XvBeast's picture
XvBeast
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+ 1 TRT & insurance coverage Question

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I'm on a self-script TRT, meaning that i didnt go through a doctor to get my testostrone due to my Endo ,whose last name is McNutt (true story), being highly judgmental because he knows i do steroids. Recently my girl has been pushing me to go through a doc to be monitored and healthy ..etc. I was wondering what are the odds my insurance (HMO) will be covering my stuff. im sure that my use is in my medical record. what are u all opinions on this, is doing this through a doctor better

Jmack1965's picture

It really depends on your insurance and how doctor writes it. Your problem comes mainly from insurance who will look for ways to deny however if your doctor words it as medically necessary insurance more likely to cover as it prevents future issues. When I initially went my PCP wrote for 10cc of cyp taken as 1cc or 200 mg 1x a month insurance would only cover a 3 month period thus (3cc from 10ml) vial was not approved. If he wrote 1cc a week they would have approved it. Also importantly is keeping girlfriend/wife happy and in loop if possible. If they see you trying to things right way they are gonna be more of an ally than a pain about it. Mine is a RN so she understands logic and wants me to see different doctor. Like someone else said private md labs is great resource and as cheap as a copayment most times. Their are some solid sources on here but if you can go through real doctor who will prescribe solid plan with legal scripts that is the way to go.

klon's picture

Testosterone Cypionate is about about $60 per 2000 mg. 1 mg of arimidex is less than $1. For a dose of 200-400 mg/wk plus 2 mg/wk of adex your cost is $8 to $16 per week.

Does it really matter if they cover?

NoPain's picture

What I don't understand is insurance (at least mine) knows I'm an addict but they covered everything and never held it against me. Why are Steroids any different they both can cause harm in many different ways. Has anyone been denied coverage for injury or illness after being know steroid user? How can they do that if they can't prove it's related.

j223's picture

it's not so much that they WONT cover you, but you just have to pay higher premiums and copays. Moral of the story, you LOSE when your insurance finds out.

Bottom line it's gonna cost you more money.

cltleo's picture

I crashed and went to my doctor, but I didn't say I was using. He did blood work and found my test levels low. He prescribes test cyp Watson labs and I pay 17.00 every six weeks. it's worth every penny. The insurance co sends me more than I need and just use the excess to cycle with. I don't think it would of changed anything if I had told my doctor that I was using.

XvBeast's picture

quite interesting... well i would need trt if i stopped doing what i am doing.. im 21.. however last time i saw the doctor, i told them i stopped taking juice two years ago becuase stuff like this ran through my head. i also later switched the story on it and told them that i had never done illegal roids, that the steroids were in a form of a legal prohormones

XvBeast's picture

i feel u and its not the money... its really my girl.

betheman's picture

Great answer. I'm creating a spreadsheet to track all my levels over time. If anyone has only hollar at me.

If in the US, private MD is so reasonable, I use hsa dollars to reimburse myself (tax free) and just keep my evidence that it was for blood work.

Another option is be up front with Dr. but just get him to run bloods on you once or twice a year. That combined with what you run you will be more on top of your health than 99% of folks.

The only risk is your test/gear and administration. You can be smart about both.

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littlefatbuddy's picture

I started TRT a little over a year ago. I went to my urologist who had recently wrote a book about replacement therapy. My blood test showed me low and he prescribed .5 ml/ 100mg weekly of test cyp. My insurance covers my therapy with just the normal copays for prescriptions. $5 a month for Watson cyp. 10ml bottle because my doc wrote it that way, he doesn't like the 1ml amps. I didn't argue, at all. That keeps my level around 650 and he is happy with that.

My insurance doesn't cover the pins or alcohol pads but they are inexpensive and my state doesn't require a script for them. I just bought a box of 100 at the pharmacy. They had to order the 1 1/2 inch pins but it came in the next day. With my insurance coverage, it costs me about $7 a month out of pocket expenses. I agree with one of the other posts, call and ask if they cover it. The worst thing that can happen is they say no. I do know of some people that their insurance won't cover it at all.

Tell the doctor you want to see your medical record. They will look at you like you have a dick sticking out of your forehead, but it is your record and you have a right to see what is in it. You can't necessarily change anything that is in it but will at least know what it contains. If there is something wrong or inaccurate in the file you can work with them to get that corrected.

