Re: Newbie...need some help

May 19, 2006

I'd suggest not trying to get insurance to cover your hypogonadism

treatment. Get whatever policy looks best but pay for your

testosterone out of pocket. There's no reason for your treatment to

cost $150 to $250/month. That might be what you've been charged for

androgel or testim but there are other products. I use injectible

testosterone. Today, I picked up a vial of 200mg/ml testosterone

cypionate from a compounding pharmacy. At my dose, that's enough for

5 months of treatment. The vial cost $35. So that's $7 per month

plus the cost of syringes and alcohol swabs. If you don't want

injections you can get compounded transdermal testosterone products

for less than Androgel/Testim.

Brad

>

> Hello all...

>

> I was diagnosed as having a severe testosterone defficiency almost

> two years ago after having spent YEARS of having doctors try to

> convince me that my fatigue, mood swings, lack of libido, etc was

> nothing more than depression. Over the last year, I've been trying a

> variety of treatments, including Androgel and currently the

> injections.

>

> The problem I'm having is this: At the end of last year I started my

> own business with a friend. Since it's just the two of us, we

> couldn't get a group plan and we go our individual insurances

> privately. I was flat out declined by 3 companies and only one would

> cover me given I added a rider (sp?) onto my policy. I thought the

> rider was that my hypogonadism wouldn't be covered for 6 months but

> found out today that it's indefinite. The only way to have the rider

> removed is after 12 months and only if I no longer need medication

> for the condition. Because it's a chronic condition, it's not going

> to be lifted.

>

> Because the business I'm in is very slow growing, I knew up front

> that it could be as much as 12 months before I could draw a salary

> and am living on a very tight budget. $150 to $250 a month for

> testosterone the next 6 months is not in that budget. Last month, I

> didn't have any testosterone and within a few weeks I had severe

> headaches, fatigue, depression...I was the person I was almost 2

> years ago and I didn't like it.

>

> It's hard enough only being 35 and having to deal with infertility

> and sexual dysfunction issues...now to have to deal with this is a

> bit much. My doctor managed somehow to get me some samples that

> should last the next few weeks, but I'm really at my wits end. Has

> anyone had any other problems with insurance coverage in the past?

> Or does anyone know an insurance that might be a good one to talk

> to?

>

> Any help that I might get from anyone would be greatly appreciated.

>

> Thanks,

>

> Jeff

>

May 19, 2006

Hey Jeff! - You're going to flip when you hear this! I live in

Hawaii. Hawaii is a VERY PRO-EMPLOYEE state which makes it a bit

hard on a small business owner to finally accept the fact that they

need employees...why? Because the STATE will NOT let you have

employees unless you provide them with medical insurance.

Obviously , you know what a cost that is to a small business owner.

Especially in the beginning. Fortunately, for the last 10 years,

I've been covered under my wife's medical plan which at that time

was FREE!!!!! And not just for the employee, but for the entire

FAMILY of the employee! That's an extreme example because when I

worked for a small CPA firm, all I got was just basic medical.

However, my wife is an executive and is in charge of payroll for

this HUGE corporation (one of the largest on Kauai), so it

didn't 'sting' so badly for them. Over the last decade, that corp.

has changed hands twice. Medical insurance has changed twice. NOW,

they obviously HAVE to cover their employees with basic medical but

they also always had drugs, dental, vision and went so far as chiro,

accupuncture at one time!!!! Now that our minor children are grown

and working for other businesses, THEY have their own insurance by

law and my wife has to pay a small percentage to have me covered on

her policy which pays very well for medical, dental, drugs and not

so well for accupunture and a few counselling/therapy thingys...it's

a good policy still and it's saved us close to a million dollars due

to my chronic conditions over the last 10 years.

I started TRT almost 2 months ago (just had the clinic give me my bi-

weekly injection this morning as a matter of fact!) and was

surprised to find that the medical insurance company treats

testosterone as if it were some sort of MEDICAL

EQUIPMENT!!!!!!!!!!!!! My wife and I couldn't believe it! We had to

pay a ONE TIME deductible amount of $100 and then $6 per multi-dose

vial of the same exact " T " that Brad is on. And just like Brad, I

have to pay $6 for a 10 dose vial of depo-t. My insurance covers the

cost of the pretty lady nurses to give me my injections. Since there

is NO copay and the clinic is three blocks away, I hoof it there

every other week and just bring my vial with me.

If you don't mind telling us, what STATE do you live in that makes

medical insurance such a drag???? I have to be sure NOT to EVER move

there! LOL! Oh, if my wife lost her job tomorrow and we needed to

get insurance right away? I have my own accounting business going

where I could get the exact same policy and pay about $700 a month

for the BOTH of us even with my PRE-EXISTING conditions!

Here all along I thought this was relatively common-place for all

states. I'm originally from Minnesota but moved here almost 17 years

ago and don't remember ever having any problems with health

insurance for my wife and children back then. I guess I just managed

to get REAL lucky and found the right jobs then.

