Cialis not covered by HMO

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rick27
Regular Member


Date Joined Sep 2010
Total Posts : 71
   Posted 11/13/2010 4:35 PM (GMT -6)   
Doc prescribed Cialis to keep little Rick on life support until he wakes up. My HMO doesn't cover prescription drugs like Cialis , Viagra, or Levitra. Before I go out of pocket, does anyone have any suggestions for where to get it cheap, or of any holistic things that work?
History: 2 brothers with prostate cancer
Age 56
PSA at age 45: 4.7. DRE normal.
PSA at age 52: 8.0. DRE normal. 1st biopsy 12 cores, negative
PSA at age 55: 9.5. DRE normal. 2nd biopsy positive 2 of 14, gleason 3+3. both cores <5%, Start WW
PSA at age 56: 9.2. DRE normal. 3rd biopsy positive 4 of 14, 3 cores <5%, 1 core 7% Gleason 3+4 in 1 core, prostate 81cc
LRP, no robot, Sloan Kettering 11/4/10

Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 374
   Posted 11/13/2010 5:01 PM (GMT -6)   
Hi Rick...........congrats on the outcome of your surgery. Quite a few of us here use Viagra, Levitra and Cialis that is manufactured in India, and obtained through the website www.alldaychemist.com-------they can't call any of the equivalents by their trade name, but they are the same drug, just way cheaper. The Viagra ("Manly") costs about $.58  per pill versus $9-10 thorugh conventional RX and insurance. My surgeon and many others sanctioned it, and i've been using for about 18 months. The Levitra an Cialis equivalents are slightly more expensive, but still correspondingly way cheaper than the brand name drugs. Safe and relatively easy to purchase. If you choose Cialis, you have to indicate that you will be traveling abroad for them to ship. They usually have a "buy one, get one free" sale running on different amounts you can order............give it a shot.
 
Arnie in DE

rick27
Regular Member


Date Joined Sep 2010
Total Posts : 71
   Posted 11/13/2010 5:11 PM (GMT -6)   
Great! Thanks Arnie.
History: 2 brothers with prostate cancer
Age 56
PSA at age 45: 4.7. DRE normal.
PSA at age 52: 8.0. DRE normal. 1st biopsy 12 cores, negative
PSA at age 55: 9.5. DRE normal. 2nd biopsy positive 2 of 14, gleason 3+3. both cores <5%, Start WW
PSA at age 56: 9.2. DRE normal. 3rd biopsy positive 4 of 14, 3 cores <5%, 1 core 7% Gleason 3+4 in 1 core, prostate 81cc
LRP, no robot, Sloan Kettering 11/4/10

airborne72
New Member


Date Joined Oct 2010
Total Posts : 11
   Posted 11/13/2010 5:35 PM (GMT -6)   
Rick:

I encountered the same situation. I religiously followed the "penile rehabilitation" program written/provided by the surgeon while using the samples of Levitra. Unfortuantely, I had a surgical clip migrating through my ureter during the process. Scar tissue and other issues resulted. Needless to say, I became "gun shy" and backed off the rehab regimen. On Dec 30 of last year I when to the Kroger pharmacy to get the prescription filled prior to the reset of insurance deductibles. The attractive pharmacist (why does it always turn out this way) told me that it would be $160. I told her that I only wanted to fill one prescription, not all five. She said that was only one (8 pills), but that the insurance (Anthem BC/BS) would not cover it. I told her that even if the pills worked it would not be worth the cost.

Curious, is BC/BS your insurer?

Jim

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 11/13/2010 5:44 PM (GMT -6)   
I've used the ADC site for the Cialis generic twice now. You will want to make sure you respond to the email if they ask you to acknowledge you will not be using it in the US. Covers them i'm sure. You can follow the deliver through us customs and everything... could be there a week or so, but then, all of a sudden, you've got a mailing from india at your doorstep. Both times, no problem.

I would note there is a $25+- shipping fee.. so you're better off ordering a larger amount. Here is an example of my recent order - My Dr had given me 5mg Cialis.. these are 20mg, $45 for 30, they always double your order for free.. + $25 shipping.:
Tadalafil 20mg 30 Pills - 60 Pills $45.00 1 $45.00.

