Blue cross/blue paying for HRT

jdub1980

New member
I am sure this subject has been covered in another thread, but I wanted to see if anyone has had any luck getting BCBS to cover HRT. I had first visit with anti-aging doctor a couple of weeks ago and had some bloodwork done. Some labwork done at local hospital, and other labwork sent to Genova. The results from the local hospital came in and my total test was 289 and TSH was 10.7 (hypothyroidism I think). Doc mailed me a script for .75mg synthroid and said there are additional hormonal imbalances to be addressed at next visit in two weeks. I believe that test levels that low means hypogonadism. Is there any advice on how to get doc to play ball and help with insurance covering TRT/HCG? Also, this doc is a GP and is a primary care provider in my BCBS key provider network.
 
jdub1980 said:
I am sure this subject has been covered in another thread, but I wanted to see if anyone has had any luck getting BCBS to cover HRT. I had first visit with anti-aging doctor a couple of weeks ago and had some bloodwork done. Some labwork done at local hospital, and other labwork sent to Genova. The results from the local hospital came in and my total test was 289 and TSH was 10.7 (hypothyroidism I think). Doc mailed me a script for .75mg synthroid and said there are additional hormonal imbalances to be addressed at next visit in two weeks. I believe that test levels that low means hypogonadism. Is there any advice on how to get doc to play ball and help with insurance covering TRT/HCG? Also, this doc is a GP and is a primary care provider in my BCBS key provider network.
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Oh, wow! I thought mine was bad. I was a decent ways out of range, but normal is something like 0.5 - 4.5 (just rounding off, here). That should be really negatively affecting your energy as well as your waistline.

I was dealing with a GP and have been on 50mcg Synthroid for ~10 weeks and it hasn't done squat for me, though they said that my levels are now "normal" - which as you can see, is a huge range. I'm going to an endocrinologist in a few more days to hopefully get some more answers / solutions.

I'm not sure how BCBS is on HRT, but they've got me covered on the Synthroid (I pay like $4/month generic).
 
I think the reason my TSH is so high is because of a testicular varicocele that has atrophied my left testicle. Had a torsioned testicle repaired when I was 17 and varicocele formed soon after. From what I have been reading, hypothyroidism can be caused by testicular varicocele. I am now 30 and have been feeling like crap for the past 5years and finally decided to do something about it.

Synthroid is dirt cheap and not an issue, I would just like to get insurance to pay for some testosterone, HCG, and maybe some HGH if doc will work with me.
 
jdub1980 said:
if doc will work with me.
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I gotcha, bro. I'm glad you decided to finally look into it.

And regarded the portion I quoted, always find a doctor that will work with you. I mean, if you're asking for outlandish things, that's a different story, but don't settle, otherwise. I'm going to an endo because my GP didn't offer much help on this at all.
 
I have federal BCBS and it covers my visits and TRT. I only have copay which is $25 and 3 month supply of test cyp runs me $35. I'm 39 and my total test was 260 and free was 42.2.
 
Thanks for the info Jup...Good to know. I just had blood pulled earlier in the week and I'm waiting for the results. Looking to possibly be put on HRT and I have the same insurance.
 
BCBS is some pretty good insurance. My copay is $15 but I have a private plan, pay $210/month which includes a prescription plan that I have never used. Would really like to get them to pay for some test.

Is free test the same as test serum? My doc said he was going to look at total test and serum test.

Jupiterak, are you taking hcg, clomid or any other post cycle therapy while on trt?
 
jdub1980 said:
BCBS is some pretty good insurance. My copay is $15 but I have a private plan, pay $210/month which includes a prescription plan that I have never used. Would really like to get them to pay for some test.

Is free test the same as test serum? My doc said he was going to look at total test and serum test.

Jupiterak, are you taking hcg, clomid or any other post cycle therapy while on trt?
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That's pretty good. I pay $246 a month. I just started test cyp two weeks ago and doc has me on 200mg every two weeks. The doc said I didn't need hcg since I'm on a low dose trt. I've considered it but gonna wait for a followup with the doc. My symptoms prior were low test levels and libido, poor sleep and mild depression. I had prior use of some mild steroids and ph's in my 20's. Since I've been on trt, everything has been 100% better. I feel like I'm in my twenties again.
 
jdub1980 said:
I am sure this subject has been covered in another thread, but I wanted to see if anyone has had any luck getting BCBS to cover HRT. I had first visit with anti-aging doctor a couple of weeks ago and had some bloodwork done.
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They cover 50% for me. The only way they might not cover is if you go to a HRT clinic.
 
Just got my script for test cyp and wanted to know where to get script filled. I read on another thread that BCBS won't pay for meds from a compounded pharmacy. What about Walgreens or RiteAid? Jupiterak, where do you get your scripts filled?
 
coverage of HRT all depends on if the plan you are on covers it. You will need to read through the documents or call your help line. The 1-800 number on your insurance card will give you FAR better information than other BCBS people who are not in your plan. For example I am on BCBS and they will NOT cover anti-aging clinics, and HRT coverage is VERY limited. That is because your employer can opt in and opt out of any aspect of teh insurance.
 
jdub1980 said:
Just got my script for test cyp and wanted to know where to get script filled. I read on another thread that BCBS won't pay for meds from a compounded pharmacy. What about Walgreens or RiteAid? Jupiterak, where do you get your scripts filled?
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Sams club does, so walmart should as well.
 
Just got back from Walgreens. $60 for 10mL of 100mg/mL. I don't care about insurance not paying for it at that price. Didn't know it was that inexpensive.
 
jdub1980 said:
Just got my script for test cyp and wanted to know where to get script filled. I read on another thread that BCBS won't pay for meds from a compounded pharmacy. What about Walgreens or RiteAid? Jupiterak, where do you get your scripts filled?
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Got mine at Safeway.
 
Pharmacist said that my insurance would cover the test if my doc gives "prior approval." Will ask him about that on my next visit in 6 weeks. I have only been to see him twice and so far I am pleased. He seemed to be a little apprehensive during first visit because I am only 30 and looking into HRT. But when he saw that my test levels were low, he became more relaxed. He also appreciated the fact that I had done a lot of research on HRT. (All research came from this website; awesome info here). He's going to start me on HCG to go along with TRT at next visit.
 
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