BCBS Denial

[NOSUPERMODEL]

Just got a letter in the mail stating BCBS will no longer cover my Test C. Said the reason was that you have to have a pretreatment total serum test level less than 300ng/dL or a free serum test level that is below the lower limit of 5-9pg/ml.

Would you all try to fight this? Or would you just pay for it straight up at the pharmacy? Or would you use other sources. They said nothing about the Arimidex, minocycline or HCG.

[bass]

fight it! fvckers.

[JohnnyVegas]

I pay retail at the pharmacy. I wouldn't go UGL because of the unreliable dosing.

Maybe you could go off TRT, let your levels drop and see if you end up lower than their required levels. I wouldn't envy you if you did that though.

[HRTstudent]

I would fight it... but what were your levels?

Can't say I know a lot about you unfortunately!

[zaggahamma]

Did they write that into your policy AFTERWARDS?...if not u would think if Dr says u need then they would b obliged y pay

[Times Roman]

test is cheap. i'd just pay

[kelkel]

Have your doctor write a letter of medical necessity. May work for you.

[Simon1972]

that sucks- maybe set up another blood test and make sure you get drunk the night before and dont sleep all night.

if its borderline it may help get you below the limit.

[JohnnyVegas]

My insurance will only pay for 30 days at a time (probably to protect them from paying for cycles, and I don't blame them)...so I cannot get a 10ml vial if I want to use insurance. I pay out of pocket just so I can get the 10ml vial and not constantly run to the pharmacy.

You must be shut down, so your numbers would be horrible if you stopped, right? But you would feel awful.

[Oldhighlander]

I have BCBS HMO Illinois and they won't pay either.The only thing that is covered on the drug formulary is AI's.I have been paying out of pocket and the costs are not bad at all but free would be better.I was at 312 when first tested.Just inside the low range.I wonder if I could get the doc to write a letter for medical necessicity for me?Hmmmm.Would be interesting to hear if anyone has had any success and how they went about it.

[run_n_fool]

Oldhighlander, what were your levels tested at pretreatment? Did they deny bc they were borderline or for some other reason? I have bcbs too and anticipate a need. Also whereabouts do you live and who is your doc?

[Oldhighlander]

Run 312 was pre treatment .I am in westmont and my doc is Leslie Sleuwen in hinsdale .As far as I can tell none of the meds will be covered except AI because they are on the formulary.Test is not. .But all of the blood work has been covered so that's a plus.

[NOSUPERMODEL]

Hoping to get a call back from the doc today. He is very cool, so I think he will help me out. I went back to look at my original blood work and found out that of all the blood work I have had done, that is the only one, I do not have a copy of.

[flatscat]

I think your doc can get it done if he has the time, and desire to do so for you.

[HRTstudent]

My plan didn't want to cover androgel at first but my doc wrote a letter of medical necessity and they squared it away. All it took was a phone call to my doc. It was an unpleasant suprise, but at least it was easy to resolve.

[jamotech]

If this is a rule they just came up with, id get ready to start paying, I've heard its fairly cheap at costco and places like that.

[lovbyts]

When I started HRT I was at the bottom but not sure if I was below. Since I changed doctors and went with an Endo I know I have at least one teast where I was below, around 250 because I had not taken anything for about 2 weeks prior to my test so I know I have at least one LOW level on file.

[GFA]

I have bcbs of nj and they don't cover test either but do cover androgel.

Just buy it from Costco, super cheap if you use their no insurance plan and a Costco member. Obviously you need a script but it's so cheap that it works out to less than your co pay monthy if you factor in a 10 ml vial will last almost 5 months at 100mg a week.

[warchild]

how much is costco?

[zaggahamma]

how much is costco?

i found cosco to be more expensive when i recently priced my new meds

sam's had them beat by 30 something dollars for one of my rx's

i called all of the pharmacies

[warchild]

yea i heard sams was cheaper. walgreens says my ins only covers a months supply.

[GFA]

You can't talk prices here even for prescriptions but I can tell you it works out to like $10 a month. I tried sams but they don't have it here in my area but Costco was $30 less than Walgreens and 1/2 the cost of cvs. You can call them for a quote.

[zaggahamma]

You can talk prices here even for prescriptions but I can tell you it works out to like $10 a month. I tried sams but they don't have it here in my area but Costco was $30 less than Walgreens and 1/2 the cost of cvs. You can call them for a quote.

did u mean can't but still did?

[GFA]

did u mean can't but still did?

Typo was using my phone to make that post. Yes I meant can't thats why I didnt say how much the vial is directly but hinted at how much it would cost

[zaggahamma]

Yeh its garbage making posts from phones..its hard correcting typos sometimes its hard setting the cursor

[NOSUPERMODEL]

Got a call back from the doc today. They are going to contact the insurance company.

[zaggahamma]

I hope u get it approved bro

[NOSUPERMODEL]

Just got an update from the doc. The insurance company approved the appeal. They are back to paying for it.

[FONZY007]

Just got an update from the doc. The insurance company approved the appeal. They are back to paying for it.

Cool that's good news

[zaggahamma]

Awesome bro

[Oldhighlander]

Nice!Now I gotta give it a shot and see what happens .

[SEOINAGE]

out of pocket i am paying well under 20 bucks a month for hcg and test at decent doses. insurance is worthless lol, they told me the same thing even though I had a blood test at 200 it was after treatment.