Insurance for treatment?

[NamelessHero]

I have prefered care blue, from Blue Cross/Blue Sheild - do you know if it covers Peyronies treatments?  

[Hawk]

I know of no insurance that does not cover Peyronies Disease.  Most insurance differs in co-pays, deductibles, etc, not in what diseases they cover.  Some pay different amounts depending if you have office visits, out patient procedures, or hospitalization.

I know reading insurance policies can seem confusing but most plans have website or brochures, and phone numbers you can call to clarify coverage.  In any event it will pay exactly what you are used to having it pay for other medical conditions when yu need, doctors visit or in-hospital procedures.

[MattFoley]

Yes, Peyronie's is covered. The only consideration is what specific treatments are covered other than surgery.

I'm fighting with my insurance about Cialis and other remedies that the insurance company does not deem part of Peyronie's treatment.  

[LWillisjr]

My insurance also covered my doctor visits, and my Peyronies surgery (deductibles of course).

But my insurance does not cover Viagra, Ciallis, or Levitra. No idea why.

[MattFoley]

Les, you may wish to try this:

If your urologist will cooperate, tell him to note that the Cialis is not for ED but as part of a treatment for Peyronie's to increase blood flow. My insurance won't cover it if it is for ED. Peyronie's may be a different story. My urologist is working with me on this strategy so I'm hoping it will work.

[Hawk]

My guess is that since that is an off-label use of the drug that the are not going to pay.

[MattFoley]

Hawk, it's possible. I really depends on the authorization unit. Some are more flexible than others. About a million years ago I used to sell health insurance and I worked with a variety of insurance companies. Some had more flexible underwriting guidelines than others and would cover some benefits that others wouldn't.

Since Peyronie's has no official treatment other than surgery (which is usually a final option), authorization units can be flexible depending on how the doctor presents the case. Also, as you know, although Pentox has a solid history of helping Peyronie's patients, it's also off-label for Peyronie's. Also, I was able to get testosterone therapy for the treatment of Peyronie's even though testosterone would be off-label for Peyronie's. So, again, it really comes down to the insurance company and how the doctor handles the case.

Lastly, I couldn't get a referral to see Dr. Lue so my urologist and I got a referral to another doctor who handles Peyronie's and then got him to agree to a referral to Lue. Now, after two recommendations to see Lue, we went back to the insurance company and that did the trick. That kind of "back door" approach got me an appointment on 3/22 with Lue.

[Hawk]

I appreciate the input.  I too sold insurance but that was more like two million years ago.

[MattFoley]

LOL.

It's pretty screwed how we have to spend our energy trying to figure out how to get the insurance companies to pay for appropriate treatment while at the same time being stressed out about our medical issue.