Insurance denied Viagra use

Hi greg,

Welcome to the forum! Hope you are recovering well from your sugery!

I have heard a lot about people getting denied those. I think some people on here get them online? Hopefully someone will come along and get you the site. Our insurance luckily covers ours.

We have UnitedHealthcare in Colorado. (can't remember exact plan name off top of head, but can look it up if interested).

Ken gets 30 viagra and 20 Cialis for $20 for each prescription.

Tanya

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Age: 63
Diagnosed: 10/30/06
PSA: 3.7 (2005: 3.4, 2004: 4.0)
Biopsy: 1/10 cancerous, 5% of one core, right apex.
Gleason: 3+3=6
Da Vinci: April 10, 2007, Denver CO
Path results: 1% of prostate involved. Very small tumors on both right and left apex. Negative margins, negative seminal vessicles, lymph nodes left intact. Gleason upgraded 3+4=7.

Hello Greg,

A warm welcome to the PCa forum. I am sorry you are having difficulty with your insurance. 

 

 

Greg,

I offered this same complaint awhile back. I found it insulting to be treated this way. I am on Medicare and they pay nothing. If your plan D does pay a portion it will be assessed at full cost against your "DONUT HOLE'. For those of you who don't know about this insidous Medicare Rx loophole, it was pushed through by Bushy and his cohorts to help bankrupt senior citizens. Hopefully the damage will be repaired in the future.

Actually you can buy some of these drugs online in generic form, but be sure to check out your source. I bought 100mg Viagra from Drugstore.com for about $10 each. This was direct and does not go against my "Donut Hole", sometimes called the GAP. Good Luck

Hey Kitt There was no illegal activity discussed, that I saw. Please don't over react, know your facts.

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To Everyone:

Warning!  Buying ED prescription drugs in the US is very costly as we well know.  It is truly a sad situation when many insurers will not cover the cost of ED prescription drugs for PCa patients.  We face the same situation for many other miracle prescription drugs that are prohibitively expensive (especially if not covered by insurance), which may be needed for survival. This has forced many of us to seek the purchase of needed prescription drugs outside of the US at substantially lower cost, principally over the internet. The US government has been unable to readily police such purchases over the internet and is trying to rectify this situation for the future, hopefully to our benefit. In the meantime, there is a great concern about the quality of any generic drugs manufactured and sold outside of the US, and the possibility that they could be detrimental to your health, especially if they are counterfeit drugs.  Proceed with great caution! 

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68, 29-core biopsy 9/27/06, PSA 7.1, Stage T1c, Gleason 7 (3+4) [less than 20% in one area],  Gleason 6 [less than 5% in two other areas], negative DRE, bone scan and Endorectal MRI. Completed 39 Proton radiation treatments 2/22/07-4/18/07.

BC/BS Federal plan does not cover the prescription either. we opted to use alldaychemist.com. I think in the future they will, but not now.

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Husband Jeff 56 years old diagnosed July 27, 2006
PSA 6.5, 2 positive areas in biopsy, Gleason 3+3=6
Radical Retropubic Prostatectomy August 30, 2006
pathology report - all clear - cancer gone
1st post-surgery PSA test <0.1, 2nd post-surgery PSA test <0.1, 3rd PSA <0.1
no more pads Oct 12, 2006
first "real" erection with use of pump 12/16/06
3/07 - occasional dribbles and erections with Cialis and pump

Sounds familiar Greg,

Paul's surgeon went to bat at a hearing that involved several of his patients. He gets a cookie and an A+ for his effort however, the insurance company stood my its opinion that there are no long term studeis on any post operative treatment involving PDE5 drugs currently available. They would not approve eating the cost of pills that cost 12-15 dollars each. Bottom line..... Approval of PDE5 drugs for men with a PCa hx is a patent expiration away in other words :>) Viagra is due to expire and Levitra right behind it..or is it Cialis that came 3rd? Anyway, it will happen in the not too distant future. Has anyone notice the major cost cutting moves Pfizer has made in anticipation of Lipitor and Viarga patent expirations? They haven't exactly been shy about why they have cut thousands of jobs. Tisk tisk tisk......

Ha...maybe it takes a long time to move!

There is a huge research complex here that is closing its doors and moving to various parts of the U.S / world.
Every month when I go there, the crowd gets smaller and smaller. Between the news and being on site once a month, this is the scoop I've heard. Will the last one out of Michigan please turn out the lights!!!!

Swim :>)

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pcdave said... To Everyone: Warning!  Buying ED prescript ion drugs in the US is very costly as we well know.  It is truly a sad situation when many insurers will not cover the cost of ED prescript ion drugs for PCa patients.  We face the same situation for many other miracle prescript ion drugs that are prohibitively expensive (especially if not covered by insurance), which may be needed for survival. This has forced many of us to seek the purchase of needed prescript ion drugs outside of the US at substantially lower cost, principally over the internet. The US government has been unable to readily police such purchases over the internet and is trying to rectify this situation for the future, hopefully to our benefit. In the meantime, there is a great concern about the quality of any generic drugs manufactured and sold outside of the US, and the possibility that they could be detrimental to your health, especially if they are counterfeit drugs.  Proceed with great caution!  We got some "viagra" from India, but B has found that it is different than the Pfizer issue, not consistently potent and sometimes there is no effect at all. Age 51 Gleason 3+3 PSA from 3.2 to 4.3 in one yr Biopsy 11/06 DRE negative 4 of 12 cores positive, one lobe, less than 10% Inflammation only second lobe Stage T1C Clinical Dx PSA prior to surgery: 3.9 Da Vinci Prostatectomy 2/27/07: PCa in BOTH lobes 5-10% of gland Gleason 3+3 Negative tissue margins Bladder, seminal ves, vas deferntia negative Two inguinal hernia repairs Catheter removed 1 wk after surgery Full continence (no pad needed) 1 wk after surgery Full potency, 12 th day after surgery