Been a very bad week - insurance won’t pay

[Empty1]

A week ago today, I was "officially" told after an uultrsound that my last & only option for Peyronies Disease & Peyronies Disease related Erectile Dysfunction was an implant. I had suspected that this would ultimately be the case for a good while now, so I was prepared to hear it and to move forward with the surgery, eventhough I was getting nervous af. But earlier this week I learned that my insurance will not cover it. I have been on Medicaid since being laid off due to COVID in March, I certainly can't afford to pay out of pocket, and the prospects for getting back to work anytime soon and on a private insurance plan that might cover the procedure look very very bleak to say the least. And every day I wait at this point only seems to be further destroying my already decimated dick as it continues to shrink into virtual non-existence. Will anything be left to even implant into by the time I might, maybe, perhaps, if I'm lucky be able to get the procedure, god knows when? Probably not. I've been dealing with this damn disease, and all of it's horrible side effects in all areas of my life, for coming up on 3 years now (and not very successfuly, frankly 😔). At this point I'm done. I'm tired. I give up. The white flag is flying, and honestly, I think I'm about ready to cash out and call it a life. Sorry to bitch & whine & rant, but this really sucks, and has caused my already severe depression and anxiety to soar to new and devastating heights. I try talking to the few friends who know of my condition, even to a few therapists, but nothing helps much. Not sure what you guys have experienced, but I've found that nobody "gets it" if they don't actually HAVE it. Ya.. been a bad week, and I'm in a very bad, hopeless place. Thanks for listening, and sincerely all the best to all of you guys.  

[TonySa]

Empty, I'm so sorry you are going through this.  Has your doc tried appealing the denial? It's pretty common to get denied the first time.  I certainly understand how this can be depressing.  Sounds like you've tried a counselor.  If not look for someone that does CBT therapy.  Also, don't be reluctant to ask your doc for an antidepressant such as Wellbutrin to get you this particularly difficult time.  Hang in there and keep us posted!

[thrownacurve]

Bad news and the last thing someone needs when they are down. Just for what it's worth, I didn't address my very severe Peyronie's for four years, or I should say, I tried shots and meds and traction, didn't help, let things go another year and my junk was shriveled to nothing it looked like. 90 degree up bend. I got excision/grafting and implant a month ago, she got me back to 6 bone pressed and says I could get back up to another inch cycling over the next year. I was only around 7 and a half to start, so honestly even at 6 and usable I am ecstatic.

So, don't panic if it takes a few months to get there, good surgeons can do some amazing work.

[TonySa]

If a doctor ever prescribed benzo's for depression-run!  BTW, I have a doctorate in clinical psychology and a post-doctoral masters degree in psychopharmacology (which allows prescribing psychotropic medications in some US states and territories).  Trust me, recommending benzo's for depression (and only allowed for anxiety short term) is dangerous.  Benzo's are not only addictive in the sense that they are difficult (and impossible for some to discontinue) with time their treatment impact diminishes-thus one needs to keep upping the dose for the same impact even to the point of a lethal over dose.  

[thrownacurve]

I don't want to hijack a thread, and don't want to really "start trouble". Apologies to OP, but I need to say this. @Jan.Schaller - man, why do you continue to come on the thread for implants for men and continuously and constantly reiterate over and over how implants are so abhorrent and freakish and horrible that a man like you, with no sexual dysfunction, would EVER consider such a move. I mean, maybe I can get a job in a freakshow now, "step right up ladies and gentlemen, see the impotent weirdo with the *bicycle pump in his dick*" <-- One of your many "descriptions".

I have a fairly long fuse, I am a pretty reasonable guy, but at this point your repeated negativity seems highly ignorant, uninformed, selfish and honestly, like you are over compensating. So why don't you get your ass out of a thread about something you have no interest in and no chance of ever allowing to invade your superior body?

Just sayin' dude, you are being a real a-hole and I'm pretty over it.

[Alibaba]

Simple list of rules for implant coverage.
Medicare covers
Medicaid does not
Private insurance sometimes does, sometimes has a specific exclusion. Some insurance will not pay if it is to promote conception. Some will pay after a prostatectomy.  Some will require you try pills, injections, and pumps first. Many will not pay for those requirements.  
If the U.S. would transition to Medicare for all and have the same rules, it would be covered.
For Peyronies, most insurance companies will require you to try Ziaflex or similar injections and meet a degree angle that prevents insertion or have pain upon insertion first.  

[TonySa]

Alibaba, do all state Medicaid programs exclude implants?

[Empty1]

Thanks for everyone's input & kind words.

I've been on pretty much every anti-anxiety med there is, including benzos (which doctors were hesitant to prescribe given a history of suicide attempt, but finally did after Peyronies Disease diagnosis sent it soaring), and none of them really even made much of a dent in my anxiety. I've also been on several different anti-depressants over the past five years, as well, most of which quit working after a few months. I've been on Wellbutrin for a few years now, but frankly it doesn't work very well for me either.

Bottom line is it's over for me. Peyronies Disease has won. "Life" has won - I'm defeated, and all hope has run out. I gave it my best shot, and in the end I've failed. Sorry, I know this is a Peyronies Disease support site, not a mental health or "coping" site, but for me, and maybe for many of others on here, Peyronies Disease & depression/anxiety have been absolutely & hugely interlinked, and both just horribly destructive to my life, so I really can't think or talk about one without thinking & talking about the other, as well.

I know with absolute certainty at this point that things will not get better for me, and I quite literally am just waiting around to die. There is obviously a limit on how long I'll be able to go on like that before I ultimately decide to put an end to it. For now, literally every single day is spent evaluating and pondering whether or not to go on, whether today will be "the day". I suppose at least it has crowded out the daily mental agony of knowing I've got Peyronies Disease, though, eh? I guess I should be thankful for that.

This is what late-stage, terminal "Peyronies/depression/anxiety disorder" looks like.

Again, all the best to all of you.

[Stabler]

Alibaba is correct about his insurance information however no matter what plan you have if it is denied you AND your doctor should appeal the denial. Yes, you both can do an appeal and should. There are different levels of appeals so it may take time but is worth the effort.

Stabler

[TonySa]

Your opinion that anti-depressant (AD) medications (benzo's are not AD) don't work IS NOT evidence based advice! (Benzo's make you high-it's called addiction.). Are you even serious?  This is downright false information and downright dangerous.  Please STOP posting such lies.  

Read the science on AD medications.  It is fine to say they didn't work for you-but not to state as fact that they never work.

[McChicken94]

My experience with SSRI's aren't too great either. I admit I rather smoke a joint or take diazepam. I don't recomment it as both can be addictive, but at least it's effective. This one pretty much describes how it feels to be on antidepressants: https://www.google.com/search?q=ssri+meme+expectation&tbm=isch&ved=2ahUKEwjLzaKoy5HtAhVLP-wKHWJ1BZIQ2-cCegQIABAC&oq=ssri+meme+expectation&gs_lcp=ChJtb2JpbGUtZ3dzLXdpei1pbWcQAzoECAAQQzoGCAAQBxAeOgYIABAIEB46BAgAEB46BggAEAUQHjoECB4QClCIkgJYyaMCYPqlAmgAcAB4AIAB3wGIAe8JkgEGMTEuMS4xmAEAoAEBwAEB&sclient=mobile-gws-wiz-img&ei=7fS3X4ujDcv-sAfi6pWQCQ&bih=648&biw=360&client=ms-android-samsung-ga-rev1&prmd=ivn#imgrc=1rQuYU_JploQRM

[McChicken94]

Same, ironically I did feel it but only when coming off.