Does Medicare cover bioidentical hormones?

Looking for answers about whether Medicare covers bioidentical hormones? Medicare Plan D might cover the cost of bioidentical hormones under certain conditions. Additionally, a Medicare Advantage plan might also cover the cost of other bioidentical hormones. If Medicare doesn't cover everything, your health insurance might cover any BHRT medications that Medicare does not. Keep reading to find out more about BHRT medication coverage.

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D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsbury’s 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve...

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: Jan 20, 2021

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The Highlights

  • Bioidentical Hormone Replacement Therapy may be covered under Medicare Plan D, but is not covered under Medicare Plan A or Medicare Plan B.
  • Bioidentical Hormone Replacement Therapy uses different hormone compounds than Conventional Hormone Replacement Therapy (CHRT).
  • Custom-compounded bioidentical hormones are considered to be alternative medicines and are not covered by Medicare or most health insurance providers.

Bioidentical Hormone Replacement Therapy uses a variety of different bioidentical hormones in order to increase the presence of these hormones in the user. These compounds are called bioidentical hormones because are identical to those that are found naturally in humans.

Because we understand that researching different BHT medications and insurance providers might become daunting, we have a variety of health insurance resources available to make things a little more manageable.

The cost and coverage of these BHRT medications can vary depending on your health insurance provider and insurance plan. If you want to make sure that you are getting the best rates and health insurance rates in your area, we encourage you to try out our insurance comparison tool. You just need to enter your ZIP code, and this free tool will provide you with affordable health insurance quotes near you.

What is Bioidentical Hormone Replacement Therapy?

Bioidentical Hormone Replacement Therapy is a form of hormone replacement therapy that uses hormones that are identical on a molecular level with endogenous hormones that are used in hormone replacement therapy (HRT).

Many experts—such as the American College of Obstetricians and Gynecologists (ACOG) and the United States Food and Drug Administration (USFDA)—have released statements that they have not seen any evidence that Bioidentical Hormone Replacement Therapy is more effective or beneficial in comparison to Conventional Hormone Replacement Therapy (CHRT).

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Is Bioidentical Hormone Therapy Covered By Medicare?

So, does Medicare cover bioidentical hormones? Neither Medicare Plan A nor Medicare Plan B will cover the cost of bioidentical hormone therapy (BHT). This is because these parts of Medicare don’t 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.

Is Bioidentical Hormone Therapy Covered By Insurance?

Whether or not the bioidentical hormone therapy is covered by your health insurance is dependent on two main factors. These two factors are what insurance provider you have a plan through, and what plan you are enrolled in.

Many health insurance providers, however, thankfully do offer assistance when it comes to covering the cost of these medications.

If you have a Medicare Advantage plan, then you will likely have a better chance of having your BHT medications covered due to the additional prescription coverage that these plans offer.

Does Insurance Pay for Bioidentical Hormone Replacement for Men?

BHRT hormones for men may or may not be covered by your health insurance provider. This depends mainly on who your insurance provider is, and what insurance plan you are enrolled in.

Are Bioidentical Hormones Covered by Insurance for Women?

Bioidentical hormones for women may or may not be covered by your health insurance provider, just like the bioidentical hormones that are commonly used by men. It depends on your insurance plan.

How Much Does Bioidentical Hormone Replacement Therapy Cost?

If Medicare covers your specific bioidentical hormone medication, then you shouldn’t have any additional out-of-pocket expense with Medicare. Your health insurance might cover any BHRT medications that Medicare does not.

Before you buy health insurance, shop around for the best rates in your area.

If you want to make sure that you are getting the most affordable coverage possible, you can benefit greatly from using our free insurance rate comparison tool. You just need to provide the tool with your ZIP code to start comparing the rates in your area.

Are you looking for free insurance quotes?

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