Insurance/Bioidentidcal HRT??

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Insurance/Bioidentidcal HRT??

Postby edelweiss » Mon Feb 14, 2005 10:24 am

I've just about reached my end of rope... :!: I have been off of my HRT for six months now (for the second time in two years - long story...) and every blasted symtom has returned with a vengence. I certainly don't have to go into detail with y'all.

I am in a high risk bracket for breast cancer (mother has had both breasts removed (1st in the 1960's - 2nd in 2003) and she has had a stroke (I believe it was related to one of the arthrisitis drugs that she was taking - but there again - another story.) Hense - my doctor refused to let me continue any HRT. I'm not so sure I am willing to live in this state of misery - high risk or not.

I have read quite a lot about bioidenticals and am searching for a doctor in my area that will work with me on this. I haven't a clue if Blue Cross covers hormone level testing and compounding formulas of hormones. This is relatively new - and controversial - like most of 'our' health care needs. It didn't take but a blink of an eye for them to nix the testosterone patch - did it.

Anyone have any advise? Where does one start :?:
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Postby Zero » Mon Feb 14, 2005 10:41 am

I went looking for an answer to your question and found a couple of leads. One thing was this:

Does insurance cover your pharmacy the same as a majordrugstore chain? Let me tell you a little bit about insurance. A few pharmacies in California were offered a special contract with Blue Cross just for compounding. We were fortunate to be one ofthem. Blue Cross is only company we can bill directly and electronically. These patients are only responsible for their deductible and/or co-pay, depending on their plan. That is 30% ofour patients. The other 70% have other insurance companies such as Aetna or United Health Plan and we give them a claimform for submission. Those companies reimburse the patient directly so consequently, they are responsible for paying us upfront. I would say 98% of these insurance companies are reimbursing now.

Another good source for info is at have a long time relationship with Pete Hueseman, who is a pharmacist and an expert on compounding. You can read the transcript from one of his interviews on power surge here:

Another option is this site:

Hope this all helps!!

Postby anonymous22 » Sun Feb 20, 2005 10:29 am

I do not have the same insurance as you but my bioidentical hormones have always been covered by my insurance. I used a compounding pharmacist in my home town and the only inconvenience was that i had to submit my own claim forms.

One thing to keep in mind is that there ARE bioidentical hormones that are made by pharmaceutical companies that you can get from a regular pharmacist. The patches climar and vivelle dot are both bioidentical estrogen. Estrace is a bioidentical oral pill. So you might only need a compounding pharmacist for your progesterone cream or testosterone cream if you are found to need that.

Here is a link to find a compounding pharmacist in your area. If there is not one in your area a good choice might be Women's International Pharmacy. I think they might even submit your insurance. You can give them a call and ask them your questions. They have been very helpful in answering my questions even though I have never actually bought anything from them. I think they have a free information packet they can send you in the mail about bioidentical hormones. Here is there link
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