Surely someone here has received an implant that medicaid and medicare paid for an knows the channels I need to take to get it approved. I have ED from something just like a stroke but the MD's can't find evidence of one. It's a mystery. Please help me or I will be unable to have it done. Where do I start?
Thanks,
Robin
how to medicaid/stroke-surely there's someone?
-
- Posts: 1204
- Joined: Sat Aug 01, 2009 11:44 pm
- Contact:
Re: how to medicaid/stroke-surely there's someone?
Robin, I can't help you but I am sure some guys here will jump in shortly. Good luck.
Cajun Jeff
Cajun Jeff
68 years old, Married 48 years. Prostate Cancer surgery 11 years ago. Tried Pills, VED, moved to injections (EdEx) for past 6 years. Implanted with AMS 700 LGX by Dr Hellstrom in New Orleans at Tulane Medical. 1/13/20
Re: how to medicaid/stroke-surely there's someone?
Robin,
Any uro surgeon worth his scalpel knows just how Medicare works and how to do the paperwork for an implant. I suggest you start with your doctor. I do know that Medicare paid for my uncle's bionic pecker. I do not know if such remedies are covered by Medicaid.
Good luck. Let us know how it goes.
Greg
Any uro surgeon worth his scalpel knows just how Medicare works and how to do the paperwork for an implant. I suggest you start with your doctor. I do know that Medicare paid for my uncle's bionic pecker. I do not know if such remedies are covered by Medicaid.
Good luck. Let us know how it goes.
Greg
Born 1948, wed 1969. BPH & Type II Diabetes at age 35. TURP-2002; ED even before that--diabetes. Cardiac valve surgery: 2007 & 2019. Poor results with pills. Started trimix injections in Nov, 2010. Great results from the very beginning.
-
- Site Admin
- Posts: 656
- Joined: Mon May 18, 2009 11:06 am
- Location: NYC
Re: how to medicaid/stroke-surely there's someone?
Robin,
For Medicaid, I'm pretty sure the doctors only have to prove the need for an implant. They don't always have to define the cause. They can simply say "venous leak" to get approval. Start with a good Penile Implant doctor. Call them, talk to the billing person. They deal with this all the time. Get the ball rolling with that. Now, if you can't pay for the doctor's visit, tell them that. Many doctors will see you as a consult to determine if they are even a match for what you need.
Where do you live? Do you need help finding a surgeon? let me know
paul
For Medicaid, I'm pretty sure the doctors only have to prove the need for an implant. They don't always have to define the cause. They can simply say "venous leak" to get approval. Start with a good Penile Implant doctor. Call them, talk to the billing person. They deal with this all the time. Get the ball rolling with that. Now, if you can't pay for the doctor's visit, tell them that. Many doctors will see you as a consult to determine if they are even a match for what you need.
Where do you live? Do you need help finding a surgeon? let me know
paul
Re: how to medicaid/stroke-surely there's someone?
Good input Paul,
As soon as you start to see a surgeon who performs implant surgery he will perform all of the necessary tests to prove that you qualify for an implant. You will most likely need to go through all other ED solutions and if they fail then insurance will see its a necessity.
-Colin
As soon as you start to see a surgeon who performs implant surgery he will perform all of the necessary tests to prove that you qualify for an implant. You will most likely need to go through all other ED solutions and if they fail then insurance will see its a necessity.
-Colin
Diagnosed with ED at age of 19, Implanted with Coloplast Titan at age 20. Now 34 (2023)
Titan failed 09/2020, replaced on 10/2/2020 by Kolher @ Mayo Clinic in Minnesota
Titan failed 09/2020, replaced on 10/2/2020 by Kolher @ Mayo Clinic in Minnesota
Re: how to medicaid/stroke-surely there's someone?
Does anyone know is you have to have an6 specific tests to determine if penile implant is justified? I have Medicare insurance which pays for the surgery. Thank you!
66 yr old male married 36 yrs use trimix four yrs, cilais and Viagra. trimix work well developed scarring on both sides had implant 1/9/2020 at UT Med Ctr, Knoxville, TN Dr. John Lacy.
Re: how to medicaid/stroke-surely there's someone?
notaes wrote:Does anyone know is you have to have an6 specific tests to determine if penile implant is justified? I have Medicare insurance which pays for the surgery. Thank you!
My implant was paid by medicare. The doctor determined it was medically necessary and it was a slam dunk from there. Cost me $160 out of pocket total.
Became DaveKell 2.0 on July 18th with Dr. Allen Morey in Dallas, TX. AMS 700 CX implant. 18cm with 5.5 RTE's.
Re: how to medicaid/stroke-surely there's someone?
Medicare paid for mine. RP and nerves removed. Pills no good. Allergic to trimix. Done deal.
82, good health, RP 7-2017, all nerves taken , PSA 0.05, 4-18,, .07 1/19,.05 4/19, .03 11-21, .04 11-23, implanted 4-1-18, Infra-pubic, AMS lgx 15 cm with 5cm rte. Implant at USC Keck. Dr Boyd and Dr Loh Doyle 6.5 x 5, 800 AUS 7-21-20
Re: how to medicaid/stroke-surely there's someone?
I live in Philadelphia… I have Pennsylvania state Medicaid and Medicare… I am smack dab between the two “best“. I had to try pills but after that, Medicare was able to approve me… I put my Medicaid through the test but I wanted to go out of state so they aren’t picking up anything… in the end, I will be paying 2900 out-of-pocket… I called my surgeon and he set me up on a payment plan “$700 a month for four months“. Kind of worth it to me as I really don’t unfortunately trust the urology department in any of the Philadelphia hospitals…. I know that I will be getting good work done… but yeah… No tests, just trial and error with the normal treatments… Medicare should put it right through given that you have the right surgeon… Best of luck, brother!
Implanted October 2019 Dr. Kramer lgx 18 cm +2 rear tips. Preop at 6.75 post op 5.25... awaiting revision… Implanted for possibility of having our first child.
Re: how to medicaid/stroke-surely there's someone?
Just for comparison purposes to other federal insurance plans, I have Tricare. (What used to be called Champus)
Retired military. 23 yrs.
My cost share would be $8400 but the catastrophic cap kicks in so I will only be out $3000.
I'm not sure about the VA but I've never been impressed with the quality of care they provide.
Retired military. 23 yrs.
My cost share would be $8400 but the catastrophic cap kicks in so I will only be out $3000.
I'm not sure about the VA but I've never been impressed with the quality of care they provide.
Robust, adolescent 65 year old. Venous leakage forever. Used shots, shots+pills 30+ years. Married to same wife ~35 yrs. Implanted 31Dec2019 in Austin Tx. AMS 700 LGX 18 cm with 5 cm RTE.
Who is online
Users browsing this forum: Google [Bot], Majestic-12 [Bot], Old Guy, wilsonmill and 92 guests