Defy Users: Have you gotten insurance to pay?

[WhatSayYou89]

Has anyone who is with Defy got insurance to reimburse them?

I know Defy can fill out the form to send to my insurance company but was just seeing if it was even worth the time to try.

 

[captain]

I am not with Defy but I have use an HSA to pay for such things with no problem. Insurance has paid for all my labs except for DHT. As for meds you use a compounding pharmacy to avoid insurance.

 

[Vince Carter]

I used to use that information from my provider to file my own claims for reimbursement and it was a horrible hassle, so much information my insurance wanted, codes and all of that and I did get some money back here and there but it was like I said a nightmare dealing with an insurance company, part of that prompted me to switch to Defy so I could afford to pay this OOP and not mess with insurance any more. Nightmare too as in they'd reject the claim for arbitrary shit and then make me refile it from scratch and they take 30 days each time to approve, mostly reject, the claim. Real PITA.

 

[Vince]

It was a pain for me to try to get my insurance to pay for it, they never did. I couldn't even get my flexible spending account to pay for it. I just pay everything out of pocket, I'm happy they are affordable.

 

[Roguejim]

I have Blue Cross Federal. I specifically asked if they would cover Testo. They will only cover hrt if one is undergoing transgender surgery. Scam.

 

[Vince Carter]

When I tried to get CVS to pay for Test, compounded test, they wanted the atomic weight of every single ingredient used in the compound. In the end that was the breaking point...they used every single kind of excuse such as that and every means to not pay on the meds. I had some luck with blood tests and a Dr's visit but they paid miniscule amounts on those too with "out of network" excuses, too.

 

[CoastWatcher]

I have Blue Cross Federal. I specifically asked if they would cover Testo. They will only cover hrt if one is undergoing transgender surgery. Scam.

That will certainly hold down the number of claims they have to pay.

 

[Vince Carter]

That will certainly hold down the number of claims they have to pay.

not these days it seems (a little sarcasm)

 

[Jon H]

Roguejim - I have BCBS Federal and they pay for both testosterone and anastrozole through my regular doctor. Test usually ends up costing $7 at CVS for a 10ml vial, and anastrozole is almost free. ...and I'm just on TRT, not changing gender.

Sorry if I'm not answering the original question in this thread. I never tried to get reimbursed for testosterone while being a Defy patient. It simply wasn't worth the hassle.

 

[Vince Carter]

Roguejim - I have BCBS Federal and they pay for both testosterone and anastrozole through my regular doctor. Test usually ends up costing $7 at CVS for a 10ml vial, and anastrozole is almost free. ...and I'm just on TRT, not changing gender.

Sorry if I'm not answering the original question in this thread. I never tried to get reimbursed for testosterone while being a Defy patient. It simply wasn't worth the hassle.

Ya that's not what we're talking about.

 

[crazyhaha]

I have Blue Cross Federal. I specifically asked if they would cover Testo. They will only cover hrt if one is undergoing transgender surgery. Scam.

I have BCBS Fed (standard) and they cover test cyp. as long as the doctor fills out a medical necessity/prior approval form. They wont cover HCG.

 

[pyater]

I have a similar question. Just in the process of switching of local urologist to Defy. Previously, my insurance was covering visits, test cypionate shots and bloodwork with deductibles and co pay. Wondering if there is a way to do this with Defy and submitting on my own?

 

[Jesse-Defy]

I have a similar question. Just in the process of switching of local urologist to Defy. Previously, my insurance was covering visits, test cypionate shots and bloodwork with deductibles and co pay. Wondering if there is a way to do this with Defy and submitting on my own?

Each insurance company will be different, and at the end of the day, the only way to find out is to try. We will complete a reimbursement form, called a CMS-1500 form. It's $16 for us to do so, and we'll mail it to you directly. Just call the office or email [email protected] authorizing the payment of $16 and provide the address you'd like the form mailed to.

 

[cholondo]

Ya that's not what we're talking about.

good to know... I have BCBS Federal (Basic) and just submitted for reimbursement from Defy... I didn't have pre-approval but from reading other forums it seems like they might at least reimburse the cost of the labs..bless their hearts (sarcasm).. we'll see if the medical necessity and all of that gets me any money back.

edit -- meant to reply to crazyhaha.. .of course I messed it up since it's my first post.