Wednesday, May 22, 2024

Is Bioidentical Hormone Replacement Therapy Covered By Insurance

Don't Miss

Is The Treatment Worth It

My Experience with BHRT – Bioidentical Hormone Replacement Therapy

Ultimately, your decision to undergo treatment comes down to your personal circumstances, and what youre realistically able to afford. Just keep in mind that the cost of treatment can often far outweigh the costs involved in treating further ailments and illnesses that arise as a result of hormonal imbalances, such as anxiety and depression, chronic fatigue, or a low sex drive. So ask yourself, could you put a price on your happiness and well-being? And if so, what would that amount be?

Do YOU have imbalanced hormones?

Who Should Consider Hrt

As we mentioned earlier, HRT is not suitable for everyone. You can only consider hormone replacement therapy if your menopausal symptoms are severe and posing a threat to your life. Your doctor might prescribe HRT for you if:

  • You have several menopausal symptoms like insomnia, painful sexual intercourse, night sweats, headaches, etc.
  • Theres a history of osteoporosis or colon cancer in your family
  • You hit menopause before age 40
  • Other approached has failed to relieve your menopausal symptoms
  • Your ovaries were removed before age 45
  • Due to chemotherapy or radiation, you hit menopause before age 45

How Much Does Hrt Cost Under Medicare

The costs for hormone replacement therapy will depend on the type of plan in which you enroll. Some plans will leave you with zero out-of-pocket costs, others may leave you with some copays or coinsurance. Make sure to talk with your doctor before receiving therapy to confirm how much Medicare will pay for and how much youll have to pay out of pocket.

You May Like: Can Hormones Cause Weight Gain

When Should I Begin Considering Bhrt As An Option For Menopause Treatment

You should begin considering BHRT as an option for menopause treatment when you start experiencing symptoms like hot flashes, night sweats, mood swings, and difficulty sleeping.

BHRT can help relieve these symptoms and restore your hormone levels to what they were before menopause. However, its important to note that BHRT is not for everyone, and its important to talk to your doctor about whether or not its right for you.

If you decide to go ahead with BHRT, be aware that Medicare does not cover the costs of the treatment. However, there are some private insurance plans that will cover part or all of the costs of BHRT.

What Is Bioidentical Hormone Therapy

Sign in

Traditionally, synthetic hormones are prescribed to restore a harmonious balance within your body. Although they are effective, the medications are not custom-made based on your individual needs. Not to mention, they are created in a laboratory using a variety of substances.

Bioidentical hormone therapy is tailored to your personal needs using substances that occur naturally. This allows your body to accept and use them similarly to the hormones your body produces on its own. You can restore your quality of life using a safe, effective solution.

Don’t Miss: How To Reset Your Hormones

What Is Hormone Replacement Therapy

HRT is a treatment primarily aimed at women entering menopause and men who have low testosterone levels due to aging. It aims to restore hormonal imbalances caused by life developments and the subsequent decline of estrogen and progesterone or testosterone production. Restoring the key hormones to a natural level can increase a patients health, sex drive, and self-confidence.

While Hormone Replacement Therapy can take many forms, Dr. Geers experienced team of experts focus on there main types

  • Oral HRT pills that are taken daily and can be tailored to meet your individual requirements.
  • HRT creams that are applied as a topical for instant absorption to the skin.
  • HRT patches that last for 7-14 days depending on your unique treatment plan.

Hormonal Replacement Therapy uses plant-based synthetic hormones that are made to offer bio-identical attributes for the most natural restoration of hormonal balance.

Medicare Part C And Hormone Replacement Therapy

Medicare Part C or Medicare Advantage is a plan that replaces Original Medicare Part A and B, and usually adds benefits like prescription drug insurance coverage. This plan is provided by private insurance companies and can be customized to fit your specifics needs, and monthly premiums depend on the plans that are available.

A Medicare Advantage plan may help you cover the cost of hormone replacement therapy.

Here are some reasons why folks choose Medicare Advantage or Part C plans for coverage:

  • Mental Health services
  • Copay and deductibles

This is just the tip of the iceberg on the different benefits Plan C has. If you would like to learn more about how to apply and find the best-customized plan for you, contact us at . Our experienced insurance agents will be able to provide a free consultation and get you in the right direction.

