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Thread: TRT and Prescription same time insurance question.

  1. #1
    GuiltyB4u is offline New Member
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    TRT and Prescription same time insurance question.

    Hey guys hoping to run into someone with the experience on this matter, for the last year I have been going to a private TRT clinic to receive my shots and my insurance has covered that with a $25 co-pay every week. Last week my family doctor decided he would finally prescribe me test cyn 200mg/ml GREAT, so I go pick up the prescription from walmart he originally put in for a 10ml vial every 3 months, then insurance came back as only covering 1 month at a time, so walmart broke it down into (4) 200mg/ml single dose vials every month to be prescribed and covered by insurance. Now i'm wondering if I can still use my insurance in 3 days to get pinned once a week at the TRT clinic while I accumulate my prescription so that I can blast after labs 2-3 times a year. Does anyone go this route or know how that will work? Wondering if it will throw red flags to everyone involved if I go to my TRT clinic try to run my normal weekly shot under insurance and it comes back as used up for the month. Is it better to just self pay for my TRT or Prescriptions and let the other be covered by insurance? Any experience of someone who goes both to a TRT clinic and has a personal prescription would be great. The dosage from my doc is not enough that I could do my home pins and have any left over to save and maintain my current test level to blast down the road when i'm ready. Thanks.

  2. #2
    Windex is offline Staff ~ HRT Optimization Specialist
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    Quote Originally Posted by GuiltyB4u View Post
    Hey guys hoping to run into someone with the experience on this matter, for the last year I have been going to a private TRT clinic to receive my shots and my insurance has covered that with a $25 co-pay every week. Last week my family doctor decided he would finally prescribe me test cyn 200mg/ml GREAT, so I go pick up the prescription from walmart he originally put in for a 10ml vial every 3 months, then insurance came back as only covering 1 month at a time, so walmart broke it down into (4) 200mg/ml single dose vials every month to be prescribed and covered by insurance. Now i'm wondering if I can still use my insurance in 3 days to get pinned once a week at the TRT clinic while I accumulate my prescription so that I can blast after labs 2-3 times a year. Does anyone go this route or know how that will work? Wondering if it will throw red flags to everyone involved if I go to my TRT clinic try to run my normal weekly shot under insurance and it comes back as used up for the month. Is it better to just self pay for my TRT or Prescriptions and let the other be covered by insurance? Any experience of someone who goes both to a TRT clinic and has a personal prescription would be great. The dosage from my doc is not enough that I could do my home pins and have any left over to save and maintain my current test level to blast down the road when i'm ready. Thanks.
    Unless I've misunderstood, this sounds like something you want to sort out with your insurance company
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  3. #3
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    Couchlockd is offline Senior Member
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    Yeah they are turning a 98$ vial into a 238$ visl with 1ml bottles
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  4. #4
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    Chrisp83TRT is offline Knowledgeable Member
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    Quote Originally Posted by m.hornbuckle View Post
    Yeah they are turning a 98$ vial into a 238$ visl with 1ml bottles
    Got to love the us and our Insurance companies... it’s almost cheaper to self medicate . Scratch that ... it IS cheaper lol
    HoldMyBeer and wellshii like this.

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    Nowadays most states have a database of controlled substances. It is a felony to obtain one under false pretenses.
    Also, your insurance company might have a legal (mandatory) responsibility to report you to the state law enforcement agencies.

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    wellshii is offline Member
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    Quote Originally Posted by Chrisp83TRT View Post
    Got to love the us and our Insurance companies... it’s almost cheaper to self medicate . Scratch that ... it IS cheaper lol
    This.Labs included.
    If an insurance doesn't cover a certain lab,that price not covered is from the actual place at that time of visit which comes out to way more than just ordering labs online.So in reality,your still paying your shit insurance premium,your uncovered lab at an extra cost(which is sometimes 200-400 bucks more than online ordering) .
    Insurance for me seems to be ok when I need x-rays or MRI's,but even then they might not be covered.
    And emergencys I suppose.
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  7. #7
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    Quote Originally Posted by Chrisp83TRT View Post
    Got to love the us and our Insurance companies... it’s almost cheaper to self medicate . Scratch that ... it IS cheaper lol
    These insurance rake people over the coals with expensive labs and meds. Its truly unbelievable when you really look at it in depth.

  8. #8
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    I got the ghetto government Insurance which sadly is weird better then “good” insurance, but it has its fall backs.
    We have a lot of things to work on in this country hah... it’s all I can say
    wellshii likes this.

