Medicare Policy on Penile Implantation for Treatment of Erectile Dysfunction


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5211.


Does Medicare Cover Penile Prosthesis Surgery?

For men with erectile dysfunction caused by underlying medical problems (diabetes, hypertension, renal failure/dialysis, prostate cancer treatment including radical prostatectomy), Medicare covers penile implant as a treatment option.

Medicare insurance coverage pays for surgical insertion of 3-piece inflatable penile prosthesis, 2-piece inflatable penile prosthesis or non-inflatable (malleable or semi-rigid) penile prosthesis including hospital stay costs and surgeon fees.

Typically, surgical costs are covered by Part A Medicare if patient needs to stay in the hospital for more than 2 days. Part B Medicare covers the costs of surgery if the procedure is performed in a surgical center or with less than 24 hour hospital stay.

Do Medicare Advantage Plans Cover Penile Implant Surgery?

shutterstock_116979886Medicare Advantage plans such as UnitedHealthcare Medicare, Cigna Medicare, Blue Cross Medicare and AETNA Medicare follow Medicare coverage policies.

If you have Medicare Advantage plan, your plan should provide insurance coverage for penile prosthesis for treatment of organic impotence (ED caused by a medical condition such as diabetes, high blood pressure, prostate cancer, radical prostatectomy, multiple sclerosis or another medical condition).

 

Medicare Coinsurance Costs and Secondary Insurance

Medicare has 20% co-insurance for all medical and surgical care.  Typically, secondary insurances will pick up the costs after coinsurance and deductibles.

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If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5211.

We offer affordable, highest-quality urology care with or without insurance.   Find out our office hours or directions to our office. We offer weekday, weekend and evening office hours.

Dr. Alex Shteynshlyuger  is a board certified urologist, who specializes in all aspects of care for sexual problems in men including ED, premature ejaculation and other sexual concerns.  He is a surgeon who does penile prosthesis for men with ED.


 

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