I think it would be like $5+- for a 5mg here in US.. equals $20+- for 1 20mg+- - But you get 60 of them for $45+25.

I should add, two nights ago I had a late night visitor.. so ther IS hope!

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 11/13/2010 6:45 PM (GMT -6)   
I had no problems with ADC and purchased antibiotics and eye-drops for them along with ED meds for a fraction of U.S. prices..Took 10 days...

Most drug coverage excludes "recreational" drugs which is how they classify Viagra..

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/13/2010 8:22 PM (GMT -6)   
Cialis has had a "one-month free" program in the US - Check the Cialis web site and see if they are still doing the program. If so, get a prescription and fill it under the coupon program. At least that way you know if they have any side effects you can't manage.
 
My insurance covers a very limited quantity as well - nothing near what the doctor prescribed.

rick27
Regular Member


Date Joined Sep 2010
Total Posts : 71
   Posted 11/13/2010 8:27 PM (GMT -6)   
Thanks all. You can get 3 free 20 mg pills from the Cialis website with a Dr's prescription. I'm going to try to get them while I'm waiting for the ones with the joint compound in them. lol My druggist told me it would be $360.00 for the first script.
Airborne; My insurer is Magnacare. They have been good except for this.
History: 2 brothers with prostate cancer
Age 56
PSA at age 45: 4.7. DRE normal.
PSA at age 52: 8.0. DRE normal. 1st biopsy 12 cores, negative
PSA at age 55: 9.5. DRE normal. 2nd biopsy positive 2 of 14, gleason 3+3. both cores <5%, Start WW
PSA at age 56: 9.2. DRE normal. 3rd biopsy positive 4 of 14, 3 cores <5%, 1 core 7% Gleason 3+4 in 1 core, prostate 81cc
LRP, no robot, Sloan Kettering 11/4/10

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/13/2010 8:59 PM (GMT -6)   
If your objective is maintenance (i.e. blood flow, as my doctor intended), go for the daily 5 mg pill instead of the 20's. You would need a new prescription. The "free" deal I picked was for a month's supply (30) of the 5mg vs. the 3 20's.
 
My objective is blood flow, not raising the dead.

Post Edited (142) : 11/14/2010 10:35:35 AM (GMT-7)


Highwayman
Regular Member


Date Joined Sep 2010
Total Posts : 148
   Posted 11/13/2010 9:29 PM (GMT -6)   
can you cut the pills twice in half and have 4 doses for the price of one?

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/13/2010 10:31 PM (GMT -6)   
Yes - they are hard to cut, but with less precision (being pear-shaped), they do cut. Problem is that the "free" deal is 30 x 5mg, or 3 x 20mg. Three in quarters is only 12 vs the 30 that you don't have to figure out how to cut.
 
The deal the first month is to get the max from the deal, so go for the 5 mg.

tedgard
Regular Member


Date Joined Feb 2008
Total Posts : 108
   Posted 11/13/2010 11:35 PM (GMT -6)   

Rick:

I just happened to notice that we are about the same age.  At least we can be happy that we found out that we had PC early and made the choice to get surgery.  This means that we have a very good chance at many years of life cancer free.

By the way, my insurance never paid for the ED pills either.  I wanted to do whatever my Doctor said that may help to prevent ED later.  My Dr recommended 20mg of Cialis, which I found out ended up costing me the same amount as the 5mg tablets.  I ended up paying out of pocked for every pill with the hope that it may prevent ED later.

At least I hope you don’t have the kind of issue that I just read.  Another guy that is being told by his insurance that he will have to pay 42K out of pocked for his surgery…. Yikes… It sounds like someone is getting ripped off.  I guess that is what happens when people are desperate to get the help they need, those that can, rip them off in their time of need.  There is a whole industry out there designed to rip off desperate people.  Sounds like universal healthcare may not be such a bad idea, where everyone would get treated the same, regardless of your income or which insurance company you may have.  Humm…

It looks like your surgery was in November, so you are just getting started on the long road to full recovery.  Even if you do have to pay for the pills out of pocket, I hope you get a full recovery in every way possible.

