I want and Implant

[squirrel]

After reading here for weeks, I have decided I want an Implant. I have been fighting ED for the last 6-7 years. Viagra worked for a while but hated the flushed face and stuffy nose. Doc recommended Cialis. It really did not work reliably at different doses and caused severe lower back and leg pain for the next several days. Will not longer take Cialis for those reasons. I have been on Test. Cyp. injections for several years because of low T. Now I have found out my Health Insurance does not cover Penile Implants period. No coverage for E.D. I have the choice to change insurance in November to a plan that says it covers implants for E.D. Now for my questions. Will the new insurance approve me with my above issues. I have not tried any other meds besides Test. and the Oral meds. I have decided to not take the injections for fear of scar tissue and other problems. I can't afford to lose any length. 5" to tip bone pressed stretching like to the max. Scared of scar tissue with injections. I have never used a pump and to be honest really do not want to. I will probably purchase one just to keep blood flowing and to tell the insurance I have tried that option also. Have plans to visit an Endocrinologist and Video chat with Urologist soon just to rule out other issues. Do you guys think I will have problems with the new insurance approving the implant? Am I moving to fast to get the surgery? Anything else I should do? To be honest, if my current insurance covered. I would be knocking on the surgeons door. Tired of a none working penis. Thanks for all the information here. Priceless.

[Gt1956]

First, my opinion is that almost all insurance companies will have a protocol that needs to be followed if they are going to cover an implant. Make sure your doctor keeps good notes. Expect to have a couple of denials before an approval. Tackle their obstacles as they throw them at you. Good luck.

[squirrel]

Thanks for the reply. I will put your advice to work.

[AST2123]

Welcome to the forum!
I had the same issue with insurance. My implant was canceled in 2020 only 2 days for the surgery, which was so disappointing to me. I waited till November and enrolled in Kaiser Permanente Mid-Atlantic (after I knew about doctor who performs this type of surgery with good results).
It depends on where you are located. Other market place plans at healthcare.gov would also cover it without restrictions.
If you enroll at KP in Nov, you can get your surgery before the end of the year. Premium and Out-of-Pocket vary according to your income.

[Lost Sheep]

Welcome to the forum, squirrel.

Re: AST2123's advice about the timing of switching insurance companies and scheduling surgery; be certain what the policies are about pre-existing conditions.

My own experiences tell me

1) make yourself an integral part of your health care team and get your team to accept your inputs. This involves cultivating their confidence in your knowledge and judgment. (Not every person likes this approach and prefer to just put themselves in their providers' hands and not question or participate in decision-making processes and I do not fault them for that choice, but that is not my style and I suspect, not yours either.)

2) Get FULLY informed about ED and its treatments. My Primary Care Physician (PCP) commented to me (as he approved me for an implant) that I knew more about ED and its treatments than he did. He was able to "go to bat" for me with the decision-makers and it was smooth sailing for the surgery.

3) Take notes of all communications, names, times and dates. Thank everyone you talk to (by name - people love to be remembered and will remember you, too). Thank them even if they were no help. They gave you their time to listen and they may change their answers with new information. (e.g. I got pushback from a travel nurse at first but she remembered me and when she learned that there was a newly-assigned surgeon available locally, called me up. She did not have to to that.)

4) Gently get the names of supervisors and follow up with thanks to those folks about all good contacts. Thanking supervisors' supervisors is even better.

5) If your insurance is provided by your workplace, your Human Resources (HR) department may be able to help interpret coverage and exclusions.

Remember, an implant renders you impotent for the rest of your life. You will be completely dependent on the implant for erections. Do not make the choice lightly. If you have any erectile function at all, think hard about what you are doing. If the implant is not satisfactory, there is no going back. If there is, indeed, nothing to go back to, push on and let nothing deter you.

[squirrel]

AST2123 Thanks for the reply. My insurance has a open season in Nov. were you can change insurance plans. The plan will then take effect Jan. 1 2022. I am a federal employee so the pre- existing conditions would not be an issue. That would put me into next summer before I could have the surgery. That is the best time for me to be able to take some time off from work.

Lost Sheep- Thanks for the detailed info. The only erections I have is an occasionally morning one while I am always on my back. If I move its gone. I am pretty much useless. I do not want to go the injection route for the fear of scar tissue. I know it is a major decision and I am not taking it lightly. I have watched most all the surgeries on Y-tube and almost feel like I could do the surgery myself. I will have approx. 9 months to keep researching and to change my mind if I chose. In the mean time I will see a few more specialist - Endocrinologist, Cardiologist. Just to make sure nothing else is going on. I will also be researching here and asking a few questions as time goes on. Thanks.

[Lost Sheep]

AST2123 (edited for focus) I will have approx. 9 months to keep researching and to change my mind if I chose. In the mean time I will see a few more specialist - Endocrinologist, Cardiologist. Just to make sure nothing else is going on. I will also be researching here and asking a few questions as time goes on. Thanks.

I hear you, squirrel.

When I first found FrankTalk, I spend a couple weekends just reading through a few years of old threads. VERY informative in a very short time. Rather than waiting for members to answer, I got a lot of answers (and more than a few new questions to ask) that I would have waited a long time to get just from asking in new threads. Also, much information I may never have gotten because it was posted from members who are no longer active.

Information is power. Get potent!