Ever try crowdfunding?

[kwazywabbit]

Hey just found out my insurance won't cover a dollar of an IPP. Dr Hakky's cash price is $19,000. That's a lot of damn money.

Any of y'all ever try gofundme to cover your procedure? I set one up just to try: https://www.gofundme.com/f/8dfrf. Feel free to share it - I need all the help I can get.

I can't believe insurances will cover trans surgeries but not this...

[SquadCaptain74]

Im not minimizing this struggle (insurance battles) at all.

Have you 100% leveraged all the appeals available? My urologist was adamant and a dog with a bone (not pun intended) to work through the authorization process. Moreover, the Boston Scientific team have an entire insurance team to help "educate/inform" the insurance providers in why this is NOT a simple "cosmetic or elective" procedure, but a medical necessity for some.

Not that you should have to - but depending on what state you are in - get your representative involved. Its amazing how a timely penned letter from a congressional office can help grease the skids!

[Lost Sheep]

Hey just found out my insurance won't cover a dollar of an IPP. Dr Hakky's cash price is $19,000. That's a lot of damn money.

Any of y'all ever try gofundme to cover your procedure? I set one up just to try: https://www.gofundme.com/f/8dfrf. Feel free to share it - I need all the help I can get.

I can't believe insurances will cover trans surgeries but not this...

I echo what SquadCaptain74 said. So I won't repeat, just amplify. An IPP is "to restore a lost bodily function" and medically necessary (i.e. not just for sex) for things like Peyronie's disease.

Look at it this way. $19k is a lot cheaper than a decent sports car and both have comparable service lives. You can get a girl with a nice corvette, but what are you going to do with her THEN? Or, you could drive a 16 year old VW Rabbit and do things with the girl that the Rabbit (vibrating sex toy) could never do.

Press your insurance company. Even if they have a specific exclusion for IPPs, they have been known to allow exceptions if you press hard enough, get your medical team on your side and maybe even a lawyer specializing in negotiating with insurance companies (a 1 hour consult is often free or nominal, just so you have an idea of your chances, for a couple hundred dollars, worth it).

[kwazywabbit]

Thanks for the advice y'all. It was denied initially, then Dr Hakky had me do the doppler ultrasound for verification and sent all the notes and documentation to them. They still denied it. But, they will cover part of the curvature correction though. I reached out to Coloplast to see if they have a team to assist - like Boston Sci does. At least I've got decent credit so I can make payments if needed - but I'll let y'all know what happens!

[Old Guy]

Good advice from Lost Sheep. Fight the insurance company. Before my implant some insurance lady called me, asking all sort of questions. Felt more like she was trying to talk me out of the surgery or find a reason to deny it. I finally asked her age and relationship status; she was mid 30's and married. Asked her what if your husband had this issue, would you be ok without any intimacy the rest of your life? I got approved.

[HappyAgain]

Fucking typical of an insurance company. They’ll take your money like clockwork then do whatever it takes to deny your care

[Musson]

Based on your signature details I can see why they are pushing back. With 30% and only mild ED you probably don’t meet the full criteria. I’m not saying I agree with that it’s just the same story I was told by Kaiser. Specifically if you can still get hard with pills and the curve doesn’t stop penetrating then they are going to “ cockblock” you ( pun intended). Perhaps a little embellishment can be justified. For example, yes I can penetrate but it’s super painful for him/her.

In my own case I was at 40% measure accurately with a Peyroines protractor. At 40% sex is still possible but not enjoyable. I have to get my wife’s hips rotated forward to a ridiculous extent. Modified Mish is the only position tolerable. Lately I’ve had spontaneous remission to 30% which I’m hoping lasts. At 30% sex can be okay and sometimes with even enhanced stimulation of the anterior side of the vagina (aka g spot). I can still get hard successfully about 75% with 60 mg of sildalifil. I hate the side effects at that dosage.

So bottom line I think our symptoms are similar. I’m on the fence about getting an implant since technically I can still perform. My wife is not particularly sexually demanding and do I pursue other outlets. If I had a horn dog of a wife that would militate in favor of the implant. So as a “tweener” I’m taking a wait and see approach.

Good luck.

[Time2Change]

I had to fight with my insurance company for months before they agreed to cover my implant.

I kept calling and kept calling. My doctor did two consults. I sent documentation of my physical problem. And I kept calling.

Ultimately, I got ahold of a customer service representative who was very sympathetic. And when she looked at my case she realized somebody entered the wrong code. Within days, she called me back with the news that I had been approved for the surgery.

I still have her voice message saved in my phone.

[kwazywabbit]

Excellent points everyone. I'm calling again tomorrow to try the case manager. I get the reasoning about still being able to function, but can't imagine not being able to use it at all. I'd much rather stay ahead of it and have a permanent solution that can be enjoyed for many years!

[Lost Sheep]

Excellent points everyone. I'm calling again tomorrow to try the case manager. I get the reasoning about still being able to function, but can't imagine not being able to use it at all. I'd much rather stay ahead of it and have a permanent solution that can be enjoyed for many years!

Yes, those enigmatic codes are a conundrum. Kept in a secret vault they can unlock many procedures. (The "secret vault" is not too much of a stretch. The books of codes are expensive to buy.) Use the wrong code and you are deadended.

I heard of one guy whose provider used a particular code and the procedure was denied, but when resubmitted with a combination of codes that amounted to the exact same medical procedures was approved without question. Or maybe it was the other way around.

This is why I recommend taking names and notes of every contact you make and to thank everyone (by name) you contact even if they were no help. They gave you their time, people love to be remembered and they are more likely to remember you kindly the next time you talk. Example: I talked to a travel clerk/nurse in the VA who was discouraging almost to the point of being obstructive. A few weeks later she called and told me she heard of a surgeon recently assigned to the local military hospital who was an expert at the procedure and had even taught the procedure. She asked if I would be interested in seeing him. "Hell YES!" was my thought. "I would consider that, thank you very much; it is kind of you to have remembered me." was my spoken response.