for 32k. If the cost is affordable I would not choose anyone else. If you have to go with a more affordable option, I hear great things about Dr Hakky in Atlanta. He should be under 20k.
47 suffering from ED for last 10 years due to hormonal issues that became pyschogenic Implanted 6/24/21 Dr Eid. Titan 24cm cylinder with 1.5cm RTE on one side and 24cm cylinder only on other.

OregonStrong
Posts: 375
Joined: Mon Mar 02, 2020 10:15 pm

Re: Affordable Self-Pay Options

Postby OregonStrong » Tue Jul 20, 2021 11:18 pm

ViaSwiss wrote:Anthem denied my operation 3x this year stating it was not medically necessary, my doc had to have 2 peer-to-peers with them before they approved.

If the plan has an exclusion, AMS will work with your HR to try to get you a one off. Michelle can help: Richelle.OReilly@bsci.com

If none of those options work, Dr. Tatem's self pay is $17,000 in Indianapolis. Dr Hakky is around $17,000 in Atlanta.



And then you have the embarassment of your HR department, and possibly your whole work, knowing about your problem that your dick doesn't work. I dealt with that myself at my work. Nobody has said anything, but I just get the feeling now a lot of people know.
50 yrs old. E.D. issues started around age 35, combo venous leak/testicular failure. Bilateral testicular implants for severely atrophic testes. Implanted 6/11/20 Dr. Kramer LGX 21cm + 1.

Mark74
Posts: 43
Joined: Wed Jan 27, 2021 11:37 am

Re: Affordable Self-Pay Options

Postby Mark74 » Wed Jul 21, 2021 12:21 am

Too bad you're not requesting a sex change. If you wanted to cut your penis off they would pay for everything and send you a get well card

hectorm64
Posts: 87
Joined: Thu Dec 31, 2020 11:46 am

Re: Affordable Self-Pay Options

Postby hectorm64 » Wed Jul 21, 2021 12:48 am

trevbalser wrote:I've been perusing this forum for some time and find all the comments very helpful. After years of contemplating it, I finally decided earlier this year to go for an implant. I met with the surgeon in May and scheduled it for 7/22/21. All summer I've been a nervous wreck, it seemed like the date would never come. Then, yesterday I found out that my insurance company, Cigna, is refusing to cover it all, even if it is proven to be medically necessary. It's simply not an included benefit in the plan. What a let down! HR rep at my company is looking into whether anything can be done but I'm not holding my breath. Hospital told me the self-pay cost for the surgery would be 40 Grand and that's not including the anesthesiologist! I know the going rate is $16 - 25K so I canceled the surgery and am shopping around. Does anyone have experience going the self-pay route? Where did you go and what was the cost? I'm in Columbus, OH but willing to travel.


Hi Trevbalser,
I work for the HR department for a big company. The HR representative in charged of Benefits can help you to get it approval, Also, it is illegal to disclose employees' medical condition. If for any reasons somebody in HR discloses your claim with anybody, you can sue the company and the HR employee gets fired.
Also, if you read several Bionic guys here. They have to resubmit their claim several times before it gets approval.
Don't give up on your first knock out.
Your doctor can appeal your claim or your HR/ Benefits department can push it through.
Good luck man. We are in this battle together.
Hector
57 yo, PHX, AZ. ED all my life.Used Viagra,Cialis,Trimix failed. Implanted AMS 700CX 21 cm +2 cm RTE on 03/11/2021. Dr Shawn Blick.
Pre/post-op size length 6.0"X 6.5" girth. Cycling at week 2,Sex at week 3.
Cycling full erected 1hr am, 1hr pm

trevbalser
Posts: 4
Joined: Fri Jun 18, 2021 10:16 pm

Re: Affordable Self-Pay Options

Postby trevbalser » Thu Jul 22, 2021 10:07 pm

Thanks for all the comments. Will keep you posted. Haven't heard back from HR yet. For now, I'm researching out-of-state surgeons with reasonable self-pay costs. Have a feeling I may end up going that route. I may also reach out to AMS to see what advice they have.
51 years old. Venous leakage since my 20s. Have tried viagra, cialis, levitra, trimix (briefly). Viagra worked best but finally decided to go for an implant. Implanted with AMS 700 9/29/22.


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