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Insurance company denied coverage of adult circumcision

nilay123
nilay123

HI i am 28 yr old man. I am diagnosed with phimosis and doctor told me to get circumcised and i am ready for that. but now insurance company denying coverage . doctor office already sent them note explaining the severity of disease and it is medical necessity. Its really painful living like this everyday.

Doctor office told me it will gonna cost me 8000$ and i told them that i don;t have that much money.

Can somebody guide me on this?

34 Replies
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Wow, my insurance covered 100% no questions asked... i would try to find a doctor that takes your insurance?

nilay123
nilay123 in reply to allstar1979

Which insurance did you had?

allstar1979
allstar1979 in reply to nilay123

Horizon Bc/bs

hey allstar, i recently got a circumcision, but the hospital is asking me to pay around $1300 because my insurance requires a 30% copay apparently, but I have horizon bc/bs. How did yours cover 100%?

We only have $20 copay

Lucky you man.

I am having ISO inurance.its multiplan. But iso is connected with coverage company named healthsmart. I dont understand why they denying.however, i am having severe phimosis. I don't have much money to pay for surgery and i do not want to live in pain every single day.

allstar1979
allstar1979 in reply to nilay123

Gofundme?

nilay123
nilay123 in reply to allstar1979

I don't know what is that. Can you please tell me further?

the doctor is ripping you off,it should cost much less probably less than $1000

nilay123
nilay123 in reply to 1zoon

oh okay thank you for letting me know this.

Phimosis is not a disease. It simply means the opening of your foreskin is too tight to allow retraction over the corona. The good news is that causes no life threatening problem and that it is fixable without surgery or cost. Simple stretching exercises can enlarge the opening.

How far back can you now retract? Will two fingertips fit into the opening?

no only one fingertip fits into opening. and thx for the suggestion of stretching exercises. however, i already tried them and it didn't worked so i went to doctor.

The laws of nature always work. Perhaps you have a skin disease such as yeast. If that’s the case, it’s just a matter of treating it and getting to work. Stretching should be done four times per day, everyday. Failure comes only from not trying.

It is common for insurance companies to deny claims initially. Try again or another Doc perhaps. I am in the UK so do not have to pay but I would try stretching and use Surgery as a last resort.

Hello, ask your doctor to do the y- v plasty or another prepucial sparing surgery. Not only is this less expensive but my work has only had 3 denied insurance claims, but we do it cheaply enough that they could afford the surgery out of pocket. If he does do this surgery it means you get to keep your foreskin 😊

timmyboy20
timmyboy20 in reply to Tangki

Please no v-plastic! It is really not good because in most cases the scar tissue makes the foreskin tight again. It's only a good thing for the wallet of the surgeon because it's quite an expensive surgery.

Tangki
Tangki in reply to timmyboy20

Luckily for all of you, you have the professional opinion of a bored Urologist- me. Any surgery causes scar tissue, v- plastics are no different. However, it does not make the foreskin tight again. If that were true it would not be used as an acceptable for of a prepucial sparing surgery.

nilay123
nilay123 in reply to Tangki

Okay. thx but can you tell me little bit more about the procedure? and cost?

My urologist didnt mention anything like this to me, is it okay to ask him about this?

timmyboy20
timmyboy20 in reply to nilay123

Your urologist didn't mention this to you because he knows that it doesn't cure phimosis on the long term.

timmyboy20
timmyboy20 in reply to Tangki

Just because of that it's not acceptable for treatment of phimosis.

Hello Nilay123, the price varies on your region and from each Dr to another so I couldnt give you an actual price. The surgery essentially makes a slit in your foreskin. This allows the foreskin to retract. From then on if the surgeon thinks it is too tight he may make another slit. When he does this he sews the damaged skin in such a fashion that the skin that originally was connected is no longer connected and the slit becomes an extension of your foreskin . This Will cure phimosis if done correctly and if you keep retracting it( which shouldn't be an issue if you masturbate or have sex) and keep away from stds/infections.

I would encourage you to talk to your doctor about this, especially if you would like to keep your foreskin.

Phimosis is the inability to retract your foreskin because of damage, scarring etc to it. Phimosis also occurs when the phimotic band is not used: it is a muscle. If you don' use it you lose it

It is very effective, even In the long term.

I dont know what timmys problem is but his mind must be plagued if he thinks his Google diploma rules over my 16 years of college and experience, so pay him no attention. Message me if you would like

timmyboy20
timmyboy20 in reply to Tangki

Dear "dr" Tangki, please just admit your mission: you are simply an ordinary anti-circumcision activist. It's not because you might be an urologist, you have a monopoly on wisdom. The procedure that you describe is expensive and it doesn't guaranty succes. I've seen it so many times here in the hospital. It's mostly interesting for the urologist's wallet. Is that perhaps another reason why you are picking on me?

nilay123
nilay123 in reply to Tangki

Okay, but i had a severe phimosis so i think this procedure wont going to help me.

