Is Hormone Replacement Therapy Expensive?
When it comes to Hormone Replacement Therapy (HRT) and Bioidentical Hormone Replacement Therapy (BHRT), your insurance coverage and your preference of therapies (HRT vs. BHRT) will both play into the amount you should expect to fork out for your hormone replacement medications.
If you are like me, by the time I realized I had to do something to manage the night-sweats and sleep-less nights, I was prepared to invest in my sanity and so as long as I could afford and fit the cost into my budget, I was forging ahead.
Is Hormone Therapy covered by insurance?
In the four years that I have been on HRT, I have worked with a local doctor's office, and I have worked with online, telehealth HRT providers. In both cases, the medical staff as well as the doctor or specialist were very knowledgeable around what is covered and what isn't.
Many of them encourage you contact their office or email their clinic to inquire about costs and insurance coverage if you have questions.
What I have found to be the case is that if you visit a local doctor in person, you'll likely find that the visit and any testing will be covered by insurance. You'll want to take into account any deductible or out-of-pocket premiums your insurance provider may require. However, what I have also experienced first-hand and heard from many Facebook and Instagram groups is that still, so many docs are uncomfortable and to be honest, just don't really know a lot about hormone therapy, so they may try to "talk" you out of it or even ghost you on the topic. Remember, OB/GYN's are surgeon's first and some have had very little training on hormones since the few hours they were required to take in med school.
If you inquire with an online, telehealth HRT provider or specialist, specifically one that specializes in Bioidentical or Hormone Replacement Therapy, they will be very versed on what is covered and what isn't. They'll be able to give you an estimate up front on what you can expect to not be covered and the direct cost to you.
What is the cost of Bioidentical Hormone Replacement herapy
BHRT refers to Bioidentical Hormone Replacement Therapy and is derived from plants. The ingredients are FDA approved, there are no standardized doses approved by the FDA. It's normally prescribed in customized dosages and made by a compounding pharmacy.
Due to the fact that the dosages are not FDA approved, insurance will not cover the cost. From the research I've gathered, the groups I'm a part of and my personal experience, many if not most women prefer the Bioidentical Hormones to conventional. So just know and understand that you will have out of pocket expense for Bioidentical Hormone Replacement, but you are not the only one paying out of pocket, every woman on BHRT is making an investment in her future health.
What is the cost of conventional Hormone Replacement Therapy
HRT typically refers to conventional Hormone Replacement Therapy which is FDA approved and available in standardized doses. It's synthetic and can be animal derived.
Because it's FDA approved, it's typically covered by insurance like any other prescription that you might be given. You may have an out-of-pocket expense, as you would with any prescription. Your HRT doc, clinic or specialist will be able to guesstimate the cost different between conventional, using your insurance and Bioidentical, not using your insurance.
Your doctor or HRT specialist may write you a prescription for a patch, a pill or maybe a cream, and in all cases, the RX can be filled at a local pharmacy. And just like any other prescription, you may or may not have a small payment and you could use an HSA or FSA card.
Average Cost of Hormone Replacement Therapy
Many of the online, telehealth Bioidentical Hormone Replacement providers offer monthly plans depending on your prescription needs. They may range from $ 75 to $229 per month. They also include, in some cases future testing so your HRT specialist can follow-up on your hormone levels to determine if tweaks need to be made to your medications. Most of the online providers will allow you to use your HSA or FSA card for your monthly fee and any other costs associated with your therapy.
If you are fortunate enough to have a local doc who is comfortable and willing to prescribe bioidentical hormone replacement therapy. It's likely that the only item not covered by insurance will be the meds, which could range from about $75 to $100 per month. Of course, you may have some co-pays with testing and office visits as well.
In my research I found that a conventional HRT estrogen patch can range from ~$45-$55 per month and progesterone cream would be an additional ~$38. You may still have doctor visits and testing that needs to be covered and paid by insurance.
It's always best if you want clear understanding of what you might expect for your out-of-pocket expenses, to call the number on your insurance card and ask for some direction on what is and isn't covered.
Online HRT Clinic
I have received hormone therapy from three different providers over the years. By far, my favorite way to be in a consultation meeting with an HRT doctor is via telehealth. Sometimes doctors make me nervous when I am in person!
Telehealth HRT allows me to be in my home office with my notes, where I can record information and keep track of my questions.
It also means that if there are purchasing decisions I need to make, I can take whatever time I need and then get back to the HRT Clinic or representative with my choice of HRT products.
One of the few good things, in my opinion that came from COVID, was telehealth. I am really bracing this new way of doing business with my doctor, maintaining my health and still showing up for work and not having to take PTO for appointments.
Click Here to see trusted online telehealth providers.