T Nation

Losing Insurance. Private Labs or GP (Medicaid)?

T Replacement
#1

So, I’m losing my current insurance that had great coverage for labs, and I had a fabulous doctor who would practically order any labs I wanted and is willing to prescribe high doses of TRT (not even a “TRT” doctor).

I’m a grad student and my school doesn’t offer discounted insurance, so I’m going to be on Medicaid for the next 6+ months until I graduate and can find employment.

I’m currently in the process of “dialing in” on TRT and will need to get labs at some point to check test, shbg, estradiol, CBC, lipids, PSA, and probably thyroid as well.

Should I use a website to order private labs? They’re pretty expensive, but I’m scared that if I go to a standard GP, he will see the very high test levels and be alarmed (even though my other doc agreed to prescribe me these doses (200mg/wk) because - long story short - I developed lasting sexual dysfunction (similar to all symptoms of PFS) from psychiatric drug use/SSRIs that has been extremely treatment-resistant.

Is it even worth going to a typical GP? If I tell them I’m on TRT, will they be willing to run such tests? It seems every time I’ve gone to one in the past (before TRT), getting them to run anything - even a standard hormonal panel - was like pulling teeth.

Thanks for any advice

#2

Depending on your state you may be able to order tests directly and there are discount sites out there. I can usually get FT & TT for between $50 & $75 and sometimes under $50 if there is a sale. Try directlabs.com or ultalabtests.com to order Quest tests at discount.

But lets consider that you are dialing in…that is really about feeling and symptom resolution. When you find that sweet spot stay there and you can get the tests done eventually when you have insurance.

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#3

With Medicaid, it will be worse. If it were me, I’d talk to my doctor and see if there is anything I could work out. It’s also possible you could hold off on labs for a while, assuming you are doing well, of course. With COVID, I had a lot of guys hold off on getting their labs for several months. In fact, some still need to go. You have special circumstances.

#4

If you’re at a pretty stable point and just need your prescription, T is dirt cheap on GoodRx at cvs or wherever, so don’t let that deter you on that side

I’d try to keep going where you’re going. If you can keep labs to a minimum you can often go 6 months between visits depending on the particular doc, which makes the expense easier to handle.

#5

What happened to the doc?

#6

I definitely agree that looking at hormone numbers matter very little right now, especially since I’m titrating up and there will still be large fluctuations. I just was wondering what the best route would be to take when I am feeling better and want to confirm that all my bloodwork looks ok (lipids, RBC, PSA, etc.) or when I’m still feeling like shit and need to confirm what is happening (I have potential thyroid and adrenal issues as well, which may have influence on my wellbeing - aside from the T/E stuff.

#7

She is still around but does not take Medicaid (and does not think practically any of the labs she would want to run would be covered under medicaid).

#8

Yeah - I’ve been using goodRX and have a nice stockpile of T. It’s great!

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#9

Oh, you said you were worried about a doc seeing high test levels and freaking out. If she’s the one looking at your labs then she should be fine with it. Get the labs run using discount labs online and give them to her. Would be about $100-150

#10

Definitely. I’m not too worried about hormone numbers, so long as I’m achieving symptomatic relief. But if I am unable to get to that point, it would be good to have labs to see what may be happening under the hood. My thyroid and adrenals have thrown up some questionable numbers a few times, so I don’t want those hindering my results. Plus, further into the future, it would be nice to measure PSA, RBC, lipids, etc. for peace of mind.

#11

Thanks for the resources. I’ll check them out.

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#12

I hope you didn’t think I was talking about going without labs long term.

#13

No it’s not, I wouldn’t go to just any ordinary doctor for TRT. Your current doctor is a rare find willing to prescribe high doses, not at all common.