You May Like: Best All Natural Hormone Replacement

Can You Use Your Health Savings Account To Pay For Bioidentical Hormone Therapy

HSA accounts can pay for the cost of conventional hormone treatments. They dont usually pay for bioidentical hormones, though. Closely review the list of approved medications. That will tell you whats covered by your plan. Flexible spending accounts are usually the same. They usually cover the cost of conventional treatments. However, they dont always cover the cost of bioidentical hormone treatments.

Does Medicare Cover Hormone Replacement Therapy

Ageless Forever | Bioidentical Hormone Replacement Therapy ( BHRT ) | Las Vegas, 89118

So, does Medicare cover bioidentical hormones? Neither Medicare Plan A nor Medicare Plan B will cover the cost of bioidentical hormone therapy . This is because these parts of Medicare dont cover medications.

There is, however, a part of Medicare that does cover bioidentical hormones. Under Medicare Plan D, the cost of the bioidentical hormone therapy may be covered. If Medicare Plan D does cover your bioidentical hormones depends on the specifics about the medication.

To know for sure, you will have to check with the Medicare formulary to cross-reference if the medication that you have been prescribed is covered.

Recommended Reading: Hormone In The Endocrine System

Are Bioidentical Hormones Covered By Insurance For Women

Menopause begins after a woman has her last menstrual cycle. The average age for women entering menopause is 51. Even before that last cycle, menopause changes the hormone balance in a womans body.

Progesterone, estrogen, and even testosterone levels begin to drop. The result is symptoms like mood swings, hot flashes, and thinning of the vaginal lining.

A doctor may prescribe hormone therapy to relieve these symptoms. Hormone therapy also treats some of the long-term effects of menopause like bone loss.

The same coverage guidelines apply here as they do for men. Your policy may cover traditional hormone therapy but not bioidentical hormones. Also, most insurance carriers dont cover testosterone when prescribed for women.

How Much Does Bioidentical Hormone Therapy Cost

With aging comes the natural decline in the production of hormones that help maintain our quality of life. For men, testosterone levels drop at around age 50 and trigger andropause. Women, on the other hand, experience a decrease of female hormones like estrogen and progesterone when theyre in their mid-40s to early 50s. This hormonal imbalance during perimenopause and menopause can cause an uncomfortable number of menopause symptoms, such as hot flashes, night sweats, vaginal dryness, and mood swings.

In order to ease the immediate symptoms of low hormone levels and prevent future health complications, most doctors would prescribe bio identical hormones in pill, patch, gel, cream, ring, or pellet form these compounded bioidentical hormones are derived from natural products like yam and soy to mimic the structure and function of human hormones to alleviate symptoms of menopause.

The cost of bioidentical hormone replacement therapy is around $200 – $500 per month, which includes the medication, a customized treatment plan, and follow-up appointments. Added costs include the initial consultation with a doctor — which may cost $75 – $200 — and a blood test to check the hormones, which can cost around $80 – $500 without insurance.

Don’t Miss: How To Cycle Bioidentical Hormones

Hormone Replacement Therapy An Overview

Hormone Replacement Therapy is a hormonal medication aimed at relieving the symptoms most women experience when going through menopause. Some of these symptoms include hot flashes, night sweats, vaginal dryness, tiredness, decreased sex drive, irritabilities, etc.

HRT is a medication used to replace a womans hormones during menopause. Menopause is a stage in every womans life when her menstrual period stops and the sex hormone levels decline. HRT is aimed at relieving menopausal symptoms and prevent complications that may arise like Osteoporosis and bowel cancer.

HRT works by replacing the hormone known as estrogen that the female body stops releasing. This hormone stops during menopause or in a case where the ovaries have been removed.

Read Also: Is It Safe For Kids To Take Melatonin

Does Insurance Cover Bio

Is Bioidentical Hormone Therapy Covered By Insurance?

Bio-identical hormone replacement therapy requires ongoing medical care with office visits and medications. Many insurance plans will provide some degree of coverage, but it usually depends on the patients carrier and benefits.

Insurance companies may be more likely to provide in-network coverage for BHRT if the patients evaluated by her primary care physician or gynecologist prior to seeking treatment. Some BHRT specialists may operate as fee- for-service providers, which requires patients to pay costs upfront before applying for insurance reimbursement.

