Test not covered by Ins?

[9second69]

I have a really good medical plan...but they are telling me "at home" injectibles are not covered. Is this the norm? Its not the end of the world...$95.00 monthly

[Leroy Jenkins]

Mine is covered. My doc said they usually don't cover syringes but they covered that too. They would not cover HCG but did cover the AI. I have United Healthcare.

[9second69]

They said they will cover if I have the Doc do the shots (at the Docs office). No coverage for at home injections. I have Carefirst / Bluecross

[zaggahamma]

if they told you that then its in the norm for YOUR insurance policy...

but/plus/however....health insurance(s) are fluid and our fun at home isnt always in anyones best interest...

wut are YOU gonna do?

[HRTstudent]

Well.... that's interesting.

You might bring it up with your doc, they may be able to do something like a letter of necessity or whatever it is they do. Bring it up with the doc's office.

Otherwise, just weigh out the costs of gas + time vs 95$. Quite frankly, I think the time alone will make this a no-brainer.

Sure it sucks that your insurance is playing their games but at the very least 95 bucks for 10mL will last you over a couple months. Stay away from androgel though unless you're made of money!

[DaRoq]

My plan doesn't cover it as a Pharmacy/Drug benefit either. They do cover it as an outpatient injectable, like yours does, but at a co-pay much higher than an office visit. As mentioned, the Dr. can write a letter to get prior authorization, but that usually requires that he show need and that you've tried other covered options. I believe most plans have a preferred drug list.

[Not so] ironically, plans that don't cover self injections do cover the higher-cost Androgel. That's the case with my plan, which prefers Brand over Generic for certain medications.

[GFA]

I have good insurance too but won't pay for home injections. They paid for my androgel not not t cyp which is 10x cheaper.

I am getting it from walgreens now. Joined their prescription club for $20 now refills are 79.99 for a 10 ml 200mg/ml vial instead of $110. I only need 100 g a week so it lasts a good 4 months.

[SEOINAGE]

Insurance wont cover me either because my one test before starting had me over 300. Its ok the local pharmacy surprisingly gave me a good deal on a generic of test cyp, 75 bucks for 200 mg/ml 10 ml vial. Better deal than I could find online. So save money where you can really. As nice as it would be for this to be 5 bucks, maybe your productivity improvements at work will get your a raise that would more than cover the 70 bucks a month. I paid out of pocket for my first t injection at the doctors office, before I knew they wouldn't cover me.

[GFA]

How is it costing you $95 a month?

A 200mg/mL vial 10mL should last you more than a month unless you are taking steroid levels of test (400+mg a week).

If your test is $95 bucks and lasts you 4 months (100mg a week) then its really only $25 a month. Thats how I look at it.

[JAMIE07652]

My plan won't cover test bought at the pharmacy directly , I have to order it from the ins company pharmacy direct and they ship it to me .. They call test a specialty drug ?

[zaggahamma]

How is it costing you $95 a month?

A 200mg/mL vial 10mL should last you more than a month unless you are taking steroid levels of test (400+mg a week).

If your test is $95 bucks and lasts you 4 months (100mg a week) then its really only $25 a month. Thats how I look at it.

20 weeks so almost 5 months

[GFA]

20 weeks so almost 5 months

Most months have more than 4 weeks (28 days) so ya somewhere between 4-5 months if you want to get technical about it.

20 weeks though to be exact like you said.

Point still remains.

$95 is not alot considering it will last you 4+ months at 100mg a week. Or if you want to break it down weekly, $5 a week, the cost of a coffee at starbucks once a week.

[zaggahamma]

yeah we can meet in the middle and say 4 and a half ...lol

i know injects ARE cheap when you lose that more is better mentality

i like frappes at mcdonalds btw...u can get a large for less than a starbucks small(they call it tall as you know...lol)

[GFA]

The funny thing is how much do we pay for supplements each month currently or in the past?

Vitamins
fish oils
whey protein
snake oil this
magic pill that

Its crazy and we dont think twice about it because its not covered by insurance.

$100 a month is still a bargain monthly for something you know will work. Although the actual cost is much less unless doing a cycle.

[SEOINAGE]

The funny thing is how much do we pay for supplements each month currently or in the past?

Vitamins
fish oils
whey protein
snake oil this
magic pill that

Its crazy and we dont think twice about it because its not covered by insurance.

$100 a month is still a bargain monthly for something you know will work. Although the actual cost is much less unless doing a cycle.

Lol good point, but if you are like me you have that part figured out, don't really take all the stuff I used to, and the whey protein I buy in 25 lb increments for a little over 100 bucks. lasts forever.

[DaRoq]

I called my insurance after reading this thread. Customer Service said that my self-admin cost would be $50/mo, which is better than the retail price for 3 vials of 200mg/ml, and certainly better than the $50/shot my provider was having me pay, but still more than the Androgel I'm curently on. I might just switch back if my bloodwork this Monday shows poor results and increased DHT.

For those who are getting 10ml 200mg/ml vials, how is the prescription worded?

[SEOINAGE]

I called my insurance after reading this thread. Customer Service said that my self-admin cost would be $50/mo, which is better than the retail price for 3 vials of 200mg/ml, and certainly better than the $50/shot my provider was having me pay, but still more than the Androgel I'm curently on. I might just switch back if my bloodwork this Monday shows poor results and increased DHT.

For those who are getting 10ml 200mg/ml vials, how is the prescription worded?

Tell your doctor that you can't afford the 1 ml vials cause it isn't covered by insurance and he should be willing to write you the proper script, that is what I had to do. I paid 65 bucks for 2 1 ml vials, and now pay 75 bucks for 1 10 ml vial, the cost difference is insane.

[funkymonk]

My old Aetna insurance wouldn't cover the cheap 10ml vial of Cyp for $80, but they would cover my uber-expensive Androgel monthly. Go figure.

Funny thing is, even with the insurance, the Androgel was still more expensive month-by-month with a $25 copay.