Trimix and insurance coverage

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Mark R.
New Member

Date Joined May 2008
Total Posts : 11
   Posted 5/14/2008 7:20 AM (GMT -6)   
My Trimix costs me $90 per 5ml bottle from Wedgewood pharmacy and my insurance, Blue Cross/Blue Shield group policy, only pays $5. They use to cover the PGE1 completely less a small copay. Anybody get BC/BS to cover Trimix? Any suggestions?
"In theory, theory and practice are the same, in practice they're not"
Joined Club PCa 4/17/08 with an open radical retropubic prostatectomy
PSA 2.8>3.4 in 6 months
3/12 positive biopsy cores, T1a
Gleason 6 - pre/post op,
Margins, bone scan, x-ray negative.
Cat-scan showed kidney mass, removed 3/14 via radio frequency ablation
Catheter 18 days, dry immediately with some conscious effort
Living with Multiple Sclerosis for 20 years - now PCa and questionable renal mass - I'm an overachiever!

Tim G
Veteran Member

Date Joined Jul 2006
Total Posts : 2291
   Posted 5/14/2008 10:44 AM (GMT -6)   
I use Wedgewood Pharmacy in NJ as well and my insurance covered for $20.  It's $120 for the Quad-Mix.  

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 5/14/2008 10:47 AM (GMT -6)   
I spoke with my BC/BS Tenn case manager while recovering, and while she was still on my case. She said that Bimix or Trimix wasn't covered, as it was a compound and they didn't cover those. They also only allow 4 ED pills per month. Strangely, they did cover the Caverject Powder.
James C.
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