T startup costs in the U.S., particularly out-of-pocket?

[Aewin]

I finally have the mythical referral letter and an appointment with a doctor that's experienced with HRT, but I know that I'm likely going to have to pay everything out-of-pocket since my insurance excludes transgender care. (Unless the doc is one of those nice ones that will code it as something non-trans-related, but with my luck I'm not holding my breath.)

I'm not worried about the cost of T itself, but I was wondering if anyone had experience with what the other startup costs might be out of pocket in the U.S., such as bloodwork. What kind of tests and how many appointments did you need with your doc before you got your prescription, and how much did they cost you out-of-pocket? (Or if you have an idea how much they would have cost if you didn't have applicable insurance, that's helpful too.) Thanks for any help you can provide, guys.

[2fish]

I'm paying out of pocket. So here is my run down.

Now, I had several options.

My first option was to use an Endocrinologist that was just starting to take on trans patients. His fee would have been $200. My insurance would have covered only the bloodwork. I personally chose not to go with this doctor because his office personnel had not training to trans patients....so can't tell you more with this.

Second option was from my therapist. She told me about Dr. Reed who is known for SRS surgery in my area. His fee was $250 for consultation (physical/blood pull). And his yearly fee of $600. He would be my main doctor and would prescribe my my prescriptions for T and blood work every 3 months.

Now, when I got my first initial blood test, my levels were all over the place so he wanted me to see an Endocrinologist just to be sure everything was okay.  The Endo's fee was $400 without insurance, but my insurance covered $300 and I paid the $100. I was billed so nothing came out of pocket until I got the bill at home about 2 months later. I had to see him twice. (I used a different endo since the first one wasn't up to my standards)

Now, once I got the clear to start T. I had two options.

My first option was to use a regular pharmacy or to use an online pharmacy.
I decided to try the regular pharmacy since I wanted to pick it up in person (I currently live at home with parents and they do not know I"m on T).
So, I paid $80 for a 3 month supply and that included the syringes. I used a special coupon from goodrx(dot)com. I suggest you do this if paying out of pocket.

I'm changing to the online pharmacy since my experience with the pharmacy was a bit of a pain.
I called the online pharmacy and the woman was very kind and friendly. I would only pay $70 for a 6 month supply...so better deal there. Online pharmacy is Stroheckers.

Also, my blood work is around $6-12 copay. Insurance pays for the rest. Total bill is usually $60-80.

Feel free to ask me any questions.

[Aewin]

 

Feel free to ask me any questions.

Thanks, that's a helpful breakdown. I know that my initial visit will be around $140, which I'm guessing will include a physical, but I'm also guessing that bloodwork will not be included in that. Subsequent visits should be less. I'm curious as to what types of bloodwork they did, if you're willing to share. I have recent results for some blood tests, but nothing that measures hormone levels, which I would assume they wanted to know before calculating a dose. I've heard horror stories on hormone test prices going into the (several) hundreds of dollars, which was primarily why I thought I'd ask around in this thread.

And I can second the recommendation of GoodRX for anyone else reading this thread. I know that there are a few states that can't use Stroheckers though, and I'm unfortunately in one of them.

Thanks again for the response.

[2fish]

Thanks, that's a helpful breakdown. I know that my initial visit will be around $140, which I'm guessing will include a physical, but I'm also guessing that bloodwork will not be included in that. Subsequent visits should be less. I'm curious as to what types of bloodwork they did, if you're willing to share. I have recent results for some blood tests, but nothing that measures hormone levels, which I would assume they wanted to know before calculating a dose. I've heard horror stories on hormone test prices going into the (several) hundreds of dollars, which was primarily why I thought I'd ask around in this thread.

And I can second the recommendation of GoodRX for anyone else reading this thread. I know that there are a few states that can't use Stroheckers though, and I'm unfortunately in one of them.

Thanks again for the response.

Glad my info was helpful. My initial blood test was a CBC and Liver Functions Test. My heart rate was very high and so he ordered a Cortisol test, it was super high and so they wanted to check for Cushing's Disease and thyroid tests. Everything came back negative, except that I do have three masses on my thyroid, but only need to get that looked at in 6 months.

[2fish]

I didn't have my hormone levels checked because he said that he has no intention of raising my dose. I take my shot every other week and my first set of T levels were 390. So I am currently in the male range.

[Kreuzfidel]

Just wanted to through out there that I am assuming you're in America - but not everyone on the forum lives in America.  So questions like "how much does bloodwork cost?" or "how much does a doctor's visit cost?" need to be qualified with something like, "for those of you in the US, how much does bloodwork cost?" - because obviously, between countries, costs can be enormously different. 

[2fish]

Just wanted to through out there that I am assuming you're in America - but not everyone on the forum lives in America.  So questions like "how much does bloodwork cost?" or "how much does a doctor's visit cost?" need to be qualified with something like, "for those of you in the US, how much does bloodwork cost?" - because obviously, between countries, costs can be enormously different.

Good point!

All my answers are for USA! -sorry about that.

[Aewin]

Just wanted to through out there that I am assuming you're in America - but not everyone on the forum lives in America.  So questions like "how much does bloodwork cost?" or "how much does a doctor's visit cost?" need to be qualified with something like, "for those of you in the US, how much does bloodwork cost?" - because obviously, between countries, costs can be enormously different.

You're very correct, I didn't think about that since I thought I had my location in my avatar/info area. The first reply of mine might have cleared it up for people since I mentioned states, but I went ahead and edited the original to make it clearer. Thanks for pointing that out.

Glad my info was helpful. My initial blood test was a CBC and Liver Functions Test. My heart rate was very high and so he ordered a Cortisol test, it was super high and so they wanted to check for Cushing's Disease and thyroid tests.

I've had a CBC and a thyroid test (I have a high heart rate as well) recently, so it might be that the doctor only wants a liver function test and potentially a hormone test. If I remember I'll check back in with what my doctor ordered and how much it cost. Thanks for all the help.

[JayDawg]

I get my blood work done by my regular doc every 6 months to keep an eye on my thyroid and cholesterol, so I just shared all of it with the endo and she didn't need to run any of it herself. My insurance pays for the blood work my regular doc does, but nothing for the endo, so I will continue to pass my results from regular doc to endo. My doc won't run total testosterone, and my endo charged $80 for that.

I will look into changing my primary care doc this summer to one who is rumored to support trans people and maintain their T, so I don't have to keep going to the Endo in another city.