Some men claim that they have achieved a full recovery within weeks after surgery; others say that it took them 18 to 24 months before they had a full recovery.  Others say that they have a good enough recovery that with the aid of the ED pills they have a fully successful erection.  For me, regardless that I paid for the pills, I still ended up with ED and never did have full recovery in regard to ED.  I tried every option available (i.e.: pills, pump, shots, etc…) and finally ended up getting a penile implant which ended up being the best choice for me.  I am letting you know this because I want you to know that regardless of which type of recovery you end up with, there is usually a treatment out there that will allow you to have a near normal sex life going forward.

Just be assured that even if things end up being like they were for me, where you do end up with ED and where all the other options available don’t end up being a successful option for you, there is still hope. With a penile implant I now can function like when I was a much younger man.  I can perform whenever I chose, wherever I want and as often as I wish.  I don’t have to worry about filling a peroration or taking a pill and waiting for it to take effect.  I don’t have to detract from an impromptu moment by having to take along my equipment or getting it out and getting pumped up before hand (and dealing with a truly abnormal feeling erection).  In order to react to the moment, I no longer have to go to the refrigerator to get my meds and needles, prepare the shot, making the injection and then waiting for things to work.  My wife of 37 years used to call me “Ever Ready Ted”.  Now I am living up to her expectations!!

I wish you the best as you move forward with your recovery and hope that you have the best of results.

Sincerely,

Ted.


Diagnosis Results – Oct 31, 2007;
•Age – 53 (turned 54 in Nov 2007)
•PSA is 3.83
•Gleason's Grade - 3+3=6, T1C

Surgery Dec 11, 2007;
•Cancer confirmed on Right mid and Left apex
•Both nerve bundles spared, some damage to the Left bundle.
•30 day PSA, .01
•90 day PSA, .00
•Latest PSA, .04
•ED treatments: Levitra, Cialis, Trimix, Erect Aid pump, Penile Implant on 3/12/2009
•Happy

MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 11/14/2010 11:36 AM (GMT -6)   
Gents,

When going for the Cialis free 30 day deal

math 101

qty=30 of 5mg pills = 150mg of Rx
qty=3 of, 20 mg pills = 60mg of RX

Please don't tell us some took the 3 - 20mg offer over the 30 - 5mg offer

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/14/2010 12:38 PM (GMT -6)   
Ted,
 
My understanding of the posts regarding to $42K surgery was if the patient went out of his network. I would have also had to pay much more of the cost if I had gone out of my insurance company network.

Acee
New Member


Date Joined Oct 2010
Total Posts : 8
   Posted 11/14/2010 2:31 PM (GMT -6)   
For those of you taking a pill a day as my doctor recommended are you taking the generic Viagra every day or are you taking the generic Cialis(20 mg) and attempting to break it up into 5mg doses?

I will soon be out of the free Cialis so I'm interested in what's working for you.

Thanks,

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/14/2010 2:47 PM (GMT -6)   
Acee,
 
Welcome to HW - sorry to have yet another new member today, but welcome to our corner of the world.
 
I am using Cialis (prescription is 5mg per day), and I use a small box-type pill cutter from my pharmacy to cut a 20mg into more or less 4 pieces. Since the pill has a pear shape, it is tough to get equal parts, so it is a given that some days I'll get more, some less. Most of the pill cutters have open slits on the bottom, so you will need to be careful to put a bit of clean paper (such as wax kitchen paper) under it. Collect all the cutting crumbs & pieces, as it seems there is a one dose collection every two or three pills I cut. I'm sure there are folks who are better at it than me, but ....
 
Reasoning is that my insurance pays for the same (small) fixed number of pills per month regardless of strength, so bigger covers more days.
 
I started with the month free deal of 5 mg, then got my uro to change the prescription.
 
Early this year samples were a lot easier to come by. I suspect the drug companies are cutting back, or more patients are asking.

