Does My Health Insurance Pay for Hormone Replacement Therapy?

Pin It

The hormone is a medication and is prescribed by a doctor. Hormone medications can be taken in the form of a pill, injection or even applied as a patch or gel. Some examples of hormone therapy include: testosterone therapy (TRT), HGH therapy, estrogen and progesterone therapy.

Hormone therapy is not always covered by insurance, and you need to check with your insurance provider about the coverage for your condition. Even if HRT is considered as a medical necessity, then it may not be covered by your health insurance policy. Progressive treatment plans offered by many age management and anti-aging clinics are not covered by insurance.

Why HRT?

HRT is recommended by doctors to treat medical conditions that are caused due to disorders of the endocrine system. HRT is recommended in the case of women who experience menopause symptoms, or to patients with conditions like diabetes, adrenal deficiency, hyper- or hypothyroidism, infertility, certain cancers, hyper- or hypopituitarism, and several other hormonal imbalances.

Men often suffer from symptoms caused by hormonal and aging imbalances called andropause or male menopause. Many aging men experience Low T and Adult Onset Growth Hormone Deficiency. In many people, obesity is caused by hormonal disturbances, abnormal adrenal functioning, etc. All these people can regain health and vitality through hormone replacement therapy after a thorough health assessment by a doctor.

Cash-for-Service HRT Programs

HRT is usually not covered by insurance providers, and most HRT clinics offer cash-for-service programs. Some clinics try to help patients with costs by providing them with a receipt that can be used to claim reimbursement for their expenses through their insurance provider, if HRT is covered in the plan.

Private HRT can be a costly affair. Initial doctor’s appointments are expensive, while prescriptions that need to be filled also cost quite a lot. You also have to consider costs incurred in follow-up appointments and lab testing.

He big hormone replacement clinics like AAG Health and Cenegenics to not work with insurance. All their services are private pay. For some this is a good thing as it ensures great customers service and the best treatment plans available.

Ways to reduce costs

Private HRT clinics charge cash for their services, but you can try to reduce your cost with the help of the suggestions given below:

  • Check if you can claim reimbursement for tests suggested by HRT clinic. Also check with insurance providers if part of the treatment can be paid by them.
  • Check if your HRT provider offers an alternative mode of payment like interest-free financing. HRT clinics may have tie-ups with companies that offer financing for specific procedures; taking advantage of such schemes could help HRT become an affordable and simple option.
  • You can also try checking for discounts from your HRT provider. Some providers offer discounts for prescriptions ordered in larger quantities. For example, if you order a 6 month treatment plan prescription, instead of a 3 month you may get a discounted rate.