Best insurance plan for TRT? (Testopel coverage)

[Pacman]

Hi there! This is indeed my first post, but I'd rather just get straight to the point.

Short history of myself:

26 years old, white male, I have primary hypogonadism, azoospermia, and I am an XYY mosaic. Causes of the primary hypogonadism are unknown, as I've not always had it (and I been to 4 urologists, 2 endocrinologists, and 1 geneticist - none of them have any flippin' clue how it happened). I experienced the symptoms of low T since I was about 19, but never actually paid too much attention to them until I got my T levels tested in October 2013 (I was 25). I've been on Androgel 1.62% (currently 4 pumps daily) since November 2013. T levels never rose above 450 Total, 75 Free the entire year I've been on TRT (and the 4 out of 5 tests I've done the levels were much lower while on TRT).

Now to my question:

I have been advised to go on Testopel, as this was explained to have the highest likelihood to bring my free T levels up to the 800 range without the potential negative side effects of the shots. Plus, I'd only have to come in once every 3-6 months (or something like that).

Uninsured, the pellets cost $1000 per insertion.

I'm trying to find the best insurance company that:

1. Will most likely approve of me being on the therapy (I know that they are all reluctant with sponsoring the expensive therapies, which is why they all love the shots)

2. Will have the highest coverage of the therapy.


Do any of you have any experience with this? Which companies or types of insurance plans tend to cover TRT (Testopel in particular) more than others? The open enrollment starts in just another two weeks, and I am really considering switching to a new insurance plan, possibly to another company if it's better for TRT (currently I have Florida Blue's 'Everyday Health BlueSelect 1451').

 

[Hydranted]

Injections are the safest, cheapest, and most effective way to administer TRT.

You will save a TON of money by opting for injections over the pellets.

 

[Pacman]

Injections are the safest, cheapest, and most effective way to administer TRT.

You will save a TON of money by opting for injections over the pellets.

Except for the fact that my endocrinologist says that injections come with many cumbersome side effects. Urologist agrees with him as well.

 

[Pacman]

And I'm interested in Testopel, as I mentioned in my first post.

 

[Hydranted]

Except for the fact that my endocrinologist says that injections come with many cumbersome side effects. Urologist agrees with him as well.

I would be curious to hear what side effects they claim to come along with injections but not with pellets. I'm not aware of any.

Pellets don't allow for much control. Injection protocols can be tweaked to optimize TRT for the patient and minimize side effects. The same cannot be said for the pellets.

 

[Pacman]

I would be curious to hear what side effects they claim to come along with injections but not with pellets. I'm not aware of any.

Pellets don't allow for much control. Injection protocols can be tweaked to optimize TRT for the patient and minimize side effects. The same cannot be said for the pellets.

You may be right. I'm still interested in trying the pellets out to see if they are right me. I think that every individual's needs are different, so mine may be different than yours. I am not saying that you are wrong, but I am saying that I was advised by my doctors to do the pellets. So all I'm trying to do is find the best insurance option for that. Worst case scenario, we'll stop the pellet therapy, I'll start with the shots, and I'll post a new thread letting you know you were right. I'd still like to find out for myself though.

 

[Hydranted]

Fair enough. Good luck.

 

[Nelson Vergel]

Very few insurance companies pay for Testopel since these pellets are expensive. If you want less frequent injections, you may want to talk to your doctor about Aveed.

If you have issues with injections, you may want to look at my protocol since it is easy and painless. It also combines HCG with TRT.

https://www.excelmale.com/?s=149-Ho...o-Preserve-Fertility-Libido-and-Testicle-Size

Here is some information on different testosterone therapy options:

Testosterone Replacement Treatment Options

 

[Pacman]

Thank you Hydranted.

Does anyone on this site have any advice regarding insurance plans? That's my main question here? There has to be people here who have experience with different types of plans and insurance carriers (and different types of therapies on those plans/companies).

This is very important to me, because my life is slowly turning around for the better through testosterone replacement therapy, and I want to be able to find the best treatment for myself without losing all my money in the process. Anyone? Please? Even if you personally don't know, maybe you know of someone or some resource that might know? I appreciate any type of helpful feedback and leads.

Thank you all in advance!!

 

[Pacman]

Hi Nelson!

I just saw your post right after I posted my above reply.

The only issue that I have with HCG is that I have primary hypogonadism - which means that my LH and FSH levels are through the roof naturally, even while on TRT (which to me is very strange, because my body's T levels are currently within "range", and the LH/FSH levels haven't dropped much from before I started the therapy). What's interesting is that even though I have primary hypogonadism, I do not have testicular atrophy. My testicles are normal size thank God.

