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Thread: GRRR Insurance!

  1. #1
    teedoff is offline Member
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    GRRR Insurance!

    so after 2 years or more on injectable test at 100mg/week, I let my PA know my prescription was due for renewal at my local Harris Teeter pharmacy. When I was on the gel, i was going through my insurance and getting it filled at Walmart. When I switched to injections, I switched to HT pharmacy. Their prices were so good, I hadn't filed the injections on my insurance. Started out paying I think around 50 to 60 bucks for 10 weeks worth of 175mg/week. My trt PA left it that dose so I could play around with my dosing to see what worked best. Found 100mg/week worked best, but he never dropped it. Gives me a cushion just in case.

    Anyway, 50 to 60 bucks each script, it went up a bit and I think the last script I filled back in Nov was 85 bucks. Still only like 25 bucks a month. Well PA called it in this time and HT came back with 164 bucks. They said the discount coupons ran out. I asked them to file on my insurance. They called back and said my ins needed a prior authorization, and then would only allow one month worth at a time. Low and behold, they got the pre auth to my insurance, which they promptly denied coverage!

    Guess I'll call them tomorrow and find out why. Might have to start buying test on my own. 45 bucks for 10 mil 250mg vials! I hate insurance!

    BTW, they also after two years of 10mg Cialis a day, will now only cover 15 20mg tablets for a 3 month supply!
    Last edited by teedoff; 04-17-2024 at 10:26 PM.

  2. #2
    kelkel's Avatar
    kelkel is offline HRT Specialist ~ AR-Platinum Elite-Hall of Famer ~ No Source Checks
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    Speak to your doc about the pre-auth again. They should not be denying it. Also use GoodRX at the pharmacy to get it discounted.
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  3. #3
    Powrbuild89 is offline New Member
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    It’s amazing how reliant this is on the sole basis of how the doc codes it. My copay is $15 for generic , I used to pay $15 for a 10ml vial. Then he changed it to 1 ml bottles and jt was $15 for 4(one month). lol now it’s $45 for a 10ml and refills occasionally get denied and he has to recode it

  4. #4
    teedoff is offline Member
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    Quote Originally Posted by kelkel View Post
    Speak to your doc about the pre-auth again. They should not be denying it. Also use GoodRX at the pharmacy to get it discounted.
    Well im thinking my pharmacy was using goodrx coupons and other discounts up until now. Perhaps not goodrx, but definitely others.

    Like I said, push comes to shove, I'll start buying from my source.

    I will be calling my insurance med provider shortly though.

  5. #5
    kelkel's Avatar
    kelkel is offline HRT Specialist ~ AR-Platinum Elite-Hall of Famer ~ No Source Checks
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    Keep pushing it. You definitely want legit test for trt in my opinion. You never quite know the efficacy of UGL test.
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  6. #6
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    almostgone is offline AR-Platinum Elite- Hall of Famer
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    ^^^ Very good advice there.
    There are 3 loves in my life: my wife, my English mastiffs, and my weightlifting....Man, my wife gets really pissed when I get the 3 confused...
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  7. #7
    teedoff is offline Member
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    Quote Originally Posted by almostgone View Post
    ^^^ Very good advice there.
    Agreed. Didn't get a chance to call my insurance yet but I will.

    Thankfully I have about 6 months worth of my prescription test tucked away I'm using.

  8. #8
    956Vette is offline AR-Elite Hall of Famer
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    Shop costplusdrugs next time when shopping generics meds like viagra and cialis, cheaper and more convenient than goodrx. I will pay whatever ransom my provider milks me for at the compounding pharmacy (as compared to involving insurance with depot testosterone ), those $100+ vials of test and deca are indeed my stupid tax...however if/when in a bind, I don't feel like a burden when harassing the dr for ancillaries.

  9. #9
    956Vette is offline AR-Elite Hall of Famer
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    Quote Originally Posted by kelkel View Post
    Keep pushing it. You definitely want legit test for trt in my opinion. You never quite know the efficacy of UGL test.
    So the alpha is the acquire bulk nandrolone on the sly, ten four

  10. #10
    teedoff is offline Member
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    Quote Originally Posted by 956Vette View Post
    Shop costplusdrugs next time when shopping generics meds like viagra and cialis, cheaper and more convenient than goodrx. I will pay whatever ransom my provider milks me for at the compounding pharmacy (as compared to involving insurance with depot testosterone), those $100+ vials of test and deca are indeed my stupid tax...however if/when in a bind, I don't feel like a burden when harassing the dr for ancillaries.
    Maybe I'm confused. Don't see test on costplusdrugs.

