qualifying for supplemental testosterone on insurance

[tompaynter]

Hello all,

I have been doing testosterone injections for while, through an online prescriber. I recently got on an HMO through my work. I wanted to see if I could get testosterone (and any related needs) covered by insurance, so I went off the shots for about three weeks and did a test through the HMO. 282 ng/dl on a range of 220 - 800 ng/dL. Doctor says, well that's not technically low so I cannot prescribe testosterone for you. He suggested going off the shots for at least 4 weeks and doing another test.

I am about to change jobs and have the opportunity to change healthcare providers. Any tips on choosing a provider that will provide testosterone and related care? Or how to qualify for it, e.g. by tanking the test? (For instance, they wanted the test done in the morning, fasted. I fasted and did the test right when the lab opened, 8:00 a.m. I could eat a big meal beforehand next time and do the test as late as they'll permit and still count it.)

Alternately, I think I'm paying about $175/month for testosterone and monitoring. Seems like a lot for an occasional bottle of testosterone and a lab test once every 6 months. The prescriber also has me on HCG but charges extra for that. Can anyone recommend a good service with a lower cost?

Thanks.

[asm44]

Wittmer is cheaper (about $100 after initial lab work) and is used by many people here.

The issue with what you're doing is that it will be hard to find a doctor that will prescribe you an optimal dose at an optimal frequency even if you meet the requirement of being below the reference range.

You say you can choose your healthcare provider. If the option is available to you I think the best thing to do is to choose a plan that offers a HSA and then use the HSA to pay for the testosterone at a clinic of your choice.

[VNV]

Wittmer is cheaper (about $100 after initial lab work) and is used by many people here.

The issue with what you're doing is that it will be hard to find a doctor that will prescribe you an optimal dose at an optimal frequency even if you meet the requirement of being below the reference range.

You say you can choose your healthcare provider. If the option is available to you I think the best thing to do is to choose a plan that offers a HSA and then use the HSA to pay for the testosterone at a clinic of your choice.

Does Wittmer charge an annual fee?

[Mark Rippetoe]

You'll have to ask him. I don't know.

[Satch12879]

Does Wittmer charge an annual fee?

I have not been asked for one.

[asm44]

Does Wittmer charge an annual fee?

Monthly.

[Jason Donaldson]

Does Wittmer charge an annual fee?

As I recall, you do a brief call with them initially to see what you're looking for and discuss their services and approach, so nothing to lose there.

[JFord]

Wittmer is cheaper (about $100 after initial lab work) and is used by many people here.

The issue with what you're doing is that it will be hard to find a doctor that will prescribe you an optimal dose at an optimal frequency even if you meet the requirement of being below the reference range.

You say you can choose your healthcare provider. If the option is available to you I think the best thing to do is to choose a plan that offers a HSA and then use the HSA to pay for the testosterone at a clinic of your choice.

Have you used an HSA account with Dr. Wittmer?

I can see some issues here. HSAs only cover certain medical expenses. Dr. Wittmer is a chiropractor. Chiropractic services ARE covered by HSAs but generally have to be for traditional chiro services. TRT may not fall under that category.

On the other hand, you might be fine if he has a physician (MD or DO) or advanced practice clinician (NP or PA) writing the actual Rx. As Mark has frequently educated us, the issue of governmental intervention of medication Rx’s is a very real problem.

I understand the DEA is planning (or has) reclassified fentanyl as a Schedule I drug which means it has no identifiable medicinal value i.e. it’s purely a recreational drug and therefore illegal. I’m prone to kidney stones and 50 to 100 mcg of fentanyl is the only thing that works for me. Morphine and other IV medications do nothing for the 11/10 pain I get that periodically sends me to the ER. Frankly, I don’t know where that leaves me.

As far as personally Rx’ing TRT, I’ve been advised by some colleagues here in California that I could jeopardize my DEA and medical license Rx’ing it for patients without a clear Rules According to Hoyle diagnosis of hypogonadism. And just so you know, NO pharmacy would fill such an Rx if I wrote it for myself (and testosterone is only a Schedule III drug).

Sorry for the rant. The OPs predicament has left me a little grumpy.

[Jason Donaldson]

Have you used an HSA account with Dr. Wittmer?

I can see some issues here. HSAs only cover certain medical expenses. Dr. Wittmer is a chiropractor. Chiropractic services ARE covered by HSAs but generally have to be for traditional chiro services. TRT may not fall under that category.

On the other hand, you might be fine if he has a physician (MD or DO) or advanced practice clinician (NP or PA) writing the actual Rx. As Mark has frequently educated us, the issue of governmental intervention of medication Rx’s is a very real problem.

All very good concerns, Dr. Ford. From my household's experiences:

Yes, Wittmer hooks patients up with MDs/DOs licensed to prescribe in the patient's state of residence as part of the process.

We have successfully used our HSA for payments, as well.

And that REALLY sucks about your pain management - I'm very sorry that you're having to deal with all that nonsense.

[JFord]

All very good concerns, Dr. Ford. From my household's experiences:

Yes, Wittmer hooks patients up with MDs/DOs licensed to prescribe in the patient's state of residence as part of the process.

We have successfully used our HSA for payments, as well.

And that REALLY sucks about your pain management - I'm very sorry that you're having to deal with all that nonsense.

That’s great news Jason. Quite encouraging. And I haven’t yet had to deal with the fentanyl thing yet. It’s just one more thing to have to (possibly) bother with in the future, something that no patient should have to deal with, myself included. I haven’t had a kidney stone in several years most likely due to some changes to my diet so I’m knocking on wood!

FYI, there are other things that fentanyl is very useful for and for which I FREQUENTLY write Rx’s for. I have many geriatric “end of life” patients with intractable pain due to cancer, etc. Fentanyl is available in a skin patch form as well as the “infamous” lollipop form for patients that can’t take medications by pill or elixir. I assume I won’t be able to write for that either.

I have nothing against the hardworking “grunts” of the DEA. In many cases, they do some good things to keep us safer; sometimes even from bad doctors! Unfortunately, they’re led by reactive, brain dead morons.

Sorry. I think people who know me here know that I don’t usually use this forum to vent anger.