I was considering shots a while back, but according to my endocrinologist, the shots come with some very big perceived disadvantages:

1. Testosterone level fluctuations are a negative side effect (very high right after the shot, very low right before; and he says it is not wise to do it more often than once every three weeks)

2. It increases the chances that I'd need to be prescribed an aromatase inhibitor as well, and he says he prefers not to prescribe me that, because the studies of aromatase inhibitors on young males are inconclusive.

3. I would need to come in for the shot, rather than self-inject, because it is hard to self-inject myself in the butt. [Side note: I see a lot of talk about people here self-injecting, as well as a guide here on the site. Are there cases where it is permissible, and other cases not?]

So the first two reasons are the main causes for my doctor to suggest against the shots, with the third one as an additional side reason pain in the butt (figuratively and literally lol).

I will definitely check out the Aveed option, but can I also get advice on Testopel? Has anyone here been on it and been covered by their insurance policies?

 

[Nelson Vergel]

No problem. You will need HCG when you start any TRT. Your LH will drop to zero, no matter what type of hypogonadism you have.

I do not think you watched the video. I describe an easy two times per week injection protocol that minimizes T level fluctuations.

Most men do not need aromatase inhibitors no matter what TRT option they use. Pellets are not exempted.

There is no website listing insurance companies that pay for Testopel. You would have to go to every insurance company (or Affordable Care Act site) and read their medication formulary to find out what they pay for.

Most doctors that prescribe Testopel do so because they get a nice margin from the company that gives them a wholesale price for the pellets for them to mark it up. Once those pellets are inside of you, it is impossible to decrease the dose. And most doctors promise you too much. 12 pellets in a 160 Lb man really last 2 months if you want your total T to be over 500 ng/dL.

Watch the video above so that you can see that your third question may not be an issue.

Your doctor may have his own agenda with Testopel, so be careful about how he presents the case for them.

 

[Nelson Vergel]

Please read these posts before you make up your mind:

Testosterone Pellets, Sublingual and Buccal (Mouth)
Testosterone Pellet Dose Comparison

 

[Hydranted]

I was considering shots a while back, but according to my endocrinologist, the shots come with some very big perceived disadvantages:

1. Testosterone level fluctuations are a negative side effect (very high right after the shot, very low right before; and he says it is not wise to do it more often than once every three weeks)

It doesn't sound like your doctor is up to speed with current best practices in TRT. Injections every 3 weeks is a terrible protocol and will leave you feeling like crap. Most guys inject once or twice weekly and T levels remain very stable.

2. It increases the chances that I'd need to be prescribed an aromatase inhibitor as well, and he says he prefers not to prescribe me that, because the studies of aromatase inhibitors on young males are inconclusive.

Injections don't increase the chance of needing an AI any more than pellets do. Any way you slice it, you're still taking exogenous testosterone. Most guys on TRT will not need an AI as long as they are taking the right amount of testosterone.

3. I would need to come in for the shot, rather than self-inject, because it is hard to self-inject myself in the butt. [Side note: I see a lot of talk about people here self-injecting, as well as a guide here on the site. Are there cases where it is permissible, and other cases not?]

There are other injection sites that can be used besides the glutes. Gluteal injections take a bit of practice but it's not as hard as it sounds. You don't have to twist all the way around. Most guys inject at home as well. In most cases, doctors want you to come in for injections for the sole reason of billing your insurance for a doctor visit.

I will definitely check out the Aveed option, but can I also get advice on Testopel? Has anyone here been on it and been covered by their insurance policies?

Bolded my input.

 

[bruin]

@Pacman........insist on being instructed in the technique of self injection,

 

[bruin]

Regarding insurance plans I think the rule of thumb is fairly simple. Its all about money, how much can you afford for a premium and out of pocket expenses, the higher level policy you have the more coverage of DR visitis, rx, and tests. I have the top o the line Anthem policy and it is worth every penney. If there are some out to this world costs for a rx, simple way to get around that by going directly to the mfg. as they are more than happy to take whatever your ins co will pay rather than have you switch to a generic or other brand.

 

[Pacman]

Wow. The urologist I saw did not describe the pellet at all in the fashion it is being described here. He told me that all I need is to have a pellet inserted in me every 3-6 months, and my testosterone levels will safely go up to approximately 800 with barely any side effects. He didn't explicitly say it would only be one pellet, but I assumed that's what he meant. This sounds like a dream come true! High T levels, so convenient, and barely any side effects? That's why I was so stuck on it. But from what I hear on this forum and from Nelson, that it's not that simple? Besides for price of treatment, there actually isn't a guarantee that it will bring the T levels up to 800 like the urologist promised?

I am actually VERY curious about the shots right now, and I would love if someone were to answer some questions I have about that treatment:

1. What about the testosterone fluctuations from doing the shots that my endocrinologist warned me about? Should I request bi-weekly injections? Would that keep everything more stable?

