First of all , I'd like to thank this site , and those that have contributed . I was diagnosed with a spermatocele 15 years ago , after my attentive girlfriend found it . I was so relived by the diagnosis , and told not to worry unless it grew , and got in the way .
Well , over the last year or so, it grew alot , aprox. the size of an oval shaped baseball . After going thru the entire process of , seeing my GP doctor ,referal to the Uroligist , ultrasound images , sheduled the procedure , I got a call from the Uroligists billing dep.. Turns out after all the steps , the insurance company ' Anthem blue cross , in Calif. ', claims that this is a ' elective procedure , and not covered . I started calling blue cross . After 4 hours on the phone , mostly on hold , or being prompted thru endless automated directions , that led me all over the country , and the globe , I found that I could not get any answers or help , and basicly , the $6,000.00 I pay per year is useless , the only time I needed it . Even though my GP / uroligist both agree , that mine is NOT considered elective , that is where I'm at so far . I will have to pay for $1000.00 per hour for the anitheiseoligist /$2-4000.00 for the facility ( operating room) , and $440.00 for the doctor , all out of pocket . I will be at the mercy of blue cross , post surgery , for any sort of reinbursement ! These fees seem pretty out of whack ! The one person I need , and is the surgen, makes the least ?? ( of corse , I live in Santa Barbara , Ca. , and REALESTATE is expencive , even an operating room !!)
This site was very helpfull in doing my pre procedure research . Finding answers , as to cost was very limited . I hope my meager contribution helps someone else
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Does it cause you a lot of pain? I'd think that something as large as a baseball in your scrotum would cause a lot of pain, which would prevent you from doing normal and routine things. I think every insurance has an appeals process, which you can start whenever you reach an impasse. At that point, you can present your case that this is a debilitating medical condition and there are no cheaper alternatives to treat it. You can ask Blue Cross about alternatives and see what they come up with - most likely nothing.
They would have to justify their denial of medical care at that point. Hell, maybe it's cheaper to hire a lawyer to see if they can settle on treating you.
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