The "retail" price quoted on my trimix receipt has varied from $150 - $180 over the last few years, and changes almost every month. The "agreed" price with the insurance company hovers between $90 - $150, also changing every month.
I pay the agreed price out of pocket until I meet my ultra-high deductible, and then pay 15% of the agreed price until I hit my out-of-pocket max.
My dispensed amount is 2 vials of 5ml. My use is .10 -.11 ml per shot.
It took several letters, dozens of phone calls, and a serious intervention from the pharmacy (a local, highly respected, family-owned company) in which they argued that the ED I suffer is a direct and absolutely identifiable result of my surgery, and lack of treatment could result in extreme depression, if not worse. My doctors (GP & Uro) had to provide letters stating that I had never complained about
ED issues in the past, that I had no known physical issues of that nature before surgery, and that total ED was expected as a result. The insurance company argued that since I was warned, I had to assume responsibility. The pharmacy got it changed. I don't know how, and refuse to upset the apple cart by insisting to know.
Moderator - Prostate Cancer(Not a medical professional)
My adjuvant IGRT journey (2010) - www.healingwell.com/community/default.aspx?f=35&m=1756808
HT (Lupron) 6-mo injection 9/12;Prolia 6-mo inj 12/12, 06/13