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getting trt approved by issurance

ronnieron

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my wife was given a script for low test. she was prescribed andgogel which wad denied, and was prescribed transdermal testim which was also denied. denied because she did not have bone or bone density loss, hiv or other muscle wasting disease.
what options to we havr? is there an online pharmacy whete to get these either with ot without script? anyother options, shes not one to inject anything especially ordered from someone she does not know.
 

heavyhitter

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my wife was given a script for low test. she was prescribed andgogel which wad denied, and was prescribed transdermal testim which was also denied. denied because she did not have bone or bone density loss, hiv or other muscle wasting disease.
what options to we havr? is there an online pharmacy whete to get these either with ot without script? anyother options, shes not one to inject anything especially ordered from someone she does not know.

Insurance is hard with these things. They only want to pa for certain things for certain reasons. It may be as simple as the wording your doctor used to explain why it was medically necessary. But.....who knows. They may just refuse to pay for it outright. Call them and find out under what circumstances they will cover trt fro women
 

richiec

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Go to goodrx.com
You type in the medication, it gives you a coupon, bada bing bada boom

Insurance is a pain in my ass with my script because I'm 33, so I use goodrx and it's relatively inexpensive
 

King-kong

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It's ridiculous they don't just prescribe injections. I went through the same thing androgel, roll on, few other things. In the end it was easier to self-medicate. Got sick of dropping off scrips only to hear it's not covered. I don't know much about female hrt. But waiting for pre-approvals or having to run through various levels of meds got old fast.
 

maldorf

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Sounds like your problem is because she is a woman. As a man I had no issues at all getting mine covered once the blood test results were in over a series of many months.

It sounds like you need to talk to your health insurance and find out exactly what you need to do to get it covered. Bone density test etc. Depending on your plan that might get mighty expensive. I don't think there is much else you can do but follow along on what they require, jump through the hoops. Did she already have the bone density test and it came back normal?
 

nothuman

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I think you just have to get lucky with your endo. I was fortunate enough to have a female endo prescribe it to me without even needing to test low. She knew I used AAS in the past and I told her I needed it and she prescribed it lol
 

Pusher

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that's odd.

my insurance always covered my hrt. even back when I had Medi-Cal when I first started hrt (sneeked into Medical back in 05 since most my income was 'off the books' from training/nutrition consults and modeling/1099's). back then I was started on testosterone patches which cost $400+ per month. injections were wayyyyyy cheaper. 6 months of injections cost less than 1 month of patches.
 

kingjmack

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It may be as simple as the wording your doctor used to explain why it was medically necessary. But.....who knows.


My insurance required all the blood work and a statement from the doctor. In my area, there are a couple of anti-aging clinics that make the process easier
 

maldorf

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My insurance required all the blood work and a statement from the doctor. In my area, there are a couple of anti-aging clinics that make the process easier

Perhaps that might be her best bet, go to one of the clinics?
 

armada

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Just went through the insurance process. My best advice is to do some googling and find the criteria your insurance company is looking for before they prior approve the drug. If you can prove you meet their criteria, you're in good shape.

For example, my insurance wanted 2 total T blood tests below bottom of reference range + some other criteria.

Also, finding a doctor who does this all the time is a good bet. This can be difficult and time consuming, but well worth it in the end.
 

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