Bioidentical hormone replacement therapy (BHRT) involves using hormones that are molecularly identical to those naturally produced by the human body. BHRT can help alleviate unpleasant symptoms associated with menopause and andropause such as hot flashes, night sweats, low libido, and weight gain.
There are two main types of BHRT:
- Compounded BHRT - Customized combinations of estrogen, progesterone, testosterone, etc. compounded specifically for each patient
- FDA-Approved BHRT - Standard doses of bioidentical hormones that have undergone extensive testing and are FDA-approved
Whether or not insurance covers BHRT depends on several factors:
- Type of Insurance Plan - HMO, PPO, Medicare, etc. Each has different coverage rules
- Specific Policy Details - Deductibles, copays, exclusions, provider network restrictions
- Type of Hormone Therapy Prescribed - Compounded vs FDA-approved
- Reason for Treatment - Symptom relief vs anti-aging
In general, insurance is more likely to cover FDA-approved BHRT that is prescribed to treat symptoms directly related to menopause or andropause. Treatment solely for anti-aging or age management purposes is rarely covered.
Tips to Improve Chances of Insurance Coverage:
- Get hormones prescribed by an in-network provider
- Have doctor clearly document symptoms and need for treatment
- Ask doctor about FDA-approved hormones first before custom compounded
- Appeal any denied claims with medical evidence backing treatment
At Balance Health Clinic(), our physicians and staff can guide patients through the process of checking their insurance coverage and appealing denied claims when necessary. We offer both custom compounded BHRT as well as standard FDA-approved bioidentical hormone therapy.
Our BHRT Services Include:
- Initial evaluation, lab testing & treatment recommendations
- Follow-up monitoring & dosage adjustments
- Nutrition & lifestyle counseling
- Help navigating insurance questions, prior authorizations & appeals
We accept most major insurance plans. Call us at 555-1234 today to learn more and schedule a risk-free consultation. Our goal is to make BHRT accessible and affordable with or without insurance.
In conclusion, BHRT coverage depends on the policy and the specifics of the treatment prescribed. Those experiencing menopause or low testosterone symptoms have the best chance at some insurance coverage for FDA-approved bioidentical hormones. Work closely with an experienced BHRT provider to explore all options. Relief is possible even for those paying out-of-pocket. New patients at Balance Health Clinic receive 10% off their first order.