    But I did find some goodrx deals. Just a little bit of a hassle having to get prescriptions called into any one of a dozen pharmacies based on which one has the goodrx deals.

    Goodrx has test c 10ml 200mg for 54 bucks at cvs and a few other pharmacies are close in cost. My current pharmacy, Harris teeter is 165 on goodrx.

    Edit: ah. Forgot i.mentioned the cialis bit, so that was what you were commenting on. Thanks will check that out.
    Last edited by teedoff; 04-23-2024 at 10:20 AM.

  11. #11
    teedoff is offline Member
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    Update. I found some good prices on goodRX, the best price being CVS. Had my Dr call my script into them, but of course when I went to get it, the pharmacist said they didn't accept goodRX any longer. lol He was able to get my price down to 80 bucks for a 10ml bottle. We'll see how long I can get a deal with them. I hate having to keep switching pharmacists though. PITA!

  12. #12
    almostgone's Avatar
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    Quote Originally Posted by teedoff View Post
    Update. I found some good prices on goodRX, the best price being CVS. Had my Dr call my script into them, but of course when I went to get it, the pharmacist said they didn't accept goodRX any longer. lol He was able to get my price down to 80 bucks for a 10ml bottle. We'll see how long I can get a deal with them. I hate having to keep switching pharmacists though. PITA!
    Try not to switch to a different pharmacy, i.e. going from CVS to Walgreens, etc.
    In my experience, they usually lose any outstanding refills you may have.

    Found the below listed on GoodRx, it sounds like it is a DEA thing.

    Some prescriptions can only be transferred once.

    Schedule III, IV, and V medications are controlled substances and can only be transferred one time, no matter how many refills you have left. After transferring them once, you'll need a new prescription from your healthcare provider to switch pharmacies again.
    Last edited by almostgone; 05-03-2024 at 11:10 PM.
    There are 3 loves in my life: my wife, my English mastiffs, and my weightlifting....Man, my wife gets really pissed when I get the 3 confused...
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  13. #13
    teedoff is offline Member
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    Quote Originally Posted by almostgone View Post
    Try not to switch to a different pharmacy, i.e. going from CVS to Walgreens, etc.
    In my experience, they usually lose any outstanding refills you may have.

    Found the below listed on GoodRx, it sounds like it is a DEA thing.

    Some prescriptions can only be transferred once.

    Schedule III, IV, and V medications are controlled substances and can only be transferred one time, no matter how many refills you have left. After transferring them once, you'll need a new prescription from your healthcare provider to switch pharmacies again.
    So I'm screwed eventually either way. Lol either let the deals run out and start paying a higher price, or I keep switching pharmacies. My clinic doesn't mind calling in new refills whenever I ask. Well see how this all works with cvs.

    I'll also try to do some more digging about how to get this approved through insurance. It's ridiculous they covered the gel, but won't cover the shot.

  14. #14
    Bio-Active's Avatar
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    80 bucks for 10cc. Reall that ain’t bad at 100 mg ew that’s gonna last 20 weeks

  15. #15
    Cuz's Avatar
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    I have switched to Publix pharmacy. My test 10ml vials are now 10 dollars like they were in 2017….and my two month supply of cialis was 10 bucks also. Hell, they GIVE me my arimidex ..pretty amazed fellas

  16. #16
    teedoff is offline Member
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    Quote Originally Posted by Cuz View Post
    I have switched to Publix pharmacy. My test 10ml vials are now 10 dollars like they were in 2017….and my two month supply of cialis was 10 bucks also. Hell, they GIVE me my arimidex..pretty amazed fellas
    Wow, that's awesome! Is that filing insurance or using goodrx or something else?

  17. #17
    Cuz's Avatar
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    Quote Originally Posted by teedoff View Post
    Wow, that's awesome! Is that filing insurance or using goodrx or something else?
    Its with my insurance but the same insurance the stuff was more expensive at a private owned pharmacy. Publix has the cheapest price by far the last three pharmacys ive used

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