question is hrt covered on insurance

**natureboy** · 07-27-2008, 03:12 PM

I am 34 yrs old been pretty bad over the last year and a half, fatigue, extreme depression, weight fluctuation. With some urging from my wife I went to the Dr. Had some blood work done, test came back at 56 estrogen 86. I had a friend who had already had some tests run and was getting some prescription meds over the internet. He gave me some info I did what I had to couple of weeks later I'm good to go. Well then my wife got the bill, pretty expensive. So now we are in the process of going to an endo had all the work done except for new bloodwork, havin to let mine even out after doing the internet meds. He made me come off what I had and stay off for 8 weeks before he could test me again. Next monday I go back. Its been a very hard road to go down but I hope I'm close to getting this thing resolved. Well now for the question, if I would have gone to a hrt clinic would insurance pay for the medication?

**TatMan** · 07-27-2008, 03:26 PM

I would think it depends on what insurance you have and whats covered under the policies of that particular insurance.

**natureboy** · 07-27-2008, 04:10 PM

Just wondering if anyone has had any succaess gettin insurance to pay?

**natureboy** · 07-27-2008, 04:16 PM

I was wondering if anyone has had success with getting insurance to pay for hrt at a clinic? I've read a bunch of posts and seen where guys were paying cash. I was curious, that is why I'm going to endo to get a prescription, to try to get insurance to pay.

**zaggahamma** · 07-27-2008, 05:30 PM

your first post was hard to read but you got the question at the end and i've been on this site for a couple years and have only read a few posts that claim to have had insurance pay for hrt clinics...best way to find out is to ask your insurance company

**bd50** · 07-27-2008, 06:58 PM

natureboy,,, i think the doc has to officially diagnose you with "hypogonadism", which basically means having low testosterone for one reason or another.

once he submits that to your insurance, they SHOULD cover any medication, exams, etc. related to your DIAGNOSIS.

it's the same if you were to have diabetes, or any other illness,, if a doc says you have an ailment/illness that requires medication, your insurance should cover that for you.

good luck

**FallenWyvern** · 07-27-2008, 08:32 PM

My drug coverage covers the prescription, but test cyp is inexpensive anyways. The clinic doesn't take insurance, but now I go only every six months.

**ottomaddox** · 07-27-2008, 09:04 PM

I have Kaiser and they cover everything. I got a box of 50 syringes for under $3.00.

**natureboy** · 07-27-2008, 09:57 PM

Thanks for the info guys. I just wanted to know if I would have come out better going to a hrt clinic or going to endo.I just didn't want to start all over, I feel that since the Dr. knows I've already used injections it may be easier for me to get him to prescribe me them.

**fiveoooh** · 07-28-2008, 09:22 AM

There are alot of variables when it comes to HRT. I started almost 2 months ago now. The HRT clinic I use (which is very liberal) does not accept insurance, cash only. I get charged a "fee" every 6 months for consultations etc. I can call them anytime with any questions or go see them if I like. The bloodwork is covered by ins, thank god because its was over 3k. Scripts are covered and all filled locally except the Deca which comes from elsewhere. A little pricey yes, some side effects yes, but worth it hell yes. Good luck 5.0

**juice2boost** · 07-28-2008, 02:29 PM

Originally Posted by bd50

natureboy,,, i think the doc has to officially diagnose you with "hypogonadism", which basically means having low testosterone for one reason or another.

once he submits that to your insurance, they SHOULD cover any medication, exams, etc. related to your DIAGNOSIS.

it's the same if you were to have diabetes, or any other illness,, if a doc says you have an ailment/illness that requires medication, your insurance should cover that for you.

good luck

Natureboy,

I agree with bd50. You will more than likely be covered by insurance. I go to an HRT clinic and they to will take insurance, but even for Cash paying customers the monthly dues are only $200 and that includes all your blood work and 3-4 shots of Cyp. 200mg. a month depending on your levels. Good Luck!

**natureboy** · 07-28-2008, 02:50 PM

Thanks for the info guys

**crypticaddict** · 07-28-2008, 03:06 PM

my bcbs covers my erm hrt.

6 bucks a month.

**natureboy** · 07-28-2008, 03:26 PM

Alright I got bcbs! What is erm?

