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HGH Prescription

nosnmiveins

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Long story short, I meet every qaulification to be put on HGH but my insurance refuses because they dont want to pay (thats not their excuse, but its the reason).

What are my options? Should I contact Omnitrope, Noditropin, Saizen, or any of the sort, directly to see if they offer some sort of co-pay program?

How should I go about this? I dont know what doses the doc wanted me on, but its a good bit I would assume. My pharmacist said I would need "3 kits per month" and each one would be $600 if I were to pay out of pocket. (I believe my doc told me he wanted me on .25mg per kg of bodyweight)

Mods, I do apologize if this is breaking any rules, please delete this thread if it is. I have a prescription and I am speaking of actual pharmacy prices my pharmacist gave me. Please let me know if I need to edit anything.
 

ThinkTank

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Long story short, I meet every qaulification to be put on HGH but my insurance refuses because they dont want to pay (thats not their excuse, but its the reason).

What are my options? Should I contact Omnitrope, Noditropin, Saizen, or any of the sort, directly to see if they offer some sort of co-pay program?

How should I go about this? I dont know what doses the doc wanted me on, but its a good bit I would assume. My pharmacist said I would need "3 kits per month" and each one would be $600 if I were to pay out of pocket. (I believe my doc told me he wanted me on .25mg per kg of bodyweight)

Mods, I do apologize if this is breaking any rules, please delete this thread if it is. I have a prescription and I am speaking of actual pharmacy prices my pharmacist gave me. Please let me know if I need to edit anything.
Do insurance companies have a right to deny this if you meet all the medical qualifications AND if they normally cover it under such conditions? Maybe touch base with a lawyer :confused:
 

nosnmiveins

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Do insurance companies have a right to deny this if you meet all the medical qualifications AND if they normally cover it under such conditions? Maybe touch base with a lawyer :confused:
Exactly my thoughts. I guess that could be an option. What the hell is insurance for then????????
 

Fitraver

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Damn bro! You be slamming that deductible in no time at that amount haha
 

richiec

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How old are you?
What are the "qualifications" for being prescribed hgh?
Not being a smart ass, just genuinely curious.
What's their "excuse" for not covering it, you said they had one and cost wasn't it, so what was their excuse?
 

MisterB

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Exactly my thoughts. I guess that could be an option. What the hell is insurance for then????????
im sure its something simply like the doctor needs to use a different diagnosis code, these insurance companies are only going to pay if it meets some defined diagnosis and the code it entered.

talk to the doc about this issue and see what he can do to change it
 
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nosnmiveins

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How old are you?
What are the "qualifications" for being prescribed hgh?
Not being a smart ass, just genuinely curious.
What's their "excuse" for not covering it, you said they had one and cost wasn't it, so what was their excuse?
Short bowel syndrom as well as gh deficiency. Have the sugery history and bloodwork to prove it.

im sure its something simply like the doctor needs to use a different diagnosis code, these insurance companies are only going to pay if it meets some defined diagnosis and the code it entered.

talk to the doc about this issue and see what he can do to change it
This is what I plan on doing. The prescription was through my GP and he said he did absolutely everything possible. I'm going to go to my gastro doc and see what he can do.
 

kingjmack

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im sure its something simply like the doctor needs to use a different diagnosis code, these insurance companies are only going to pay if it meets some defined diagnosis and the code it entered.

talk to the doc about this issue and see what he can do to change it
That may be the key right there.
 

richiec

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Short bowel syndrom as well as gh deficiency. Have the sugery history and bloodwork to prove it.
Ok, so how old are you?
What was the insurance companies response for not covering it?
What does short bowel syndrome and gh have to do with each other? Again, not being a smart ass, genuinely curious.

Simply being "gh deficient" isn't necessarily a qualifier in the insurance company's eyes, even though it may be in ours and the doctors. If being gh deficient isn't causing unnecessary life impingements they may see it as non medically necessary, especially 3 kits a month.

I'm 33 and my doc wrote a script for Test C.
The insurance company said nope due to my age. We submitted blood work showing my levels of that of a deceased woman and was approved. Low T has been studied and effects of it known, has GH deficiency been studied at length as well?

I'm genuinely curious about this, I enjoy learning
 

MonkeyBoy

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My wife works at a dentist office and its the same thing with insurance. Your dr has to document his findings, they submit and the insurance can deny it or approve it. If not, Dr and Dentist would be doing all sorts of work for nothing.

In your case, you have to fight your insurance company. I believe you can put in a claim but its more you vs them which sucks
 

nosnmiveins

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Ok, so how old are you?
What was the insurance companies response for not covering it?
What does short bowel syndrome and gh have to do with each other? Again, not being a smart ass, genuinely curious.

Simply being "gh deficient" isn't necessarily a qualifier in the insurance company's eyes, even though it may be in ours and the doctors. If being gh deficient isn't causing unnecessary life impingements they may see it as non medically necessary, especially 3 kits a month.

I'm 33 and my doc wrote a script for Test C.
The insurance company said nope due to my age. We submitted blood work showing my levels of that of a deceased woman and was approved. Low T has been studied and effects of it known, has GH deficiency been studied at length as well?