  9. #9
    GuiltyB4u is offline New Member
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    Gentlemen, appreciate the feedback and I think Quester may have hit on this, but what info I was trying to get is if ipicked up my prescription for 1000mg of 200mg/ml test c (5 units) for the month already. And insurance did in fact cover that, and i continue to go to my TRT clinic appointments and use my insurance to cover the once a week pins there for 220mg, will there be red flags thrown from the insurance company or any way for my general doc to know I am stashing his prescription? Trying to stock pile for a 16 week blast this winter after labs. Totally agree insurance is a joke without a doubt, but it is required for my job so if I can use it without an issue I will go that route, if not I will stick with my prescription and then just UG Labs for the blast. Thanks for the replies guys.

  10. #10
    Windex is offline Staff ~ HRT Optimization Specialist
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    Quote Originally Posted by GuiltyB4u View Post
    Gentlemen, appreciate the feedback and I think Quester may have hit on this, but what info I was trying to get is if ipicked up my prescription for 1000mg of 200mg/ml test c (5 units) for the month already. And insurance did in fact cover that, and i continue to go to my TRT clinic appointments and use my insurance to cover the once a week pins there for 220mg, will there be red flags thrown from the insurance company or any way for my general doc to know I am stashing his prescription? Trying to stock pile for a 16 week blast this winter after labs. Totally agree insurance is a joke without a doubt, but it is required for my job so if I can use it without an issue I will go that route, if not I will stick with my prescription and then just UG Labs for the blast. Thanks for the replies guys.
    We aren't going to know this - we don't work for your insurance company.

  11. #11
    GuiltyB4u is offline New Member
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    Right on windex thanks for the response, just wasn't sure if anyone else had done this before and either had problems or not.

  12. #12
    Quester's Avatar
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    Guilty, (LOL)
    The minimum charges are Felony Insurance Fraud and Felony Possession of a Controlled Substance (per each time you go and get pinned while you already have the vial). Add to that, it isn't just the law but your insurance company, the pharmacy, the state medical board and your doctor that will be motivated to work against you.
    V
    not being so greedy that you can't just pay for it and be happy that you got a doc and insurance company that is working with you.
    Knowing that, hopefully you will feel confident in the decision that you make.
    Chrisp83TRT likes this.

  13. #13
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    Quote Originally Posted by GuiltyB4u View Post
    Gentlemen, appreciate the feedback and I think Quester may have hit on this, but what info I was trying to get is if ipicked up my prescription for 1000mg of 200mg/ml test c (5 units) for the month already. And insurance did in fact cover that, and i continue to go to my TRT clinic appointments and use my insurance to cover the once a week pins there for 220mg, will there be red flags thrown from the insurance company or any way for my general doc to know I am stashing his prescription? Trying to stock pile for a 16 week blast this winter after labs. Totally agree insurance is a joke without a doubt, but it is required for my job so if I can use it without an issue I will go that route, if not I will stick with my prescription and then just UG Labs for the blast. Thanks for the replies guys.
    You go to the doctor for him/her to do your injections ?

  14. #14
    Chrisp83TRT's Avatar
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    Quote Originally Posted by Quester View Post
    Guilty, (LOL)
    The minimum charges are Felony Insurance Fraud and Felony Possession of a Controlled Substance (per each time you go and get pinned while you already have the vial). Add to that, it isn't just the law but your insurance company, the pharmacy, the state medical board and your doctor that will be motivated to work against you.
    V
    not being so greedy that you can't just pay for it and be happy that you got a doc and insurance company that is working with you.
    Knowing that, hopefully you will feel confident in the decision that you make.
    What he said

  15. #15
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    Quote Originally Posted by GuiltyB4u View Post
    Hey guys hoping to run into someone with the experience on this matter, for the last year I have been going to a private TRT clinic to receive my shots and my insurance has covered that with a $25 co-pay every week. Last week my family doctor decided he would finally prescribe me test cyn 200mg/ml GREAT, so I go pick up the prescription from walmart he originally put in for a 10ml vial every 3 months, then insurance came back as only covering 1 month at a time, so walmart broke it down into (4) 200mg/ml single dose vials every month to be prescribed and covered by insurance. Now i'm wondering if I can still use my insurance in 3 days to get pinned once a week at the TRT clinic while I accumulate my prescription so that I can blast after labs 2-3 times a year. Does anyone go this route or know how that will work? Wondering if it will throw red flags to everyone involved if I go to my TRT clinic try to run my normal weekly shot under insurance and it comes back as used up for the month. Is it better to just self pay for my TRT or Prescriptions and let the other be covered by insurance? Any experience of someone who goes both to a TRT clinic and has a personal prescription would be great. The dosage from my doc is not enough that I could do my home pins and have any left over to save and maintain my current test level to blast down the road when i'm ready. Thanks.
    Your insurance company knows what they're paying for. They won't pay double for your shots.

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