insurance

[springer]

Just got letter from my insurance company {carmark}.tri-mix no longer covered by them. They are saying compounds not FDA approved. Any body else getting dropped from there insurance company? Funny how insurance company management can override Doctors prescriptions. Love my tri-mix supercharger.

[ohohiakane]

Springer......
I have been using (very successfully, btw ) trimix for over 3 years... and it has always been "out of pocket"... but worth it .
Since my dose is very small, i have calculated that the cost is under one dollar per use. I will not complain at all.

Bill

[Spartan]

I'm curious to know how many of us have insurance that covers our Trimix. Is there a trend in denial of coverage as cited by Springer?

For me, I am on a Medicare Part D prescription plan provided by my pension plan. It is administered by Express Scripts. I have a $10 copay for two 2ml vials.

[dtwarren1942]

Caremark is my insurance provider and they covered my last order in August from Avella in AZ. Two years ago, Caremark turned down an order from my previous compounding pharmacy because that pharmacy refused to provide costing details on the individual ingredients.

What was the date of the Caremark letter?

[springer]

carmark stop coverage as of September 27 2014. they made compounds sound like witch doctors....how disappointing...cost for my copay went from 35 dollars to no copay 93 dollars....still can do it just frustrating

[tomas1]

I don't have any prescription insurance except for the VA. I don't bother with the VA since so many others need it more than I do.
I pay $110 for 4 vials of 2ml each. It's still a hell of a lot cheaper than US Viagra/Levitra.

[Spartan]

Like Springer, last week I had my Trimix refilled by Avella Pharmacy and was advised that my insurance would no longer cover the cost. My cost went from $10 copay to $92 self-pay for 4 mL. I'm certainly willing to self-pay for Trimix just to get it.

Interesting that Express Scripts probably makes no money paying for compounded drugs, however they make $$$ for their 3 month mail order pharmacy! As an alternative I could obtain 18 doses of Edex every 90 days through their mail order service. According to their website, 18 doses of 10 mcg of Edex (the limit for 90 days supply) costs $4,766.36 with a $70 copay! 40 mcg dosage has an $8,407.25 price tag!. Caverject is much less costly at $678.74 for the 10 mcg kits.

The point is that they would pay over $4,000 for 18 doses of Edex, but not $82 (their portion) for 4 mL of Trimix.

Their claim is that compounded drugs are not verified to be effective!

[tomas1]

Spartan, I use Community Clinical Pharmacy located near Dobson and Southern in the Banner Desert hospital complex. I think that's what it's called now.
Phone is: (480) 969-0600. I see you're in Phoenix, so it should be easy to get there.

[Spartan]

Spartan, I use Community Clinical Pharmacy located near Dobson and Southern in the Banner Desert hospital complex. I think that's what it's called now.
Phone is: (480) 969-0600. I see you're in Phoenix, so it should be easy to get there.

No problem finding a pharmacy to fill the Rx. Problem is with insurance coverage that has changed.

My insurance will no longer cover any compounded prescriptions (Trimix, etc.). If other insurance carriers are doing the same thing, it's a huge issue.

I suspect that Express Scripts, Caremark (CVS) (see original post) would rather sell prescriptions through their mail order, or in the case of CVS their own stores, than to pay someone else to compound a medication. There is a lot more profit in selling Caverject and Edex than paying someone else to compound a medication.

My insurance carrier told me that compounded drugs aren't proven for effectiveness! Tell that to my penis! My Rx is from my doctor at Mayo Clinic. Mayo is well known for practicing outcome based medicine. They wouldn't be prescribing if it didn't work. And it does work!

[tomas1]

The point of my reply was that 4, 2ml vials for $110 isn't too bad if you don't have insurance.