Most insurance companies will not cover bio-identical hormones from compounding pharmacies or over-the-counter medications.

Also Check: Hormonal Acne After Birth Control

Note On Breast Reduction/mastectomy And Nipple Reconstruction

The CPT codes for mastectomy are for breast cancer, and are not appropriate to bill for reduction mammaplasty for female to male gender affirmation surgery. CPT 2020 states that Mastectomy procedures are performed either for treatment or prevention of breast cancer. CPT 2020 also states that âCode 19303 describes total removal of ipsilateral breast tissue with or without removal of skin and/or nipples , for treatment or prevention of breast cancer. There are important differences between a mastectomy for breast cancer and a mastectomy for gender reassignment. The former requires careful attention to removal of all breast tissue to reduce the risk of cancer. By contrast, careful removal of all breast tissue is not essential in mastectomy for gender reassignment. In mastectomy for gender reassignment, the nipple areola complex typically can be preserved.

Thus, Aetna considers nipple reconstruction, as defined by CPT code 19350, as cosmetic/not medically necessary for mastectomy for transmasculine gender reassignment, and that CPT code 19318 includes the extra work that may be necessary to reshape the nipple and create an aesthetically pleasing male chest.

Why Use Hormone Pellets And Creams

When hormones are absorbed rather than swallowed, they go directly to the tissues and are not altered by the liver. This is called the first pass effect. Bypassing the gastrointestinal system also avoids many possible side effects. We use pellets as a convenient and measurable way to provide your hormone replacement.

Read Also: How To Stop Hormonal Hair Growth On Face

Does Medicare Cover Bioidentical Hormone Therapy

Typical Medicare insurance only covers certain prescriptions costs. Only part D will cover the cost of hormone treatments. Medicare Prescription Coverage may also pay for bioidentical hormones in some instances. Look at your plans list of covered medications to see whether thats the case for you. Medicare Part A and B do not cover the cost of bioidentical hormones.

Consultation And Evaluation For Hormone Pellet Therapy

Are Bioidentical Hormones Safe? | Holtorf Medical Group

Completion of the Female Hormone Pellet Therapy Consultation will involve full symptom discussion and evaluation, a pelvic ultrasound in our facility, and a panel of laboratories for baseline hormone levels plus other indicated labs. Hormone Pellets may be inserted during the second visit after a discussion of lab and ultrasound results.

Don’t Miss: Things To Eat To Balance Hormones

Cost Of Womens Hormone Replacement

The cost for pellet treatment for women who require an average schedule of pellets is $4.25 per day. That is $1,560 a year.

All the costs you avoid and the improvement in your quality of life could cut the total cost bioidentical hormone pellet therapy in half, making the cost about the price of a small cup of coffee from Starbucks$2.10/day.

Two consultations are required one before and one after the first insertion of pellets. After that, consultations are only needed once a year, when they are required by the patient who needs a change in dosage, or to review labs in complicated cases.

Learn more about your rights and protections related to the No Surprises Act .

*Keep in mind that each patient is unique and your results may vary.

**These statements have not been evaluated by the Food & Drug Administration. Rejuvime Medicals products are not intended to diagnose, treat, cure or prevent any disease.

Rejuvime Medical is a wellness and anti-aging clinic which offers bioidentical hormone replacement therapy and other services at its 2 locations in Baton Rouge and Metairie, Louisiana. The medical director, Dr. Jonathan Weiler, is a board-certified plastic surgeon. Women and men seeking hormone replacement therapy travel from New Orleans and throughout the state to Rejuvime Medical, which also offers blood testing and cosmetic injectables to patients.

But What If Testosterone Pellet Costs Seem A Little High For Your Budget

Sometimes, you need to make an investment upfront to save money and time over the long run. This is especially true when considering testosterone pellets cost.

Consider these points:

1 Testosterone pellets provide relief for multiple symptoms. Treating multiple symptoms with one therapy means less time in a doctors office, fewer out-of-pocket costs, and fewer medications to keep up with.

2 Testosterone pellets are convenient and easy to use. Relief of symptoms can save:

  • your job by increasing work performance.
  • your marriage by optimizing your health and sex life.
  • money on weight-loss programs, skin treatments, and age-defying procedures

3 Your risk of getting Alzheimers Disease and Dementia may decrease, saving you and your family heartache and high medical bills.

