Penile rehab...Cialis...Tricare Prime insurance

Doctor wrote script for 1 tablet 5mg per day explaining reasons why. Insurance approved 6 for a 30 day period for a year. Doctors office said welcome to Obama Care! Trying to get an authorization override, but not holding my breath. What sources do you recommend for out-of-pocket purchases?

If your insurance will do 6 at 5mg they will probably do 6 at 20mg. If you cut them into quarters that gives you 24 5mg doses per 30 day period. Pick up two more at the cash price and you are there. If you can't get your insurance to budge that might be your lowest out-of-pocket alternative.

Cialis pills are an odd shape and hard to cut but it doesn't really matter if you get 4mg one day and 6mg the next. It averages out.

Good advice PeterDisAbelard!
Cut them things up and stretch it out.

My insurance has a limited number of pills regardless of the strength. They are one of the biggest, and won't cover ED pills at all unless you have a physical injury or surgery on their watch. We wrote letters and appeals, and wasted a whole lot of time.

This sort of limit existed years ago, not because of any recent healthcare legislation - whoever made that comment was off base.

But with Cialis, do this. There is a "free month" with the 30x5mg prescription. Take your prescription to the pharmacy, get them to process the "free month", then stop filling that one. Get a new prescription for exactly the number of pills your plan will pay for, but in the 20mg strength, then cut them up as previously mentioned. Don't do the "free pills" offer on the 20mg prescription, as they only give you 2 or 3, and you loose.

Also, beg samples at your uro & GP. Sometimes they have them, sometimes not.

I went to the Cialis website and downloaded a voucher that can be used for 30 5mg pills at no cost.
Go to your doc and get a script for the 30 day 5mg Cialis, take both papers to the pharmacy for your free month.

I'll have 60 days of 5mg pills, the voucher and the free pack the doc gave me.

Waleygator,

I'm on Tricare for Life and use Express-scripts mail in pharmacy.  I just went on line and found that I could get a 90 day supply (18, 20mg tablets) for $43.  If your existing perscription with Tricare (Express-scripts) is for 5mg they will not change the dosage on their own ... it will take a new script from your doctor.  In my case I've actually had Express-scripts contact my doctor (at my request) to get a new script.

Also, to fill the gap (you'll come up a few tablets short each month) consider looking in your paper for Cialis advertisements for a free 30 supply.  I see these adds in the Denver Post about once a month.  The doctor can write a script for the one month supply and you can take it and the advertisement to your local pharmacey and get it filled. You can use one Cialis advertisement per year ... but that will fill your gap.

Hope the pills are a passing need for you.

PS.  If you get an overide from Tricare (Express-scripts) I would sure be interested in finding out the particulars ... I was not successful 4 years ago.

Post Edited (RCS) : 5/22/2013 12:23:08 PM (GMT-6)

There could possibly be a "gray" market alternative. I bet "Google" could help find a non US pharmacy that has something that could fit the bill. Hmmm.. something to think about.

It will be interesting to see what the final outcome is. Yes, my email is listed on my profile. UR and I will have a good talk as to whether they are even necessary.

I am a recent beneficiary of the remarkable advances in robotic bi-lateral nerve sparing robotic prostatectomy surgery, though am still on the mend in the normal fashion for folks whose prostate has been removed in the last 10 weeks. As part of my rehabilitative therapy, my physician prescribed 5 mg Cialis every Mon, Wed, Thu, Fri and Sun and 15 mg Cialis every Tue and Sat. That adds up to about 47 5-mg tablets per month, which is many more than the 6 per month for the "standard" allowance with prior authorization by TRICARE. After getting my initial free 28-day supply with the coupon my physician's office gave me and having received a written notice from Express scripts that my prior authorization had been approved, I have twice gone to the pharmacy to get my prescription filled and twice been both frustrated and disappointed. Through a series of yet-to-be-resolved circumstances, each time I have ended up pulling out my wallet and paying the $400 for a month's supply after spending several hours on my cell phone pushing numeric keys in response to repetitive Express scripts auto-prompts and eventually speaking to humans who proved unable to assist, all while standing at the pharmacy counter. I have filed the DD Form 2642 each time for reimbursement, but have yet to get a response of any kind from Express scripts, and when I try to call (and go through the same series of key-pushing through the same menu over and over again), I get a totally different answer each time I call, and nobody can seem to find a status of either claim. I am now in the process of getting my physician's office to send in a fourth request for prior authorization, which greatly pleases both them and me, as you can well imagine.



While not making any editorial commentary about the limits TRICARE's formulary places on tadalifil (Cialis) or other PDE-5 inhibitors, I offer the following as a potential solution as just recommended to me by my physician's office. The Canadian Pharmacy Online (CPO, call toll free <snipped phone number>) will reportedly set up an Order Number with a prospective patient, who provides the order number to their physician's office. When the physician's office sends them the prescription, they contact the patient for shipping and payment information. The current rate for tadalifil (the generic for Cialis) is $125 plus $10 s&h for 90 5-mg tablets. Once payment is received, they ship to arrive in 10-16 days. There is no minimum time to wait between placing orders. As soon as you receive the first order, you can call CPO to get your next refill on the way. I have no personal experience to provide on this, as I am still hopeful that I will eventually be able to speak with a human at Express scripts who can actually help resolve the situation in a reasonable fashion.

Post Edited By Moderator (PeterDisAbelard.) : 12/23/2014 12:10:10 PM (GMT-7)

Our insurance Wouldn't cover cialis even tho my husband had no ed before surgery andv his nerves were removed. The doctor wrote the insurance company a letter of necessity but that wasn'T accepted either. . We got the coupon from cialis website for afree month, then I asked doctor if she wss ok with us using an online pharmacy. She immediately gave us the phone number of a good one to use. It was about a Hundred and thirty dollars for a year supply with shipping. 96 20 mg if I remember right

I used the same Canadian pharmacy...but the package I received was from India.....In any case....it worked just the same. Theres plenty of stories on the internet about those overseas drugs being spiked with poison and what not....and my guess is those rumors are started by drug companies who don't want to lose business because they know theyre charging you 4000% more than its worth. There all over the web but you have to be careful of some scams. I went back to my Dr. giving me 6 pills a month and cutting them in half because I rarely use them anymore...most Tricare prime doctors or doctors on base are more than willing to work with you on giving you the most they can but they are bound by legalities...heck the Major I saw even gave me a class on how he used his....telling me its all about getting in the mood or the pill wont work.......I said Doc......have you ever had ZERO testosterone before.....those non cancer military doctors just don't have a clue when it comes to chronic illnesses.....but that said Tricare Prime is relatively cheap and you can always get referred to the best doctors you want.