“I am covered by my State Medicaid or Medicaid Managed Care program.”
Medicaid coverage for Coloplast products varies a great deal, particularly for penile prostheses. Your physician should be able to advise you about local coverage, or you can contact the Medicaid program directly for answers about coverage.
If there is coverage, procedures still must be determined medically necessary. Your doctor should be able to help you understand this criteria, but these are some general standards:
- A penile prosthesis (Titan or Genesis) is considered a medically necessary treatment for erectile dysfunction if the patient has tried and found ineffective non-invasive treatments (drugs, injections and/or vacuum devices), and the dysfunction is the result of an organic rather than psychogenic cause.
Medicaid plans will usually require authorization for these procedures. Your physician’s office will probably secure this on your behalf. Here are some guidelines to help you know what to expect:
- Penile prostheses (Titan or Genesis) are covered by Medicaid programs in a little over half of the states. Your physician will be able to advise you on this. Occasionally, a state will cover Malleable (Genesis) but not Inflatable (Titan) implants.
If you have questions about your Medicaid coverage, please contact Medicaid or your physician’s office.
