Bad news...but a possible opportunity?

[PowerliftingDad]

I watched that clip. I also discussed it at length with ChatGTP. I sent the transcripts. This urologist is jumping the gun. There will likely a pre-approvial process. But especially with revisions....its not an option, its essential.

[Courage]

I watched that clip. I also discussed it at length with ChatGTP. I sent the transcripts. This urologist is jumping the gun. There will likely a pre-approvial process. But especially with revisions....its not an option, its essential.

I researched it awhile ago when an article appeared in the Times. The pilot program doesn't begin until next year. Further, prior authorization denial is subject to appeal. Nevertheless, it does without a doubt suck that it is happening at all and it is likely true that the quality of medical insurance in the US is going to go down.

viewtopic.php?f=6&t=27125&p=260830#p260830

Misinformation is bad whether it comes from real doctors or fake ones like . . . .

[Colby-jack__]

Im sure that comment isnt pointed at Dr Taj.

If it is, they 1000% have no idea what they are talking about.

He did mine a month ago. You can look up his background. He's not short on qualifications. He's been amazing every step of

[PowerliftingDad]

I think that Dr. performing the surgery in the YouTube video is jumping the gun saying that IPPs will no longer covered. I think that is very pessimistically speculative based upon some states now requiring pre-approval.

That is not uncommon....even with great insurance.
I have gold level blue cross blue shield and still had to get approved to get a revision.

I think that they might be an extra couple hurdles to jump through...But I highly doubt that covered for IPPs is going to disappear.
And certainly those already implanted that need revisions will definitely be covered.

[Courage]

Im sure that comment isnt pointed at Dr Taj.

Correct. He was the "real doctor" referred to, licensed by the Commonwealth of Virginia.

Congrats on the result!

[Courage]

I think that they might be an extra couple hurdles to jump through...But I highly doubt that covered for IPPs is going to disappear.
And certainly those already implanted that need revisions will definitely be covered.

My worry would be more that it might be added to the list of excluded procedures under more plans. My own experience with infection and revision has been hellaciously expensive.

[PowerliftingDad]

I would be very surprised if coverage was excluded for the initial implant if deemed medically necessary and all other treatment options were exhausted.

I would say there is no way a revision wouldn't be not covered.
A revision isn't optional....it is medically necessary and there are no other possible treatments.

[Colby-jack__]

Thanks courage.
Sorry if I jumped the gun to defend dr Taj.
I believe very strongly in him and his practice.
When I went to him I was fairly sure IPP was for me but I was fairly happy to work with any general surgeon that performed them and worked with my insurance.
After researching Dr Taj and meeting with him, I was willing to pay out of pocket but fortunately his team got me covered by Insurance EVEN WITH A SPECIFIC IPP EXCLUSION!
He's an amazing surgeon and a great person.
Im.planning to go.back to him for a vasectomy soon since now my ED is fixed and I have a reason to get it done!
If anyone on here is shopping for surgeons I strongly encourage you to at least check him out and take a consult to see if you agree.

[PowerliftingDad]

Colby, it looks like your surgeon did an amazing job and clearly is very skilled.
My critique was that I personally feel his statement that IPPs will no onger be covered by insurance or medicare is pessimistic and speculative.

There is quite the difference between an AI automatic denial and a denial after the review process with documentation of medical necessity.

I absolutely believe there may be automatic denials requiring more documentation of medical necessity....but to blanket say Medicare and insurance won't cover IPPs in the future I feel is not going to be the case.