Wow.
My employer had Cigna last year when I had my implant, as well as an ankle replacement.
They payed all but my out of pocket limit on all claims.
I just looked at my record, and I had claims totaling over $429k last year submitted. Of course, the amounts paid were a lot less, due to insurance agreements with providers.
I suspect it's limitations mandated by your employer, and not necessarily the insurance company.
Definitely keep fighting. This is every bit as important to men as gynecological care is to a woman.
Cigna declined me
Re: Cigna declined me
Age 59. AMS 700 LGX 21cm + 2cm RTE.
Peniscrotal, 2/23.
6.25" OEM with Cialis, about 5" post-op. (11/01: Length 6.75" and girth is up to 4.75" mid shaft.) Still growing, albeit slowly.
Cycling daily. Hoping to get to 7".
Peniscrotal, 2/23.
6.25" OEM with Cialis, about 5" post-op. (11/01: Length 6.75" and girth is up to 4.75" mid shaft.) Still growing, albeit slowly.
Cycling daily. Hoping to get to 7".
Re: Cigna declined me
This blows my mind! - does your surgeon do a lot of implants? A lot of the commercial insurers have really strict criteria and the surgeon has to carefully document the medical need. As mentioned above they may need to do a doc to doc review with the insurance folks.
check this out https://static.cigna.com/assets/chcp/pd ... nction.pdf
Keep fighting!
check this out https://static.cigna.com/assets/chcp/pd ... nction.pdf
Keep fighting!
62 year old, ED+PD, Coloplast Titan 22 cm no RTE in 2019 with Dr. Irwin Goldstein => failure, now with plaque excision/tunical expansion to Coloplast Titan 26 no RTE in 2022 by Dr. Darshan Patel, now with classic pump 2024
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- Posts: 19
- Joined: Tue Apr 11, 2023 1:33 pm
Re: Cigna declined me
jwdetails wrote:This blows my mind! - does your surgeon do a lot of implants? A lot of the commercial insurers have really strict criteria and the surgeon has to carefully document the medical need. As mentioned above they may need to do a doc to doc review with the insurance folks.
check this out https://static.cigna.com/assets/chcp/pd ... nction.pdf
Keep fighting!
Oh, I have already started the fight.
My doc (Matthias Hofer) is drafting a letter for me, and I am preparing some statements. And it does have to do with my employer. Funny thing is they cover the same procedure under gender affirming care, and I am using that as a point in my appeal.
46 m / ED and PD combo platter / Severe horglassing / working toward getting implanted soon
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- Posts: 19
- Joined: Tue Apr 11, 2023 1:33 pm
Re: Cigna declined me
So, a bit of an update.
Cigna has an “advocate” helping with the appeals process. Might hear something more next week. Boston Scientific has a type of patient support team that is a little helpful as well.
Here’s to hoping things get done soon.
Cigna has an “advocate” helping with the appeals process. Might hear something more next week. Boston Scientific has a type of patient support team that is a little helpful as well.
Here’s to hoping things get done soon.
46 m / ED and PD combo platter / Severe horglassing / working toward getting implanted soon
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- Posts: 301
- Joined: Fri Jun 17, 2022 11:15 am
Re: Cigna declined me
I have Cigna. It was approved for Perroto but then I decided to use Cordone where it was denied.
Made no sense.
My Doc kept up with them and they approved it 24 hours before surgery.
Keep pushing
Made no sense.
My Doc kept up with them and they approved it 24 hours before surgery.
Keep pushing
ED survivor 5 years. Tried pills, Gainswave, PRP, Bi-Mix/Tri Mix (worked 50% but very painful for 24 hours after injection.) 55 Gay - Single Titan Coloplast implanted June 1st, 2022, scrotal in Miami by Dr Billy Cordone..,very happy. Zero regrets
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- Posts: 19
- Joined: Tue Apr 11, 2023 1:33 pm
Re: Cigna declined me
Here’s a little update. I am taking my employer, and Cigna, to task on this one.
I made it a point to scrutinize the exclusion, and looked at covered options. My employer covers gender reassignment procedures, and this included the IPP. I asked why I am being excluded, and pointes that out so it looks like things might be moving in the right direction finally.