I'm genuinely curious about this, I enjoy learning
Hgh would be used to heal the intestinal lining in my case.

The only thing they came back with was that i didn't receive "dietary adjustments"

that was all the denial letter said. i'm sure i can get around that fairly easily though but getting my doctor to actually get stuff done is near impossible. he's gung-ho when i'm at his office talking to him then i feel like the second i leave he completely forgets everything.
 

ldog

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Your situation is exactly why brothers self medicate to include TRT and GH. Take your health by the reins and run with it.


Sent from my iPhone using Tapatalk
 

pimpman

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Yes insurance can deny. I believe if it's not a life threatening problem like let's say your sickness is making your hair fall off. They say you can live without hair. Also they pay for generic I believe in some cases if no generic is available they deny.

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MooseKnuckles

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Insurance will only pay for pain medication so everyone can become dependant on them, HGH and Test aren't addicting so they feel there isn't a need. Lol
 

nosnmiveins

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Insurance will only pay for pain medication so everyone can become dependant on them, HGH and Test aren't addicting so they feel there isn't a need. Lol
Very true. I can get Percocet whenever I want just have to go to the doc and say I'm in pain. Get it cheaper than a burger and fries.

Surprisingly there was no problem getting them to cover my TRT. Got blood work, doc submitted it and they covered it without any issue. Of course test is WAAAY less expensive than pharm hgh.
 

BlastCruiseBooze

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im sure its something simply like the doctor needs to use a different diagnosis code, these insurance companies are only going to pay if it meets some defined diagnosis and the code it entered.

talk to the doc about this issue and see what he can do to change it
I was a medical admin assistant, this is true. Insurance companies will do anything to try not to pay, you need the right icd10 code, look it up if possible

●Strength is gained in the range it is trained●
 

nosnmiveins

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I was a medical admin assistant, this is true. Insurance companies will do anything to try not to pay, you need the right icd10 code, look it up if possible

●Strength is gained in the range it is trained●
Hmm ok i'll look into this. I know my doctor submitted everything the insurance company was looking for multiple times. I was denied about 4 times
 

BlastCruiseBooze

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Hmm ok i'll look into this. I know my doctor submitted everything the insurance company was looking for multiple times. I was denied about 4 times
Doctors a fucking NOTORIOUS for not knowing a fucking thing about insurance. Don't say that to him, because they tend to be also known for their fucking egos as well, lol.

I'd get the codes yourself online. Find them.
Look at your docs written prior authorization request to your insurance company, should be in your visit notes or if your not in the stone age clinic, they should have an online medical record system (EMR), this info and the codes used for request should be there if your doc has his shit together.

I would just pay cash and go see rand mcclain in Santa Monica or get an appt online. He'll prescribe you.

●Strength is gained in the range it is trained●
 

nosnmiveins

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Doctors a fucking NOTORIOUS for not knowing a fucking thing about insurance. Don't say that to him, because they tend to be also known for their fucking egos as well, lol.

I'd get the codes yourself online. Find them.
Look at your docs written prior authorization request to your insurance company, should be in your visit notes or if your not in the stone age clinic, they should have an online medical record system (EMR), this info and the codes used for request should be there if your doc has his shit together.

I would just pay cash and go see rand mcclain in Santa Monica or get an appt online. He'll prescribe you.

●Strength is gained in the range it is trained●
Prescription isn't the problem, price without insurance is. I see my gastro tomorrow and I'm definitely bringing it up to him. Since he's a specialist I feel like he has more pull with insurance. I need meds that cost $11,000 per month. Insurance kept denying it for bullshit reasons. I met every single qualification. Finally he got pissed and he called directly. I had the med in my hands the next day and its a $0 co-pay
 

richiec

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Hgh would be used to heal the intestinal lining in my case.

The only thing they came back with was that i didn't receive "dietary adjustments"

that was all the denial letter said. i'm sure i can get around that fairly easily though but getting my doctor to actually get stuff done is near impossible. he's gung-ho when i'm at his office talking to him then i feel like the second i leave he completely forgets everything.
Gotcha. I didn't want you to think I was being a dick or anything asking those questions, tones can't be read lol
I was genuinely curious about it.

Hmm ok i'll look into this. I know my doctor submitted everything the insurance company was looking for multiple times. I was denied about 4 times
One thing I've come to learn over years of surgeries and dealing with doctors, they don't always do the follow up with the insurance companies like they say they do/have. Many times they just resubmit the same damn thing that was denied. I would talk to the office manager, they are the ones who deal with companies on the regular

Doctors a fucking NOTORIOUS for not knowing a fucking thing about insurance. Don't say that to him, because they tend to be also known for their fucking egos as well, lol.
I would absolutely HATE it if my doctor knew anything about insurance. I don't pay him/her to know anything about insurance, I pay them to diagnose my problems and find a solution. The office manager is the person he should be discussing this stuff with regarding insurance, not the doctor. They doctor doesn't call the company, the staff does.

I'm a P&C insurance agent so I write car insurance, home insurance and commercial. Should I know how to fix a car since I insure them? What about building a house since I insure them?
 

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