# Insurance Companies That Pay for TRT?



## mickems

Will someone tell me what insurance companies cover/ pay for TRT?


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## ccpro

None, that I know of....


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## j2048b

Actually a lot do, but it comes down to who ur insurance is and who ur doc is,

I have blue cross blue shield and all mine can be covered bu insurance IF the doc can prove that it is neccessary, thats what it comes down to, hell i get my test scripted from my doc and it only costs me $10 per month or $30 for 1 vial for 3 months depending on how fast its use


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## Serumwriter

Id call myself a rich man if i could afford insurance.. Period


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## ccpro

I didn't answer this quite right...my insurance blue cross health options would only cover TRT creams, etc.


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## PillarofBalance

Tufts covers it under an HMO if medically necessary. That determination is made by the doctor based on blood testing that comes in below range.


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## RustyShackelford

My BC/BS covers TRT and my script runs $10 a month. However, my prescription coverage only allows me to get one month at a time. So every month I go in a pick up 4 - 1ml viles for $10.
 A few months ago there was a hick up with at the counter and they didn't have it under my insurance. The lady said my total was $117 for 4ml.......I almost passed out. 
That's Big pharma for you.


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## mickems

PillarofBalance said:


> Tufts covers it under an HMO if medically necessary. That determination is made by the doctor based on blood testing that comes in below range.



so does each doctor have his own idea of what low range would be? or do they go by a certain standard?


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## PillarofBalance

mickems said:


> so does each doctor have his own idea of what low range would be? or do they go by a certain standard?



There are two standards that I have seen. 250 being low or 300 being low. I was at 236 so it didn't matter


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## mickems

would it be wiser to just go to anti aging clinic for trt? what's the deal with them?


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## getm

I copay $20 bucks BC/bs home depot and Starbucks has good health insurance you'll be the biggest barrista there lol


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## mickems

getm said:


> I copay $20 bucks BC/bs home depot and Starbucks has good health insurance you'll be the biggest barrista there lol


lol. those really are two of my favorites places.


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## ccpro

For what it's worth..
If you are legit with low t...most docs will prescribe but usually not injectable.  TRT clinics will prescribe to any one but won't take insurance...in my experience.


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## snake

Serumwriter said:


> Id call myself a rich man if i could afford insurance.. Period



Didn't that guy you voted for help you out with that? lol


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## snake

ccpro said:


> I didn't answer this quite right...my insurance blue cross health options would only cover TRT creams, etc.



If your on a TRT program, the insurance company would rather have you on injectables then a cream. A bottle of test cyp runs about $100 for 10 weeks at 200mg/week compared to Testum at $300 for 30 days.

I guess everyone else answered the OP question. You just have to get tested and oddly enough, hope your TT is at 220.


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## ccpro

Snake that makes sense, when I look back it was my Dr's office pushing the creams/gells...they wouldn't entertain injectables unless done by them.  I made a bad assumption about the insurance.  Then when I went to a clinic they discourage you trying to use your insurance...saying they won't get paid.  And I was legit at 135 on my test level.  I know many of you have have more liberal Dr's, but in my case clinics too expensive and insurance would only cover a shot every two weeks and it had to be done by the Dr.   So, find the right doc or go underground.


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## mickems

ccpro said:


> Snake that makes sense, when I look back it was my Dr's office pushing the creams/gells...they wouldn't entertain injectables unless done by them.  I made a bad assumption about the insurance.  Then when I went to a clinic they discourage you trying to use your insurance...saying they won't get paid.  And I was legit at 135 on my test level.  I know many of you have have more liberal Dr's, but in my case clinics too expensive and insurance would only cover a shot every two weeks and it had to be done by the Dr.   So, find the right doc or go underground.



ok so lets assume someone went underground for trt. how often would they get bloods done?


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## event462

If you are a Vet, the VA might cover you for free but it has to be BEYOND low!


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## snake

mickems said:


> ok so lets assume someone went underground for trt. how often would they get bloods done?




That can get complicated depending on the state you live in. Some “Nanny States” don’t want you to do your own doctoring and will prevent you from getting your own BW done.

