Scrotum Removal and Insurance

[Qunuch81 (imported)]

Hi folks,

Anybody have their scrotum removed post-orchie and get their insurance to cover it? I read an old thread in which Raymar (RIP) said you can just tell a urologist that it's uncomfortable/painful and they'll figure out a billing code. Anybody else have that experience?

[seanthomas (imported)]

Funny you should bring this up just now. I've just decided two years post orchiectomy and long consideration to have the scrotoplasty surgery and have been doing some research today. Reading some doctor's websites I think you are right that if it's for "medical reasons" versus strictly cosmetic then you have a much better change of getting insurance to cover it. Otherwise it appears to be about a $2,000 procedure, but I have found doctors are often negotiable on cash payments. Of course I am legitimately going for the "it's painful due to constant chaffing between my legs" routine, which is actually legitimate in my case. As I am not transgender and hate wasting money on "witch doctors and shamans" I need to find a surgeon that will to a total removal without the usual SRS psychology letters I've read about here.

[TopManFL (imported)]

I've had a bit of experience with insurance companies. On anything a bit out of the norm, they almost always say "no" up front. Often, with just a bit of effort (such as a phone call) they will change their mind.

If not, there is a formal appeals process on most health insurance policies. Again, sometimes they cave at that stage and sometimes you have to fight a bit.

Fighting can involve detailed notes on dates and times you experience problems, prescriptions for creams, pictures of rashes and abrasions from chaffing. Also, mention your chaffing problem at every doctor's appointment and ask them to chart it. Then ask for copies of the chart notes from that visit.

Lastly, there's the State Insurance Commissioner. They have a complaint process. For now, health insurance is sold state by state and the insurance companies are accountable to the State Insurance Commission. This is the main reason insurance companies are pushing to be able to sell health coverage across state lines - they'd like to all settle in one state with the least friendly rules for patients (like credit card companies do).

Hope that helped. I've dealt with this with friends, family and (thank God) not so much myself. It's a bit frustrating to be told no by the insurance company, but very satisfying when they agree to pay.

[daifu-orchid (imported)]

FWIW, mine was by a regular genital plastic surgeon, who like most wants money ($800) on the barrel. He doesn't do insurance at all.

[gandalf (imported)]

Mine was covered by my insurance. Did not ask what codes the doctor used, was just glad to be rid of the loose skin.

[Qunuch81 (imported)]

I think any insurance rep who turns down a claim for scrotum removal should be sacked!

Sorry, couldn't resist.