4 Pellets provide the longest-lasting average level of hormones. This means that you will only have to go back to the doctor for a pellet insertion every 3 to 6 months. Compared that to:

  • injections that typically last 1-2 weeks
  • patches that last a few days
  • pills that last a single day and have to pass through the liver
  • creams and gels that last a few hours

See? When thought about this way, testosterone pellet therapy can be convenient and economical.

And the good news is, we have hormone membership packages available, which might just make the difference for you when price is an issue. Why not take a look here to learn more?

You May Like: What’s The Best Testosterone To Take

Are You Ready To Feel Like You Again

The bioidentical hormone replacement therapy cost should not be the reason you shy away from balancing your hormones and living a more comfortable life. By taking part in this treatment option you can be your own advocate and bring balance back to your life.

Did you enjoy learning about the cost of bioidentical hormone therapy? To learn more about your hormone therapy options check out our website here to schedule your free consultation today.

ReVital gives you the balance you need to get back to you!

Current Locations

  • 230 S 68th Street, Ste 1201West Des Moines, IA 50266 316-2226
  • 2323 N Mayfair Rd, Suite 104Wauwatosa, WI 53226 662-9858

Current Locations

  • 11704 W Center Rd, Ste 103BOmaha, NE 68144 875-5510
  • 124 Chesterfield Towne CenterChesterfield, MO 63005 254-8057


What Should Be Included In The Cost Of Your Growth Hormone Therapy

Bioidentical Hormones and HRT for Women

Remember, when evaluating the costs of HGH therapy, you have to consider that what goes into the cost of growth hormone therapy is more than just the cost of the HGH. The price of the HGH prescription may be the lion share of the cost, but other things factor into the cost of your therapy, such as blood tests, follow-up doctors visits, perhaps some additional nutritional supplements. Make sure when you get a quote for the monthly fee for growth hormone therapy, you know exactly what you are getting.

Also Check: Breakthrough Bleeding On Bioidentical Hormones

Recommended Reading: Hormone Medication After Breast Cancer

Medical Science Has A Solution

Treatment for hormone imbalance is now available in the form of Bioidentical hormone replacement therapy . Hormone replacement therapy replaces missing hormones to bring levels back into balance.

You may have heard of conventional hormone replacement therapy, which uses hormones made from the urine of pregnant horses and other synthetic hormones.

Bio-identical hormones are made from plant estrogens that are chemically identical to those our bodies produce naturally.

According to the North American Menopause Society , about 1.4 million women currently use BHRT to treat their menopause symptoms.

Dont Let Insurance Drive Your Decision

We strongly encourage prospective clients to set the insurance dilemma aside when selecting a provider. If the treatment youre seeking is based on current best practice and is customized to your needs, theres a better than good chance that all or most of your costs will not be covered by insurance. That being the case, why let insurance be a factor in your decision?

Instead, focus on finding a provider whos a good fit for you relative to your treatment goals. How is that accomplished? Our advice is to ask lots of questions. If youre speaking with a prospective provider who either cant answer your questions, or wont take the time to do so, that should be a red flag. Move on and find someone else.

Read Also: Average Cost Of Bioidentical Hormone Replacement Therapy

How Are Bioidentical Hormones Made

If you are wondering Are hormones covered by my insurance? its important to understand how biodentical hormones are made.

Bioidentical hormones are derived from a plant chemical extract found in yams and soy. They are often available by prescription at a drugstore or may be prepared by a compounding pharmacy.

Are Bioidentical Hormones Covered By Medicare


Original Medicare has limited prescription drug coverage. It doesnt cover hormone therapy medications at all, even those for menopause.

If you need coverage for HRT, youll need a Medicare Part D Prescription Drug Plan. You can opt for a private insurance company. Or, you can add a stand-alone Part D Prescription Drug Plan to your original Medicare.

Another avenue is a Medicare Advantage Prescription Drug. This plan covers prescription drugs, including those for hormone therapy.

For a list of covered medications, see the plans formulary. A formulary is a list of covered medications. If your doctor prescribes a drug thats not on the formulary, you can request a substitute.

Don’t Miss: Blood Work To Check Hormone Levels

More articles

Popular Articles