If you are not in communist NY or one of the other states that don’t permit you to get your own BW, you can use Private MD Labs: here’s the link: 
http://www.privatemdlabs.com/

You want to use the Hormone Panel for Females, it’s $62.99 plus if you sign up you get a 10% off and they will send you coupons periodically; free to sign up. I know, why the FEMALE one when you’re a male? It’s also used for guys, MAKE SURE YOU CHECK THE MALE BOX WHEN ORDERING! Otherwise you get female ranges. 

As for timing; I would assume you would be using Test Cyp for the long ester so give it at lest a month to level out and then test. Test again at the 3 month mark and assuming you are where you want to be and everything is in check, once every 6 months is fine. If you change your dose or add a compound, you should test again.


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## snake

ccpro said:


> Snake that makes sense, when I look back it was my Dr's office pushing the creams/gells...they wouldn't entertain injectables unless done by them.  I made a bad assumption about the insurance.  Then when I went to a clinic they discourage you trying to use your insurance...saying they won't get paid.  And I was legit at 135 on my test level.  I know many of you have have more liberal Dr's, but in my case clinics too expensive and insurance would only cover a shot every two weeks and it had to be done by the Dr.   So, find the right doc or go underground.



No problem, we are all here to learn. That's what makes UGBB the best place, Brothers caring for Brothers!

Hay if you are at 135, your doctor is a complete ass for not seriously addressing that! You need another doctor that has you best interest at heart. 135 must have you feeling like a 90 y.o. man, no energy, carrying a bit too much belly fat and zero sex drive and performance. Ask for the test results and go to another doctor with them. Tank candidly with the new doctor and tell him your symptoms. He  (don't go to a female) will want his own BW to cover his ass but you should be good to go after that.


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## mickems

snake said:


> That can get complicated depending on the state you live in. Some “Nanny States” don’t want you to do your own doctoring and will prevent you from getting your own BW done.
> 
> If you are not in communist NY or one of the other states that don’t permit you to get your own BW, you can use Private MD Labs: here’s the link:
> http://www.privatemdlabs.com/
> 
> You want to use the Hormone Panel for Females, it’s $62.99 plus if you sign up you get a 10% off and they will send you coupons periodically; free to sign up. I know, why the FEMALE one when you’re a male? It’s also used for guys, MAKE SURE YOU CHECK THE MALE BOX WHEN ORDERING! Otherwise you get female ranges.
> 
> As for timing; I would assume you would be using Test Cyp for the long ester so give it at lest a month to level out and then test. Test again at the 3 month mark and assuming you are where you want to be and everything is in check, once every 6 months is fine. If you change your dose or add a compound, you should test again.


just tried to pay for hormone panels online at privatelabs. unfortunately it won't allow me to because of my state. bastards.


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## snake

mickems said:


> just tried to pay for hormone panels online at privatelabs. unfortunately it won't allow me to because of my state. bastards.



Hay if you're not in too far away, go for a drive to a neighboring state that allows it


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## mickems

snake said:


> Hay if you're not in too far away, go for a drive to a neighboring state that allows it


just tried to setup labs in York but the site (labcorp) says creditcard address must match state that is doing the labs. any suggestions?


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## Beedeezy

Maybe try a prepaid/reload able card.


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## BubbleGuppies

My insurance covers TRT. I get 10ml vials for $10.


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## BubbleGuppies

Sorry, didn't answer the question. I have BCBS.


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## HydroEJP88

I have Health America, and as of now they don't cover, so I'm paying $80 for a 10ml vial.

Trying to get the doc to fight for me but I don't think it will happen


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## Beedeezy

HydroEJP88 said:


> I have Health America, and as of now they don't cover, so I'm paying $80 for a 10ml vial.
> 
> Trying to get the doc to fight for me but I don't think it will happen



Why won't they cover it? My insurance required a prior approval which is just your doctor saying "no, we are not trying other methods first, the patient needs testosterone."
I received a letter about a week later saying my TRT would be cover going forward.