I made it a point to scrutinize the exclusion, and looked at covered options. My employer covers gender reassignment procedures, and this included the IPP. I asked why I am being excluded, and pointes that out so it looks like things might be moving in the right direction finally.
46 m / ED and PD combo platter / Severe horglassing / working toward getting implanted soon
Re: Cigna declined me
I asked people that do the claims thing for their living - if we have Cigna or Aetna, it's not going to cover it.
Happy Fucking
Re: Cigna declined me
LastHope wrote:I asked people that do the claims thing for their living - if we have Cigna or Aetna, it's not going to cover it.
Aetna Advantage picked upwhat ever Medicare didn't cover on mine. Admittedly it might of been a very low amount, maybe even zero. I never heard a word either way.
68yo, HBP at 40, high triglycerides at 45. Phimosis at 57. Type 2 at 60. Dr. William Brant May 1, 2023 CX 21cm w/no rte's penoscrotal 6" girth @ 6 months
Re: Cigna declined me
jdsatx1977 wrote:jwdetails wrote:This blows my mind! - does your surgeon do a lot of implants? A lot of the commercial insurers have really strict criteria and the surgeon has to carefully document the medical need. As mentioned above they may need to do a doc to doc review with the insurance folks.
check this out https://static.cigna.com/assets/chcp/pd ... nction.pdf
Keep fighting!
Oh, I have already started the fight.
My doc (Matthias Hofer) is drafting a letter for me, and I am preparing some statements. And it does have to do with my employer. Funny thing is they cover the same procedure under gender affirming care, and I am using that as a point in my appeal.
You know, it’s funny but I brought up the bit about gender affirming care a year or two back when we had a rash of insurance denials on here.
My recommendation would be a letter to the insurance carrier claiming to be an impotent MTF pansexual equipped with a faulty penis and due to your gender fluidity they need to make sure you’re functional.
It was strange and I was fortunate. When Viagra hit the market we had absolute hell getting the Army to put it on the formulary and even then you’d get 6 pills per month. By the time I retired and on Tricare didn’t bat an eye about paying as long as it was properly coded.
Iirc between surgeon, hospital, anesthesiologist, and lab it came to $43K, they got paid just less than $19K, which was essentially the same as the doctor’s out-of-pocket/self pay price of $17,200.
Age 68. Physically fit educated red neck in Texas. Very married. 23 cm (18+5) of LGX installed by Dr. Bryan Kansas 12/31/2019. I fought the ED and my wife & I won. I’m either full of shit or sound advice. You decide which.
Re: Cigna declined me
Txagq8 wrote:jdsatx1977 wrote:jwdetails wrote:This blows my mind! - does your surgeon do a lot of implants? A lot of the commercial insurers have really strict criteria and the surgeon has to carefully document the medical need. As mentioned above they may need to do a doc to doc review with the insurance folks.
check this out https://static.cigna.com/assets/chcp/pd ... nction.pdf
Keep fighting!
Oh, I have already started the fight.
My doc (Matthias Hofer) is drafting a letter for me, and I am preparing some statements. And it does have to do with my employer. Funny thing is they cover the same procedure under gender affirming care, and I am using that as a point in my appeal.
You know, it’s funny but I brought up the bit about gender affirming care a year or two back when we had a rash of insurance denials on here.
My recommendation would be a letter to the insurance carrier claiming to be an impotent MTF pansexual equipped with a faulty penis and due to your gender fluidity they need to make sure you’re functional.
It was strange and I was fortunate. When Viagra hit the market we had absolute hell getting the Army to put it on the formulary and even then you’d get 6 pills per month. By the time I retired and on Tricare didn’t bat an eye about paying as long as it was properly coded.
Iirc between surgeon, hospital, anesthesiologist, and lab it came to $43K, they got paid just less than $19K, which was essentially the same as the doctor’s out-of-pocket/self pay price of $17,200.
Yo Tx, any updates ? I’ve been denied by Cigna too- this week, trying now to get it approved.
30 yrs old. Current IPP failed in 2022. Waiting revision. No insurance. I’ve had both Titan & AMS.
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