2. What dosage would be a good starting dosage considering that I'm on 4 pumps of Androgel 1.62% for about a year now, and my total T never went above 450? Should I be starting at a higher dosage?

3. When I do the blood tests to see how effective the treatment is, when should it be done? Should it be done the day before I do an injection? (Side note: I always do my blood tests before I apply the Androgel the same day)

4. I know that this question may bring up some controversy, but what is the most effective TRT form of treatment for building muscle? My endocrinologist said "you shouldn't be on TRT for that reason". But the truth is, building muscle and getting in shape is so much more important to me right now than having a sex drive (which is what my endocrinologist seems to put the most emphasis on every time I see him). I do not have a girlfriend right now, and the most important priority for me in life, is to get very fit! I am not trying to use TRT like steroids, but if I am already on it, might as well choose the most effective form of TRT for building muscle, don't you agree? What form/dosage of the shots (or other forms of TRT) have shown to be the most effective for bodybuilding and workouts?

Thank you all in advance for helping me out!

 

[Hydranted]

Wow. The urologist I saw did not describe the pellet at all in the fashion it is being described here. He told me that all I need is to have a pellet inserted in me every 3-6 months, and my testosterone levels will safely go up to approximately 800 with barely any side effects. He didn't explicitly say it would only be one pellet, but I assumed that's what he meant. This sounds like a dream come true! High T levels, so convenient, and barely any side effects? That's why I was so stuck on it. But from what I hear on this forum and from Nelson, that it's not that simple? Besides for price of treatment, there actually isn't a guarantee that it will bring the T levels up to 800 like the urologist promised?

I am actually VERY curious about the shots right now, and I would love if someone were to answer some questions I have about that treatment:

1. What about the testosterone fluctuations from doing the shots that my endocrinologist warned me about? Should I request bi-weekly injections? Would that keep everything more stable?

Typically the large fluctuations are only an issue on bad protocols, like every two weeks. Or when doses that are far too large are injected at once. Bi-weekly injections will ensure very stable levels. Many guys do just fine on a once per week protocol, but bi-weekly works better for some.

2. What dosage would be a good starting dosage considering that I'm on 4 pumps of Androgel 1.62% for about a year now, and my total T never went above 450? Should I be starting at a higher dosage?

Most guys start on 100mg/week. It's a reasonable dose and will work great for many. Follow up bloodwork after a couple of months, plus a review of how you're feeling will dictate if you need to adjust the dose in either direction.

3. When I do the blood tests to see how effective the treatment is, when should it be done? Should it be done the day before I do an injection? (Side note: I always do my blood tests before I apply the Androgel the same day)

Follow up labs are usually done roughly 8 weeks after starting treatment. Most doctors will want a "trough" reading, which is when your levels are the lowest. Timing depends on your protocol. If you were injecting 100mg of testosterone once per week, let's just say on a Sunday, and 250iu of hCG on days 5 & 6 (Friday and Saturday) after your testosterone injection. You would want to have labs drawn on day 5 but before you injected your hCG.

4. I know that this question may bring up some controversy, but what is the most effective TRT form of treatment for building muscle? My endocrinologist said "you shouldn't be on TRT for that reason". But the truth is, building muscle and getting in shape is so much more important to me right now than having a sex drive (which is what my endocrinologist seems to put the most emphasis on every time I see him). I do not have a girlfriend right now, and the most important priority for me in life, is to get very fit! I am not trying to use TRT like steroids, but if I am already on it, might as well choose the most effective form of TRT for building muscle, don't you agree? What form/dosage of the shots (or other forms of TRT) have shown to be the most effective for bodybuilding and workouts?

Injections.

Thank you all in advance for helping me out!

Hope this helps.

 

[Sungolf28]

Nelson: Unfortunately I don't know what insurance companies will pay but I do know I paid for my TRT pellets since I had to do something to get my life & energy back. Found a hormone/testosterone pro which was 5th Dr I had seen who knew what & how to treat. He had the pellets compounded with testosterone & an estradiol lowering med. My orig blood test was 249 TT and 48 estradiol. Other items tested were normal. At follow up testing after 5 wks, TT was 1045 & Estradiol was 26. Cost me $725 for the pellets insertation & all office visits. My insurance covers blood test. Best and most benefit I have received for the money. I go back in 4 months for insertation of more pharmacy compounded pellets. By the way I'm 68 and feeling like I'm 40 again! Good luck.

 

[Vince]

Pacman, if you inject twice weekly your levels stay steady and I inject in my shoulders very easy https://www.youtube.com/watch?v=0uXoBb6mkys and i never injected myself with anything before. but it is a hard decision to make.

 

[Phoenix]

Except for the fact that my endocrinologist says that injections come with many cumbersome side effects. Urologist agrees with him as well.

I question the motives of any MD or clinic that doesn't offer options for TRT.