Does Medicare Cover Hormone Replacement Therapy?

In this article...
  • Both men and women might have reasons to seek hormone therapy. But does Medicare cover hormone replacement therapy? Get some answers with this short article.

Whether or not Medicare covers hormone therapies is a complex question. First you have to define the exact hormone therapy and what it's being used to treat. You also have to understand which part of Medicare might come into play and check your benefits to understand exactly what is covered. Find out more about whether or not Medicare covers hormone replacement therapy below.

What Is Hormone Replacement Therapy for Women?

Most of the time when people refer to hormone replacement therapy for women, they're referring to a treatment for menopause symptoms. Hormone replacement therapy, or HRT, involves attempting to boost a woman's estrogen levels by adding hormones into her system. Because many menopause symptoms occur due to a drop in estrogen levels, boosting those levels has been shown to improve symptoms.

Hormone replacement therapy can occur in a number of ways. Doctors can prescribe oral medications, patches or topical estrogen creams or sprays. They might also prescribe creams, tablets or rings for vaginal delivery of estrogen.

What Is Low T Treatment for Men?

Men can also experience hormone issues as they age. Testosterone in men peaks around the age of 19 and slowly falls off over time after that. Some men can experience especially low testosterone levels that lead to symptoms including memory issues, fatigue, lower sex drive, sexual dysfunction, hair loss, muscle or bone mass loss and mood issues.

Low T treatments seek to replace some of the testosterone in a man's system. Testosterone hormone replacement therapy can be done via injections, oral or topical gels, patches or a small implant under the skin.

Does Medicare Cover Hormone Replacement Therapy for Women?

Since most of the hormone replacement therapies for women are prescribed items you administer yourself at home, they are considered prescription drugs. This means they're typically covered under the Plan D prescription drug benefit Medicare beneficiaries can choose to purchase as an addition to their hospital and medical coverage.

The only way to know if your Plan D prescription benefit coverage would pay for HRT drugs is to check the formulary for your plan. That's the list of drugs and treatments covered under the plan. If you're not sure, call the customer service phone number for your plan to ask.

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