On the other hand, the first thing my urologist asks is if you plan to have children. If you do he starts them on Clomid and most of them respond pretty well to that. He is still open to therapy but always takes the cautious route to start with. I had a vasectomy 10 years prior, and 5 kids, so it wasn't an issue. Keep your health in check whether it is through private labs or a doc, that decision will be ultimately up to you.

Doss's picture

When I went that route, I didn't have insurance, which is why I didn't stick to the doctor and started doing it myself.

I was seeing a hormone replacement specialist about an hour from my home. I actually found the program online and went thru the initial consult over the phone before they recommended the specialist nearest me within their network. This was a couple years ago, so I'd have to look it up to give you the info.

Like I said: i didn't have insurance at the time, so I was a self-pay patient. Honestly, I never even asked of they accept insurance for their services. The cost at the time was around $300 for the initial physical and blood test. Then about 150-200 for the scripts, if I remember correctly. This doc took an wholistic approach and dealt with supplementing test with cyp, regulating estrogen with adex, and supplementing gonadotropins with hcg to help with atrophy as well as fertility issues.

As for your question, I'd consider another doctor for this particular issue, if your endo is being a pain. Also, it never hurts to call your insurance company to verify coverage. They work for you, so there's no issue with asking. Just tell them that you recently had a blood panel ran for a check up and found some issues with low testosterone, and you wanted to find out of your policy covered any treatment. If so, ask if they have any info on what is and isn't covered, so you can become familiar before you start seeing a doc and spending money. If not, ask if they know what sort of policies do provide coverage.

Keep me posted bc I'd like to know. I do have insurance now, and I wouldn't mind getting back on a script for backup.

XvBeast's picture

i got it done, i told em that i took prohormones in the past and it messed up my system. and that i have never touched the devil's juice in my life because i get scared of needles ever since i was a kid. now just waiting for approval

Doss's picture

Awesome. That last bit may get in the way of getting injections initially. They'll prolly try the androgel. Luckily the specialist I saw didn't prescribe topicals. But, if I were you, I'd tell them that gels are not an option bc you with have children or the ole lady has them. The younger the better, since they require more hands on time from you. Topical gels can transfer to whoever you touch. Not a good thing for a small child.

XvBeast's picture

thank u bro, im going to see the endo tomorrow.

XvBeast's picture

u see the only reason i ll go through the insurance is because it might be cheaper if they choose to cover, if not then i ll keep pinning myself, but honestly i ll never pay more for test then what most sources charge on here. im 21 yrs old bro, u mention that i can HGH , i doubt it, also trt will be hard.. my medical record has in bold , steroid user on it, so that already been done. i dont really care that they know, i actually got a tendon surgery not too long ago and the insurance covered it , knowing that i took roids.

snuka2012's picture

Always liked your thoroughness and reasoning T3

j223's picture

You can get coverage for sure but yeah you are gonna need to go through the process - blood tests, then thew will prob start you on clomid... or put you on androgel or pellet...

gonna be a hell of a hassle especially at your age. Might be best to chill for a few years then when you hit mid/late 20s you won't be such a red flag for the insurance company.

just my thoughts

OmNom's picture

Man you have to actually get a doctor who's not a complete moron when it comes to TRT.. half of them wanna pin you once every two weeks LOL.. you run blood tests now? What do YOU think a doctor looking at your trt bloods will do for that YOU already didn't know how to do.. I'm basing this off the fact you've already educated yourself pretty damn well

XvBeast's picture

i ll try bro, going in tommorrow.. i hope then just give my the shit and not make me jump through hoops

XvBeast's picture

glad to be here for u entertainment , thanks for sharing bro +3

Optimus Prime's picture

But i have heard some getting the Script with an HMO i'm waiting for people to chime in on that. I think Dossier my know more about this??....

Optimus Prime's picture

My wife tried to get me to do the same, when she realized how ignorant the doctors are with HRT. The doc's said i was too young for it i'm in my 30's. So she helps me with it since she a nurse but as long as you are doing labs and know what you are looking at. My HMO would not cover even if they give me a script. I went to an HRT clinic they charge an arm in a leg. I still did it cuz i needed the script just in case cuz i was spooked by my work who sometimes test. From now on i'm just gonna go UG.