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Do I need to see a specialist to get a penile implant?

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Is it covered by insurance?

Most health insurers cover the medically necessary diagnosis and treatment of ED.

All healthcare plans require that medical treatments be reasonable and medically necessary. To show this, health plans may require you to produce diagnostic evidence of organic impotence. The diagnostic work-up for ED can vary since the cause could be related to a vascular, neurogenic, psychogenic, or endocrine problem. It can also occur after a radical prostatectomy.

Medicare has a national coverage policy for the diagnosis and treatment of erectile dysfunction (ED), which includes the implantation of a penile prosthesis. Medicare coverage is further defined in most states by Local Coverage Decisions (LCDs).

To avoid delays in payment or reimbursement, you should work with your physician's office and insurance carrier to verify coverage and insurance payment levels before beginning a treatment path.