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Mexico Medical Tourism, frustrated with insurance pre-authorization

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  • Mexico Medical Tourism, frustrated with insurance pre-authorization

    I haven't been on here in several years, but frustrated by the continuing breakdown of the US medical system. My medication has been androgel, which has worked great for me for the last ten years, but each year my BCBS insurance makes me go through hoops with pre-authorization. The process is punitive, and in the last go-around, it took me four-months of dozens of calls to renew my medication, something I have been prescribed for TEN CONSECUTIVE YEARS! The problem is never with my doctor giving me a refill, it is the insurance company forcing him to fill out reams of paperwork for pre-authorization before the pharmacy can fill the order, despite my established medical history.

    With a new year approaching, I am dreading the torture chamber of getting pre-authorization and want to skip insurance entirely. I live in Texas and considering cash-pay medical services in Mexico. Anyone try this specifically with HRT and testosterone? Thanks!

  • #2
    Funny, I have BCBS and the pre-authorization when I was on Androgel just took a week or so and that was that. Refill went smooth. Now I am on Aveed injections and it also is going smooth. I am using a specialty pharmacy for it and the specialty pharmacy waives most of the copay as well.
    6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
    6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
    7/7/15: bHCG 56, AFP 42, LDH 322
    7/13/15 - 9/18/15: 4xEP
    10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
    10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
    4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
    4/20/16: RPLND @ IU - teratoma only!
    3/29/2018 all clears up to this date!

    Comment


    • #3
      Every BCBS is different depending on location, mine is Texas. Which state are you? Also, it has gotten 1000% worse in the last year.

      Comment


      • #4
        Ah, yes. I am in MN. Last year or the year before they went to a new computer system and changed everyone's ID numbers. They reset our out-of-pocket tally at that time on accident and caused a bit of a paperwork issue. Took about 2-3 months but that finally got settled correctly.
        6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
        6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
        7/7/15: bHCG 56, AFP 42, LDH 322
        7/13/15 - 9/18/15: 4xEP
        10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
        10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
        4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
        4/20/16: RPLND @ IU - teratoma only!
        3/29/2018 all clears up to this date!

        Comment


        • #5
          It's because it's so expensive, (close to $400/month when I was on it) My currant insurance refuses it completely so I switched to injections every 3 weeks which is actually more convenient as well as very low cost. My company is switching prviders next year, & I'm not sure if I'd go back if it is covered.

          BTW, there is a generic version of Androgel 1% available, itwas the last one I was on & it worked very well.It was just clled"testosterone Gel" 7 the one I was on was made by Perrigo:
          https://www.perrigo.com/business/pro...x?ID=351&let=T

          It was still pricey, but a bit less than Androgel.

          Dave
          Jan, 1975: Right I/O, followed by RPLND
          Dec, 2009: Left I/O, followed by 3xBEP

          Comment


          • #6
            I had a horrible time getting BCBSTX to approve my testosterone. My company switched to them this year, in previous years I'd had UHC and Aetna. I've been on it for nearly 4 years and never had any trouble, then all of a sudden I go to the pharmacy and they tell me I need pre-authorization. It took nearly a month to get everything worked out. Come to find out, they really just wanted two different blood draws. My doctor was trying to go through an appeal process because he thought it was stupid that they wanted two blood draws for someone that very clearly needs testosterone; but after I got off the phone with the pharmacy benefit manager I got my doctor to call in an order for a second blood test and the next day I got my testosterone.
            Back pain Nov 2012
            Got Engaged 4/27/13
            Swollen neck lymph node 5/13
            Diagnosed with stage IIIB non-seminoma 6/13/13
            AFP 3,511
            Beta HCG 19,482
            Lung and lymph node metastasis
            Large tumor in abdomen caused my back pain
            Testicular tumor could only be seen with ultrasound
            4xBEP 6/25/13-9/10/13
            Graduated college 8/15/13
            Markers normalized
            RPLND and Orchiectomy 11/11/13
            Beta HCG: 38.5 on 12/17/13
            Start 4x TIP 12/17/13
            Got Married on 12/27/13
            Neuropathy: plans change. 3x TIP + 2x ATP

            Comment


            • #7
              where are you in texas? when I was living in Houston I was going to the Low T Center to get my injections. I think they're better equipped to handle the insurance company paperwork. When I moved to Mississippi I had to get a urologist to write me a prescription for the self injected testosterone.
              Back pain Nov 2012
              Got Engaged 4/27/13
              Swollen neck lymph node 5/13
              Diagnosed with stage IIIB non-seminoma 6/13/13
              AFP 3,511
              Beta HCG 19,482
              Lung and lymph node metastasis
              Large tumor in abdomen caused my back pain
              Testicular tumor could only be seen with ultrasound
              4xBEP 6/25/13-9/10/13
              Graduated college 8/15/13
              Markers normalized
              RPLND and Orchiectomy 11/11/13
              Beta HCG: 38.5 on 12/17/13
              Start 4x TIP 12/17/13
              Got Married on 12/27/13
              Neuropathy: plans change. 3x TIP + 2x ATP

              Comment

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