But it STILL makes my wife and I shake our heads in disbelief when

we think of the insurance company treating testosterone like some

sort of medical equipment like a wheelchair or crutches!!!! Isn't

that weird? Well, actually...it kinda fits. Living here is weird

anyway.

Just thought I'd let you know how lucky you made me feel Jeff. Good

luck on that problem. I agree with Brad though, YOU shouldn't have

to pay THAT MUCH for your " T " .

Did you ever wind up taking any anti-d's? If so, what kind(s)? I am

on my 2nd day of not taking ANY anti-d after tapering slowly off of

20mgs of Celexa. I took that for 18 months and what I REALLY should

have had was this TRT instead. The symptoms are SO SIMILAR, I can

see how docs get low " T " confused with depression. But this

replacement therapy has been great and I actually feel so good as to

be able to quit my anti-depressant now! I also am starting to take

less and less of my pain medications (all narcotics).

I'm a happy camper!

Aloha for now,

Wayne

> >

> > Hello all...

> >

> > I was diagnosed as having a severe testosterone defficiency

almost

> > two years ago after having spent YEARS of having doctors try to

> > convince me that my fatigue, mood swings, lack of libido, etc

was

> > nothing more than depression. Over the last year, I've been

trying a

> > variety of treatments, including Androgel and currently the

> > injections.

> >

> > The problem I'm having is this: At the end of last year I

started my

> > own business with a friend. Since it's just the two of us, we

> > couldn't get a group plan and we go our individual insurances

> > privately. I was flat out declined by 3 companies and only one

would

> > cover me given I added a rider (sp?) onto my policy. I thought

the

> > rider was that my hypogonadism wouldn't be covered for 6 months

but

> > found out today that it's indefinite. The only way to have the

rider

> > removed is after 12 months and only if I no longer need

medication

> > for the condition. Because it's a chronic condition, it's not

going

> > to be lifted.

> >

> > Because the business I'm in is very slow growing, I knew up

front

> > that it could be as much as 12 months before I could draw a

salary

> > and am living on a very tight budget. $150 to $250 a month for

> > testosterone the next 6 months is not in that budget. Last

month, I

> > didn't have any testosterone and within a few weeks I had severe

> > headaches, fatigue, depression...I was the person I was almost 2

> > years ago and I didn't like it.

> >

> > It's hard enough only being 35 and having to deal with

infertility

> > and sexual dysfunction issues...now to have to deal with this is

a

> > bit much. My doctor managed somehow to get me some samples that

> > should last the next few weeks, but I'm really at my wits end.

Has

> > anyone had any other problems with insurance coverage in the

past?

> > Or does anyone know an insurance that might be a good one to

talk

> > to?

> >

> > Any help that I might get from anyone would be greatly

appreciated.

> >

> > Thanks,

> >

> > Jeff

> >

>

May 19, 2006

Hello Sir. Welcome to the group and Im available if you never wish to talk in

private. I understand what it feels like to have primary hypogonadism.

Instead of looking into so many different business insurance plans for heath

maybe you should seek information on public state and federally funded hospitals

and clinics. These type of medical outpatient services operate with little to no

cost to the patient providing you meet the quotas. No one has to know you own a

business. If you are applying toward state funded health insurance i.e medicaid

and medicare you would have to provide more specific information concerning your

employment, etc.

Public hospitals are different in the information they seek. Public hospitals

have their own department where medications are little cost if that person

doesnt have income and insurance. Doctors can make finacial exceptions that

void patient payment but to what direction I don't know. Something to research

or just call for infor from a public hospital.

Keep in mind T shots are controlled and Im not sure about androgel. In concise

Im sure in-house doesn't provide hypogonadism IM nor do they provide androgel.

Its not that prominent and the males that take it normally are older and have

medicare, etc

Until you can find insurance for your business maybe you can research which

state and public health hospitals and or clinics are within your area. Ask for

information before coming in. If you need to keep what you do secret so be it;

if you have to pay a small fee for meds and visits so be it.

The important thing is your health sir and you must combat your way in getting

better. Don't feel sorry but research all areas including out of state opinions

as well.

Hypogonadism consist of specialists that cost insurance companies big money.

Tests along with monthy treatments as well not to forget to mention the side

effects so few discuss. I can see why its hard to get coverage because in

America its about profit over caring for a life.

The problem with state funded insurance which is pretty good is, that person

must be in poor economic conditions. And of course their are " red-tape "

everywhere given our federal goverment is cheap while sending the money to fix

our problems in America over to other countries to fight situations that can't

be defeated with money alone.

It's sad how the middle class gets blowed without feeling pleasure. If you're

not poor or rich you have few options.

If I can help let me know.

" Does Shands provide free care for patients without

insurance?

Shands HealthCare is a state and federally funded

hospital. Shands Health Care does provide an

assistance program for those that qualify.

Our outpatient practices require some type of payment

at the time of the service. Most all departments will

work with patients to reach an agreement as to the amount

that is owed per each visit. For specific information,

please contact a financial representative in the office

in which you wish to be seen. "

Jeffers <jeffers1970@...> wrote: Hello all...