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## HydroEJP88

They are making me and my family doc jump through hoops, that's why he sent me down the road to a urologist. Hopefully he will be cool enough to get it on the right path


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## ColoradoJay

Without going down the rabbit hole of insurance in the US....the answer also depends on if your company is on a "self funded" or "fully funded" insurance plan.  Odds are better that your coverage will cover for T if you are on a self-funded plan, as that gives the company a lot more flexibility in their benefit definition.

I'm on a self-funded plan through my employer that uses the Cigna network.  My plan covers injections, but NOT bio-identical pellet therapy.


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## Redrum1327

when i was on trt 3 yrs ago my doctor was gonna give me shots in his office every 3 wks but my insurance wouldnt cover it then he prescribed me Androgel and my insurance wouldnt cover that til the Doc gave me test pills called Androxy 10mg. pills twice a day and i got bloods done again and my t levels barely went up at all so after 6 months of ****ing around my insurance would cover the gel but we all know the down falls of the gel , i think it all depends on the insurance company i know mine wont cover a trt/hrt clinic and most around me dont except insurance either . Best of luck brother


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## grizzldsealpoacher

I have bc/bs the magic number was 300 my doc was straight up with me he told me unless I test below it he still could prescribe it how ever insurance would not cover it. He offered me the gel and cream I told him b/c I had children in house I was worried about them touching my close or me etc, he agreed and offered for me to come in once a week for a shot I countered with a busy work schedule and home life , he eventually caved in to the depots . The first year was sweet he wrote the script for 10ml depots with 5 refills I had no issue going into cvs and filling all five with in a 6mo period even with the instructions saying .5ml/wk tc the next year something changed even though my script had not it still was for 10ml depots the pharmacy would only give me 3ml's. my insurance would only cover 1ml per mo and they would give me 3 1ml depots per script hardly worth my time and co pay .


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## KingBee

I wonder if thats why my Doc only prescribed me one 200mg per ml shot a month. I also have BC/BS


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## HydroEJP88

I just got a letter in the mail explaining what my insurance covered and didn't cover, so I'm going to say that I will be receiving a bill shortly, and if it's as bad as I'm thinking it's going to be, this will make or break my trt regimen


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## j2048b

HydroEJP88 said:


> I just got a letter in the mail explaining what my insurance covered and didn't cover, so I'm going to say that I will be receiving a bill shortly, and if it's as bad as I'm thinking it's going to be, this will make or break my trt regimen



A bill? Are they billing u after the fact? U already  got ur trt stuff and paid and now u might have to pay more? If so that blows badly


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## HydroEJP88

I'm guessing it's going to be for the blood work that I had done, so if that's the case it will be coming out of pocket and it will be cheaper for me to go my own route for the bloods


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## j2048b

HydroEJP88 said:


> I'm guessing it's going to be for the blood work that I had done, so if that's the case it will be coming out of pocket and it will be cheaper for me to go my own route for the bloods



Oh man yeah it would be, WAY CHEAPER!


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## HydroEJP88

Well my bill is only $54, could have been almost $400 if my insurance didn't cover it. I'm hoping that I don't have a certain amount of times that I can use it


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## wabbitt

HydroEJP88 said:


> Well my bill is only $54, could have been almost $400 if my insurance didn't cover it. I'm hoping that I don't have a certain amount of times that I can use it



Well that's good news!


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## HydroEJP88

You're telling me, I was almost in panic mode. I have to get bloods done at the end of July so hopefully everything goes good. 

Most importantly I hope that they cover my scripts, if they don't then I will self medicate


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## ToolSteel

I don’t even use my insurance for my trt. It’s under $30 for 10ml of 100mg cyp at Walgreens with a GoodRX coupon.


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## notsoswoleCPA

BC/BS here covers it IF one goes to a doctor that accepts BC/BS.  United also covered it.  Unfortunately, many of the local doctors stopped accepting insurance for HRT due to the hassle involved with getting reimbursed once total testosterone goes over a certain level.  If one doesn't mind a total testosterone in the 500s, most GPs will do this all day long.  If one wants to get to the top end of the spectrum, most GPs aren't comfortable with going there and most insurance companies start to ask a lot of questions.


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