**warchild** · 07-28-2008, 03:39 PM

i have a health savings account, and I just use the debit card for test cyp and doc visits. i pay 96 bucks for test from my account which isn't out of pocket

**THORSZ** · 07-29-2008, 08:11 PM

Mine did. I guess it depends on your plan. My doc said a 10 ML bottle of cyp is $135 without insurance. My current plan covers it and I only had to pay $13.

**zaggahamma** · 07-29-2008, 08:16 PM

depends on pharmacies that make it too i believe...cuz cash price i remember was usually a little over 100 from watson labs...but now its around half that.....only 9.00 when i had insurance

**natureboy** · 07-29-2008, 09:15 PM

That sounds reasonable.I hope I can get everything worked out with a prescription. Thanks. The natureboy WOOOOO!

**warchild** · 07-29-2008, 09:20 PM

mine was 95 bucks from sandoz pharm

**natureboy** · 08-04-2008, 11:11 PM

Thanks guys, paid $9 for my script this morning.

**Philly Grappler** · 08-05-2008, 01:55 PM

I have Aetna and they cover my doctor appointments and prescriptions, minus my co-pay. I do not know about the online clinics though. The trick is to find a legitimate doctor to put you on it, which was a pain for me. I went to 2 endo's who didn't even want to hear it before I stumbled upon the doc I am going to now. I was fortunate too because people come from all over to see this doctor and he is located 15 minutes from my house.

**bd50** · 08-05-2008, 05:53 PM

INSURANCE UPDATE: my insurance (united) was paying for the testim gel, and the androderm patch,, but are now giving me a hard time about the injection.

i have been calling them for a couple days now, waiting for them to "verify" my script with the doc, then i will be informed what my co-pay will be.

if they dont cover it, i know the 5ml bottle of test e by watson is $95.00 at walgreens, without insurance.

my regular co-pay has always been $20.00

**zaggahamma** · 08-05-2008, 09:06 PM

Originally Posted by bd50

INSURANCE UPDATE: my insurance (united) was paying for the testim gel, and the androderm patch,, but are now giving me a hard time about the injection.

i have been calling them for a couple days now, waiting for them to "verify" my script with the doc, then i will be informed what my co-pay will be.

if they dont cover it, i know the 5ml bottle of test e by watson is $95.00 at walgreens, without insurance.

my regular co-pay has always been $20.00

so the fuktards want to pay more money?....testim from what i remember had a 200 plus cash price and 10ml vials were 'round 100 and now a little over 50 cash....i wonder if it has something to do with the dosing and refills of a 10 ml vial like i always feared

**natureboy** · 08-05-2008, 09:58 PM

How long were you on the gel, doesn't it come in 5 mg pouches that u have to rub on every day? That had to be way more expensive than I 10 ml bottle that could last you around 10 weeks depending on your dose. Are they freakin kidding, maybe sombodies gettin kickbacks!

**bd50** · 08-06-2008, 12:33 AM

i tried the gel 1 month, then patch 1 month. both sucked as far as comfort, although i started to feel good after first month.

united healthcare covered both of them, but now with the injects apparently they verify the script a little more (?) according to their customer service.

hopefully they can cover the vials,, otherwise i would pay 95 every 2 months.. which still isn't that bad i guess..

**natureboy** · 08-06-2008, 08:51 AM

Yes it doesnt sound bad when you say it real fast. The problem is your ins. covered one prescription that is basically the same meds, its only been two months and you have tried 2 different types of the same thing, they didnt work for you now it is time to try something different. I would think that if the Dr changed your medicine that insurance is responsible to pay their portion. If they can pick and choose what you are prescribed why do you need a Dr. Next time you get sick call em up ask them what should you be takin.

**bd50** · 08-06-2008, 05:42 PM

Originally Posted by natureboy

Yes it doesnt sound bad when you say it real fast. The problem is your ins. covered one prescription that is basically the same meds, its only been two months and you have tried 2 different types of the same thing, they didnt work for you now it is time to try something different. I would think that if the Dr changed your medicine that insurance is responsible to pay their portion. If they can pick and choose what you are prescribed why do you need a Dr. Next time you get sick call em up ask them what should you be takin.

lol,, that's exactlly what i was thinking! believe me, i argued with them on the phone for about 30 mins. i'm expecting good news in a couple days, i will update when i get their call.