I was diagnosed as having a severe testosterone defficiency almost

two years ago after having spent YEARS of having doctors try to

convince me that my fatigue, mood swings, lack of libido, etc was

nothing more than depression. Over the last year, I've been trying a

variety of treatments, including Androgel and currently the

injections.

The problem I'm having is this: At the end of last year I started my

own business with a friend. Since it's just the two of us, we

couldn't get a group plan and we go our individual insurances

privately. I was flat out declined by 3 companies and only one would

cover me given I added a rider (sp?) onto my policy. I thought the

rider was that my hypogonadism wouldn't be covered for 6 months but

found out today that it's indefinite. The only way to have the rider

removed is after 12 months and only if I no longer need medication

for the condition. Because it's a chronic condition, it's not going

to be lifted.

Because the business I'm in is very slow growing, I knew up front

that it could be as much as 12 months before I could draw a salary

and am living on a very tight budget. $150 to $250 a month for

testosterone the next 6 months is not in that budget. Last month, I

didn't have any testosterone and within a few weeks I had severe

headaches, fatigue, depression...I was the person I was almost 2

years ago and I didn't like it.

It's hard enough only being 35 and having to deal with infertility

and sexual dysfunction issues...now to have to deal with this is a

bit much. My doctor managed somehow to get me some samples that

should last the next few weeks, but I'm really at my wits end. Has

anyone had any other problems with insurance coverage in the past?

Or does anyone know an insurance that might be a good one to talk

to?

Any help that I might get from anyone would be greatly appreciated.

Thanks,

Jeff

May 20, 2006

Hawaii is the ONLY state that mandates medical insurance for

employees of a company and their dependents. For that we are called

communist and antibusiness. Not to get off track, but the United

States is the only industrialized, Western nation where reasonable

healthcare is dependent on who you work for, or what state you live

in. Compared to the other 49 states, medical insurance premiums are

not outrageous in Hawaii. Why? Because more people are paying into

the system.

I do not understand what the problem is with testosterone

injections. But I do know that it seems to fall in the category of

unusual and exotic treatment according to the insurance companies.

People who need insulin are not treated this poorly.

> > >

> > > Hello all...

> > >

> > > I was diagnosed as having a severe testosterone defficiency

> almost

> > > two years ago after having spent YEARS of having doctors try to

> > > convince me that my fatigue, mood swings, lack of libido, etc

> was

> > > nothing more than depression. Over the last year, I've been

> trying a

> > > variety of treatments, including Androgel and currently the

> > > injections.

> > >

> > > The problem I'm having is this: At the end of last year I

> started my

> > > own business with a friend. Since it's just the two of us, we

> > > couldn't get a group plan and we go our individual insurances

> > > privately. I was flat out declined by 3 companies and only one

> would

> > > cover me given I added a rider (sp?) onto my policy. I thought

> the

> > > rider was that my hypogonadism wouldn't be covered for 6 months

> but

> > > found out today that it's indefinite. The only way to have the

> rider

> > > removed is after 12 months and only if I no longer need

> medication

> > > for the condition. Because it's a chronic condition, it's not

> going

> > > to be lifted.

> > >

> > > Because the business I'm in is very slow growing, I knew up

> front

> > > that it could be as much as 12 months before I could draw a

> salary

> > > and am living on a very tight budget. $150 to $250 a month for

> > > testosterone the next 6 months is not in that budget. Last

> month, I

> > > didn't have any testosterone and within a few weeks I had

severe

> > > headaches, fatigue, depression...I was the person I was almost

2

> > > years ago and I didn't like it.

> > >

> > > It's hard enough only being 35 and having to deal with

> infertility

> > > and sexual dysfunction issues...now to have to deal with this

is

> a

> > > bit much. My doctor managed somehow to get me some samples that

> > > should last the next few weeks, but I'm really at my wits end.

> Has

> > > anyone had any other problems with insurance coverage in the

> past?

> > > Or does anyone know an insurance that might be a good one to

> talk

> > > to?

> > >

> > > Any help that I might get from anyone would be greatly

> appreciated.

> > >

> > > Thanks,

> > >

> > > Jeff

> > >

> >

>

May 20, 2006

What I've done in the past is I formed a corporation with a minimum of

two people (the more people you have applying for the plan the better)

and then apply for group coverage for your company from one of your

medical insurance providers. Go through an insurance broker as they

sometimes know tricks to get accepted. Officers of the company do not

have to be on salary to qualify for the medical plan as it is

understood that officers/owners don't usually have salaries during the

startup phase and thus insurance companies can't deny them coverage

because they can't prove they have a paycheck. You may have to

provide some proof as to who the officers/owners are though. The more

people you have on the plan the better.

This was how I handled a period of time where I wasn't working and

didn't have insurance. Of course this still doesn't solve the cost

issue as often times the insurance premiums can cost more than the

treatment costs unless you still require a lot of testing. I figure I

broke even as far as treatment costs were compared to my premiums but

it was all the testing that really made the insurance pay off for me.

ASaxon