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Welcome to Dr. Landon Trost - Directly answering member questions in the "Medical Professionals" section below the Treatment boards. https://www.peyroniesforum.net/index.php/topic,16512.0.html

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Author Topic: Implants not covered by insurance  (Read 3712 times)

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tmwstw

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Implants not covered by insurance
« on: December 08, 2010, 08:49:08 PM »

Hi guys,
To those of you had the implant, how did you pay for it? I just got in touch with Peggy at Vanderbilt, was trying to set up a consultation with Dr. Milam. She told me to check with my insurance company, it turns out my policy doesn't cover sexual dysfuntion. Does this mean i'll have to pay everything myself? Is a penile implant considered treatment for sexual dysfunction?? My head spinning ...  :(. I heard JackPsaid the cost for self-pay patient is around 20,000. Any information will be greatly appriciated. Thank you!

P.S I shoped around, none of the policy seems to cover for sexual dysfunction treatment though. So beside medicare, what are my other options?
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jackp

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Re: Sexual Dysfunction is not covered by insurance.
« Reply #1 on: December 08, 2010, 09:32:57 PM »

Insurance does not pay for surgery for just sexual disfunction. You have to have a condition like peyronies, venous leakage, corporal fibrosis to qualify.

This is how it is covered under Medicare and most insurance companies.

Prosthetic/Orthotic Items
Includes arm, leg, back, and neck braces; artificial eyes; artificial limbs (and their replacement parts); some types of breast prostheses (after mastectomy); and prosthetic devices needed to replace an internal body part or function (including ostomy supplies, and parenteral and enteral nutrition therapy) when your doctor orders it. For Medicare to cover your prosthetic or orthotic, you must go to a supplier that is enrolled in Medicare. You pay 20% of the Medicare-approved amount, and the Part B deductible applies.

A penile implant is a prosthetic device needed to replace an internal body part of function, if you have damage caused by peyronies, corporal fibrous, corporal fibrosis and other conditions. Not Just Erectile Dysfunction.

Jackp
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tmwstw

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Re: Sexual Dysfunction is not covered by insurance.
« Reply #2 on: December 08, 2010, 11:51:13 PM »

Thank you Jack. I'm waiting for the underwriting process for my insurance, and will get back to Peggy after that. Looking forward to se Dr. Milam at Vanderbilt. I had a good conversation with Peggy she told me Dr. Milam do a lot of cases for Peyronie and not just implants. Thanks again Jack.
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skunkworks

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Re: Sexual Dysfunction is not covered by insurance.
« Reply #3 on: December 09, 2010, 12:13:57 AM »

Hi guys,
To those of you had the implant, how did you pay for it? I just got in touch with Peggy at Vanderbilt, was trying to set up a consultation with Dr. Milam. She told me to check with my insurance company, it turns out my policy doesn't cover sexual dysfuntion. Does this mean i'll have to pay everything myself? Is a penile implant considered treatment for sexual dysfunction?? My head spinning ...  :(. I heard JackPsaid the cost for self-pay patient is around 20,000. Any information will be greatly appriciated. Thank you!

P.S I shoped around, none of the policy seems to cover for sexual dysfunction treatment though. So beside medicare, what are my other options?

I think you can get around that by saying it is for fertility.
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