insurance

Sticking a needle Where? Courage, guidance and help.
dtwarren1942
Posts: 1907
Joined: Wed Oct 27, 2010 7:58 pm
Location: Jersey Shore

Re: insurance

Postby dtwarren1942 » Sat Oct 25, 2014 3:16 pm

I believe Avela charges $80 for 10 ml of Trimix and Caremark billed me $40 for my co-pay. Not a major difference in net cost to me. However, since Trimix has become less effective, I will be using my VED/tension band more often - no cost at all.
Age 81
Diabetic
Pumping
Started Trimix injections 8/'11

Spartan
Posts: 57
Joined: Thu Jan 19, 2012 9:19 pm
Location: Phoenix AZ

Re: insurance

Postby Spartan » Tue Oct 28, 2014 7:51 pm

tomas1 wrote:The point of my reply was that 4, 2ml vials for $110 isn't too bad if you don't have insurance.

Thank you for pointing that out.

I use only 0.06 mL per dose, so four2 mL vials would expire before I would use them up. I believe that a big part of the price is the cost for compounding the medication. So, the cost per mL may be less when larger batches are prepared?

Avella has closed their Glendale office, consolidating their Phoenix operations in Scottsdale. I am going to price it at the Mayo Hospital outpatient pharmacy to see what that would cost. That would be closer for me and I go there anyway to see my urologist.

Spartan
Posts: 57
Joined: Thu Jan 19, 2012 9:19 pm
Location: Phoenix AZ

Re: insurance

Postby Spartan » Tue Oct 28, 2014 7:54 pm

dtwarren1942 wrote:I believe Avela charges $80 for 10 ml of Trimix and Caremark billed me $40 for my co-pay. Not a major difference in net cost to me. However, since Trimix has become less effective, I will be using my VED/tension band more often - no cost at all.

Have you had your prescription refilled recently? It was Caremark that the original poster had cancel coverage for compounded meds. He has his filled at Avella too.

tomas1
Posts: 1956
Joined: Tue Jul 23, 2013 5:12 pm
Location: Tempe, AZ

Re: insurance

Postby tomas1 » Tue Oct 28, 2014 8:09 pm

The thing that I like about my compounder is that they give vials with dry tri-mix that I add the sodium chloride (supplied) to. Although the packages contain a use by date, I don't believe it can go bad.
85 years
Inject testosterone weekly.
Implant on 1/22/19 by Dr Avila.
Scrotal, hor. incision just over 1"
18cm AMS 700 CX, 3.5cm RTE 100cc res
Gleason 6 prostate cancer. Monitoring it for now.
Update: On my last biopsies the cancer wasn't found.

dtwarren1942
Posts: 1907
Joined: Wed Oct 27, 2010 7:58 pm
Location: Jersey Shore

Re: insurance

Postby dtwarren1942 » Tue Oct 28, 2014 9:16 pm

Spartan wrote:Have you had your prescription refilled recently? It was Caremark that the original poster had cancel coverage for compounded meds. He has his filled at Avella too.

I placed my last order just before the "cut off" date. I will not need to reorder for another two months. I will let you know then what happens.
Age 81
Diabetic
Pumping
Started Trimix injections 8/'11

Spartan
Posts: 57
Joined: Thu Jan 19, 2012 9:19 pm
Location: Phoenix AZ

Re: insurance

Postby Spartan » Tue Oct 28, 2014 10:53 pm

tomas1 wrote:The thing that I like about my compounder is that they give vials with dry tri-mix that I add the sodium chloride (supplied) to. Although the packages contain a use by date, I don't believe it can go bad.

That is cool!

Actually, as I understand it, that is how Caverject is supplied. It's in powder form. You inject the saline solution into the vial with dry powder and then withdraw the amount that you want to use. Or something like that. I believe the rest is discarded, but I don't see why you couldn't freeze it. For this technology the cost is in the $800 range for 18 doses! However, I believe that Caverject is straight Alprostadil (PGE-1). Caverject and Edex are charging big $$$$ just for the injection system.

Personally, I'll stick with Trimix, even if I have to pay out of pocket.

dtwarren1942
Posts: 1907
Joined: Wed Oct 27, 2010 7:58 pm
Location: Jersey Shore

Re: insurance Update

Postby dtwarren1942 » Wed Dec 10, 2014 4:07 pm

Placed my order for Trimix with Avella last Friday. The rep advised that after insurance (CareMark), my cost would be $40 for 5, 2 ml vials and charged my credit charge accordingly but advised that if there was a change in cost, I would be advised by phone prior to shipment. Today, Wednesday, I received my order so I assume, Avella received approval from Caremark.

If I hear differently, I will update the thread.
Age 81
Diabetic
Pumping
Started Trimix injections 8/'11

ohohiakane
Posts: 413
Joined: Tue Nov 23, 2010 9:43 am
Location: Michigan. Email Ohohiakane@yahoo.com
Contact:

Re: insurance

Postby ohohiakane » Wed Dec 10, 2014 10:56 pm

Spartan,

CVS is likely not able to compound Trimix as Compounding Pharmace need to have STERILE ROOMS for Compounding.... Two of my compounding pharmacy have gone out of business when govt. inspectors found that their rooms were NOT sterile.

I don't know anything about other state's Compounding laws
75 Year Old guy in Michigan, married in 1958, ED since late '90s, then surgery in 2008 (not prostate or other genital) damaged some nerves making the ED worse. Now on trimix

Personal email Ohohiakane@yahoo.com
am always willing to discuss stuff and help

wlliam40
Posts: 9
Joined: Tue Jan 13, 2015 5:59 pm

Re: insurance

Postby wlliam40 » Sat Jan 24, 2015 4:12 pm

I filled my Rx with a Compound Pharmacy in Clayton MO and was told that my insurance (medicare and Tricare) did not cover the RX. Yesterday I checked the Marion Illinois VA and they do not cover TriMix 5, I am a retired USAF NCO and I checked with express scripts and it is covered there, my out of pocket expense $17.00

spanzo
Posts: 44
Joined: Mon Apr 29, 2013 11:29 pm

Re: insurance

Postby spanzo » Sun Jan 25, 2015 11:32 am

my insurance still covers it. There have been some horrible problems at USA compounding centers in the news (spinal meningitis), so maybe your ins. company is scared of the liability?


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