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Author Topic: Insurance might not pay  (Read 1855 times)

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chasema

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Insurance might not pay
« on: May 14, 2018, 10:02:11 AM »

I just got back from Doctors office to discuss Xiaflex shots. Turns out my insurance won't cover or only partial coverage. They will call me about the details later, but if it's too much out of pocket guess I'm done having sex. Got to wonder why it cost this much for the shots anyhow when a vial of Xiaflex probably cost the company a few dollars to produce.
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TonySa

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Re: Insurance might not pay
« Reply #1 on: May 14, 2018, 10:11:38 AM »

Insurance denials can be appealed, but you want to research how best to support your appeal.  PM me if you have any questions.
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PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

chasema

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Re: Insurance might not pay
« Reply #2 on: May 14, 2018, 10:15:34 AM »

Thanks. will keep this in mind. I thought that since there is some pain involved with my condition that it would be covered.
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TonySa

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Re: Insurance might not pay
« Reply #3 on: May 14, 2018, 11:36:14 AM »

If you have a 30 degree or greater curvature, it is medically justified.
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PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

chasema

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Re: Insurance might not pay
« Reply #4 on: May 14, 2018, 12:22:10 PM »

I am at 45 degrees. I'll have to call the insurance company if they turn me down and remind them of this. Thanks for the info Sanchez. Personally thought there would be no problem with Highmark PPO they were pretty good in the past about coverage
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TonySa

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Re: Insurance might not pay
« Reply #5 on: May 14, 2018, 07:44:30 PM »

Generally much easier w P.O. vs HMO
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PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.
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