Acee
New Member


Date Joined Oct 2010
Total Posts : 8
   Posted 11/14/2010 4:53 PM (GMT -6)   
142,

If the 20mg are the same physical size as the 5mg I can see how it would be hard, let me rephrase that, difficult to cut them accurately. So you are using regular Cialis not the generic type sold by ADC I assume.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/14/2010 5:30 PM (GMT -6)   
Acee,
 
I am using the brand Cialis. The 20mg pills are larger physically than the 5mg, but they are the same form, a drop/pear shape, so it is hard to cut.
 
Although most of the reports about ADC are good, I can't be caught up in any issues with Customs. It would be unpleasant for reasons beyond the lost money. As well, my GP has great reservations about them.

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 11/14/2010 5:33 PM (GMT -6)   
Acee, I take the 20mg cialis, each day. Had my 1st visit the other night.
Re customs.. I dont think they could be bothered to come to your door, your stuff simply wouldn't show up. And that would be rare.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/14/2010 5:41 PM (GMT -6)   
Bob,
 
I presume you are using the ADC variety of "Cialis"?
 
I did try the 20mg as a single dose as we were experimenting, and had such back pain that I could not walk the next day. The 10mg is not much better. The 5mg is ok generally, but I did have to stop taking it during my IGRT, because the pain made it almost impossible to stay still as required. Moving around, it does not bother me, but ...
 
 

Woodworker
Regular Member


Date Joined Apr 2010
Total Posts : 90
   Posted 11/15/2010 9:38 AM (GMT -6)   
We have placed about 6 orders with ADC over the last year. No problems at all.

My doctor told me 5mg of Cialis a day. The 20mg tables from ADC have a score line and snap in half easily. Instead of fighting it,
I just go ahead and snap at the score line and take 10mg each day. No problems with it since staring this the first part of last July.

I would not rule out taking shots. I have tried TRIMIX and it was extremely painful (the medicine not the shot).
I just started on BIMIX and I have no pain at all. I am a bit of a sissy though. I use an auto-injector.
Age : 56
Diagnosed 3/29/2010
5mg Cialis daily
PSA 2.7; Gleasen (3+4) Biopsy 2 cores of 12 25% positive
DaVinci surgery 6/25/2010
Returned to work: 7/12/2010
Post Surgery
Final Biopsy report
5 slides of 35 were 2% positive for cancer
Clear Margins
Final Gleason (3+4)
Incontinence: None
ED: 5mg Cialis Daily
Just started on BIMIX. First results were very good

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 11/15/2010 10:14 AM (GMT -6)   
I order and take the 20mg Cialis. Daily. I haven't had any problems with pain, though I do notice my potential for getting angry increase shortly after taking it - I dont act out on that, now that I am aware of it.. but I would snap at people when I first started, and we all assumed I just had too much pressure on me.

Pressure, what's that?

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/15/2010 11:18 AM (GMT -6)   
I had the impression from the uro that the 20mg Cialis (as a dose) was something to take only once, perhaps twice a week, but not daily. I sure couldn't deal with the back pain from one -

jake930
Regular Member


Date Joined Oct 2010
Total Posts : 29
   Posted 11/15/2010 6:30 PM (GMT -6)   
OK GUYS. I CHECKED THE ALL DAY PHARMACY SITE AND FOUND THE GENARIC FORM OF VIAGRA. BUT IF IT IS FROM INDA HOW DO WE KNOW THAT IT IS WHAT THEY SAY IT IS? AND NOT JUST A SUGAR PILL? AND IS IT LEGAL TO BUY IT?
MY DOCTOR JUST PERSCRIBED VIAGA 25 mg 3 X PER WEEK TO TRY TO GET THINGS STARTED. BUT IT COST ME A $70.00 CO-PAY FOR SIX 100mg PILLS. I JUST CAN NOT AFFORD THAT EVERY MONTH. THE ADP LOOKS GOOD I JUST DON'T WANT TO END UP IN JAIL, TRYING TO GET WEE WILLY TO STAND UP.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 11/15/2010 6:41 PM (GMT -6)   
Try some, you will not be disappointed.. You can have a good friend verify the effectiveness of the pills.. You have a prescription for Viagra. Nobody's going to jail..

The WORST thing that may happen is U.S. Customs MIGHT seize the package, about a one in a hundred chance..If that happens, ADC will replace the "lost" order free...
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