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Posted 10/18/2017 1:42 PM (GMT 0)
Medication for testosterone. I think I could write a book.... But I've been getting the impression it is getting harder to get.

Blue Cross - besides wanting an annual letter from my URO on why he wants me to have it....ended up denying me a couple of months ago. I had to submit two blood tests that were taken a week apart. (this was new) I was in the 355 range for both which is above the 350 level that BC had set.

Fast forward a couple of months and I have a new Insurance Company called Lifestyle Health Plans. After some arm twisting they approved my prescription for Androgel. All I have to do is pay a $785.00 per month co-pay. shocked

The good news (i think) is that the mom and pop pharmacy that I use also does compounding..They can mix up a batch of generic T-Meds for around a $100.00 co-pay. We're just waiting for my Uro to send a specific formula on what he wants me to have.

Side note - the new generic version is apparently going to be cream versus a gel. The pharmacist had called me asking if I had any skin conditions and if I was overly hairy confused

(((STAY TUNED)))
Posted 10/18/2017 2:22 PM (GMT 0)
Steve - Which BC plan are you on? I am currently on United Healthcare group plan from work, and they cover Testim with a $30 co-pay, but do not cover Androgel.

Once I retire, I will be on Medicare as primary with BC Federal Employee plan as secondary. I hope they don't quibble over coverage.

I may not be in quite the same place as you are, though, since my last blood test result without the T gel was below 150. . .
Posted 10/18/2017 5:40 PM (GMT 0)
I "was" on a standard BC plan.... And I've down the road with United H. and had to switch to Testim...

As I mentioned, BC made me do two additional blood tests before they would approve. And since I was over 350, they denied me.
Posted 10/18/2017 6:08 PM (GMT 0)
Can you appeal BCBS? Your doc should be able to assert that he is treating symptoms, not numbers. Or, you could try a different lab for blood tests. The lab my uro uses states that their "normal" range is from 300-1100. Maybe some lab has different assays, like the PSA tests do?

. . . And to show that we're all different, I tried Androgel and it did not absorb effectively for me. I changed to Testim and it seems to work fine -- it just smells funny.

PS - Maybe if you can't get acceptable coverage for topical gels, you can possibly get periodic injections at the doc's office for a reasonable price. . . or you might be able to get the meds and self-inject. I hear that this is the most cost-effective delivery method.
Posted 10/19/2017 4:14 PM (GMT 0)
Just had this discussion with my VA primary care nurse. I just had labs done and my T was 274. The VA won't treat above 175. If I was that low I would probably be feeling fairly lousy.
Posted 10/20/2017 3:28 PM (GMT 0)
Go to Goodrx. It will show drug prices in your area WITHOUT insurance. The prices listed for Androgel in my area range from $155-250. We have found that some drugs are cheaper if we leave the insurance company out of it.
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