People who are contemplating bioidentical hormone replacement therapy (BHRT) will naturally want to know how much it will cost. While not exorbitant, the initial outlay for BHRT may, in many cases, be more than what you are used to paying for a doctor's visit and getting a prescription filled. If your primary care doctor, gynecologist or other health care provider is willing to evaluate you prior to prescribing BHRT, you may only need to submit the copayment required by your medical insurance at the time of your appointment. However, if you seek out a specialist in BHRT, he or she may not be a member of the network of health care providers covered by your insurance policy, and you may have to pay the full price of an office visit if your out-of-network deductible has not been met. Blood tests ordered by your BHRT physician also may not be covered by your insurance.
The answer to how much does hormone therapy cost may depend greatly upon your health insurance coverage.
Some prescription hormone therapy costs are covered by insurance
Some prescription bioidentical hormones may be covered by insurance, but others may not, particularly those formulated by a compounding pharmacy. Compounding pharmacies will often provide a claim form that can be completed by patients and mailed to their insurance company to obtain a reimbursement. Nevertheless, many health insurance policies exclude coverage for compounded medications.
Some hormones are available over-the-counter
Some hormones may be available without a prescription, including micronized progesterone, DHEA, and pregnenolone. The purchase of these over-the-counter products is usually not covered by insurance. All of this can add up to a significant upfront cost, not to mention the continued expense of follow-up visits with your BHRT doctor and periodic prescription refills. Yet, BHRT can save you money. While the initial hormone replacement therapy cost may seem high in some cases, the preventive benefits of BHRT can be considerable.
BHRT saves money in the long-run by preventing disease
Bioidentical hormone replacement therapy has been associated with the prevention of a range of diseases, the price of which, to the individual and society, is staggering. For example, the cost for disability caused by osteoporosis and associated fractures is significant, and the use of bioidentical hormones, along with nutrients, can go a long way toward preventing the disease. Natural progesterone has been associated with a reduced risk of blood clots in comparison with the risk in nonusers.1 Having a high level of estriol, a natural estrogen, has been associated with a lower risk of breast cancer.2 Furthermore, it is believed that estradiol, another natural estrogen compound, may protect a woman from Alzheimer's disease if given at the onset of menopausal symptoms.3,4,5
Preventing suffering is priceless
Perhaps the greatest cost in terms of human suffering is the mental and emotional toll exacted by the decline in hormones associated with aging. Anxiety, depression, insomnia, fatigue, low libido, "brain fog," irritability, and more can result in years of psychological counseling (which may be partly covered by insurance), with little resulting benefit if the root cause is actually hormonal imbalances. For years, women have suffered from hormone-related symptoms in silence and men have been too embarrassed to consult their doctor about low testosterone. Rather than restoring their biochemistry to proper levels, women endure hot flashes and bad moods in the hope that the ravages of menopause are only a temporary transition. And lacking medical knowledge, men sometimes attempt to alleviate their depression and restore lagging libido with a different partner. The price of ineffective counseling, bogus remedies, antidepressants, sleeping pills, and other prescription drugs with their attendant side effects can be significant, but far worse is the human cost of mental anguish.
The bottom line
Far from wishing to paint a bleak picture, these significant costs to the individual and society can be prevented or relieved, in many cases, by the use of hormone replacement therapy. Although the initial out-of-pocket expense may be more than the cost of doctor office visits, one can't put a price on the long-term benefits.
- Circulation. 2007 Feb 20;115(7):840-5.
- Unpublished study performed at the Public Health Institute in Oakland, California, and funded by the US Army Medical Research and Material Command under DAMD 17- 99-1-9358.
- J Midlife Health. 2014 Jan;5(1):38-40.
- Front Biosci (Elite Ed). 2012 Jan 1;4:976-97.
- J Alzheimers Dis. 2011;26(3):495-505.