Tangki
Tangki in reply to nilay123

Hello nilay123, if you think it won't help and you would rather get circumcised- it is your body and I'm not telling you what to do. I have seen this surgery done on a sikh child- where their religion requires you to be uncircumcised and had great results. If you are caught between two worlds there is also the option of removing the phimotic band- essentially what is causing your foreskin to be tight. This is often referred to as a partial circumcision. If you do that you will have a foreskin that does not grip your glans and keep it laying on your glans and may retract, but you get to keep the inner foreskin that many men feel erogenous. In the end it is entirely up to you in what you do with your own body

nilay123
nilay123 in reply to Tangki

Okay , thx.

let me tell you the severity of phimosis. I am not able to insert even two finger tips.

Tangki
Tangki in reply to nilay123

That is an issue- you are right at the point where stretching would be beneficial if it works for you in such a stenosed area. However it seems that is not possible for you and if you were to use betamethizone cream(prescription) it may help stretch butg it also has some side effects. I would keep trying to stretch if you can but if not I would definitely see a different doctor for your wallet's health as well. I wish you the best of luck!

I live in Los Angeles and I paid $1500

I paid $1600 in Dallas.

nilay123
nilay123 in reply to timmyboy20

Can you provide me doctor name and address?

timmyboy20
timmyboy20 in reply to nilay123

I sent you a message

Are you seeing a urologist or plastic surgeon? There are plastic surgeons out there that do urogenital surgery and will charge thousands of dollars. Out of pocket for a circumcision should be no more than $2,000. A plastic surgeon may charge $5000+. If you are seeing a plastic surgeon, I suggest you switch to a urologist and ask the urologist to submit the letter of medical necessity to the insurance company for circumcision, they might approve it if a urologist submits it. My out of pocket cost for my circumcision would have been $1800 if my insurance company had not covered it. I am in NJ.

nilay123
nilay123 in reply to j_flow230

I got diagnosed by urologist. Moreover, he submitted a letter of medical necessity but insurance company is denying that this is not covered in my plan. So i asked okay tell me which plan will over it i will switch to that and company said it is not covered in any plan.

I clearly explained them that untill i got money i have to suffer right? they are repeating the same story about the plan.

Perhaps your insurance company has done you a favour. This will give you an opportunity to try manual stretching which will save your foreskin.

drelastic.com/

Phimosis is a Greek word that simply means that your foreskin will not retract. Phimosis is a condition, not a disease.

It is good practice to try conservative therapy before going for radical circumcision.

Phimosis

The word “phimosis” is derived from the Greek word that means “muzzled”. The word is used to describe the condition of having a foreskin that does not retract for any reason. Phimosis is a condition; it is not a disease. It is not life-threatening and may be left untreated in the vast majority of cases.

There are three possible reasons that cause a foreskin not to retract:

1. The tip of the foreskin is too narrow to pass back over the glans penis.

2. The frenulum is too short (frenulum breve) to allow retraction.

3. The inner foreskin is fused or adherent to the underlying glans penis.

The first cause is the most usual cause.

A male with phimosis has several options.

1. He may elect to remain as he is and do nothing. One can live a lifetime with a non-retractable foreskin. It is reported that sex with a non-retractile foreskin not only is possible, but very pleasurable.

circumstitions.com/Restric/...

2. He may elect to undertake manual stretching to widen the tip and/or to lengthen the frenulum. It works by tissue expansion. Stretching skin induces “mitosis” which is a word that means “division of cells”. New skin cells are formed and the skin expands but it takes some time. Complete information on that is available at:

willywellbeing.com/forums/f...

Even a very tight foreskin can be stretched.

reddit.com/r/Phimosishelp/c...

3. Plastic surgery. Preputioplasty is one of several plastic surgical operations that reshapes the foreskin without removing it. Preputioplasty preserves the foreskin and all of its numerous protective, immunological, sensory, and sexual functions.

medic8.com/healthguide/circ...

en.wikipedia.org/wiki/Prepu...

Frenulum breve may also be treated by a simple plastic operation either to lengthen the frenulum or to cut it.

urologicalcare.com/patient-...

4. Circumcision is a radical operation that amputates more than 50 percent of the skin from the penis. It destroys the 20 protective, immunological, sensory, and sexual functions of the foreskin. It is now considered to be an operation of last resort, to be used when conservative treatment fails.

circumstitions.com/Function...

References:

doctorsopposingcircumcision...

15square.org.uk/

menshealthforum.org.uk/circ...

en.wikipedia.org/wiki/Phimosis

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