What is the cost of testosterone therapy?

[desperate believer]

Hi. My name is hope. I'm a 30 year old FTM living in North Carolina. I've come here for support and information. I was wondering how much you guys pay for testosterone and how much lab/blood work cost - both out of pocket. I have Medicaid but as far as I know they don't cover anything associated with "changing" genders. I know these cost will vary depending on a lot of factors but I'd like to get a good estimate because I have no clue how much either will cost me to the point of not knowing if it's even possible financially for me to transition anytime soon. Thanks in advance for your support and help =) ~hope

[Simon]

How is it that there are supposedly all these transguys in NC and I have yet to meet one? Well, there is one guy I've spotted in my town who is pre T but I can't very well stroll up and ask. Maybe I should. Every time I shop where he works he stares like he wants to say something. Anyways, I'm rambling...

Check your pm's. I sent you a name of a doc.

[Nygeel]

For me 6 months of T, needles, etc was roughly $125. My tests were usually around $50.The test including T levels was about $300.

[Caleb]

Hey man...

I'm still on my parents insurance until I'm 25, thankful for that one. But I go to a doctor in Charlotte. His costs are 200 for the first visit, then 100 after that. I see him every three months. My blood work is done with my primary doctor, it falls under blood work. There doesn't have to be a reason. Insurance covers that for me as well except for about forty to fifty dollars. Then I don't know how or why, but insurance also covers my actualy hormones, which come out to be ten bucks, without it though it'd be around 98 bucks. 12 to 15 syringes and needles usually run me a little under five dollars. So overall, without insurance I know it can get pretty pricy. But do some checking to see if there are any loopholes you can get into!

[desperate believer]

Thanks Nygeel and Caleb =) I've thought about loopholes but don't want to risk frauding Medicaid. It's not that I'd feel bad about manipulating my insurance, I just don't want to get caught doing so. According to my family if you get caught frauding Medicaid you get in serious trouble. So it's just not worth it to me; my disability is the only form of income I have so I can't risk loosing it. That's why I hope to be able to pay out of pocket. I looked online to see if Medicaid would even consider paying for anything associated with "changing" genders but it apparently doesn't. From what you guys have told me it sounds like the testosterone wouldn't cost me much. It's the lab work that could be a problem. ~hope

[Darrin Scott]

I get medicaid and no they won't cover any transition related expenses. You can go to jail if you get caught lying to them. Be careful. I'd see what is available in your area. Maybe someone offers a sliding scale. They should cover blood work. They covered mine when I lived in Florida.

[DriftingCrow]

Thanks Nygeel and Caleb =) I've thought about loopholes but don't want to risk frauding Medicaid. It's not that I'd feel bad about manipulating my insurance, I just don't want to get caught doing so. According to my family if you get caught frauding Medicaid you get in serious trouble. So it's just not worth it to me; my disability is the only form of income I have so I can't risk loosing it. That's why I hope to be able to pay out of pocket. I looked online to see if Medicaid would even consider paying for anything associated with "changing" genders but it apparently doesn't. From what you guys have told me it sounds like the testosterone wouldn't cost me much. It's the lab work that could be a problem. ~hope

Frauding them is a horrible idea like you've said, but falling into a "loophole" isn't fraud. A loophole is just something that the statute/regulations don't cover. It may seem sneaky, but it's perfectly legit. Though finding a suitable loophole would be pretty difficult, and I wouldn't try anything without consulting an attorney who specializes in medicare/medicaid.

[desperate believer]

Hi Simon. Thank you for the message you sent me. I can't drive so I'm hoping I can find someone in Greensboro which is about 45 minutes from me. It's up in the air: I may or may not be able to afford to transition. As I come to realize my limitations/possibilities more I'll let you folks know. I don't think you live too far from me Simon. I live in Rockingham county. You should strike up a conversation with that fellow you keep noticing =) ~hope

[Robert Scott]

Sorry ... my insurance covers it all for me ... however, about three years ago when my son started our insurance didn't cover it .. it cost us $60 for his T and needles & stuff through mail order --- which lasted him like 4-5 months.  His blood work was covered by the insurance since it was routine bloodwork -- it's the same tests your physicians run annually for a normal physical minus the t level checks.

[desperate believer]

Thank you for the information everyone! ~hope

[Felix]

I'm on Medicaid and the rules are different state by state (I'm in Oregon), but if I had the patience to get my T administered at the doctor's office it covers that. I stopped doing it that way though because it was too complicated to fit into my schedule and I couldn't do weekly like I do at home. Paying out of pocket it's roughly 10 dollars a month from Strohecker's at the dose I'm on, and they will mail it to you if you have the doctor fax them the prescription.

Bloodwork for liver panels and such is covered in any state but getting T levels checked may not be. I asked my lab what it would be if I were paying out of pocket and they said around 200 dollars, but that seems steep. I get bloodwork every few months.

And yeah, loopholes won't get you in trouble and aren't fraud. The main way people get in trouble with Medicaid is by lying about their income, which I assume you aren't doing. Your doctor's office might have ideas about covered procedures and how to get the care you need.