The short answer to this question is no, Original Medicare Part A and Part B does not cover the cost of hormone replacement therapy (HRT). However, Medicare Advantage or Medicare Part D may cover the cost of hormone replacement therapy drugs.
A Medicare Advantage plan is provided by private health insurance companies, so depending on the plan you get and which provider, you can customize your drug plan to accommodate hormone therapy drugs.
Agent Tip
In order to get coverage for HRT under a Medicare Advantage plan, you must choose a plan that includes prescription coverage.
If you’re wondering which carrier to sign up for, or which plan to choose, give us a call at 800-208-4974. One of our licensed insurance agents will be able to help you choose a plan and provide a free consultation.
What Is Hormone Replacement Therapy?
Hormone replacement therapy is mainly used to help women experiencing menopause symptoms which can be hot flashes or vaginal issues. It is also used to protect women with their long term health plan because it helps reduce bone loss and fractures.
There are three different stages of menopause which include:
- Perimenopause: This is the time before menopause when women’s ovaries decrease estrogen output.
- Menopause: This is when the female body no longer produces eggs and the individual no longer experiences a menstrual or period cycle.
- Postmenopause: This is after menopause, and an individual can experience a number of symptoms.
Symptoms at all these stages of natural menopause can be experienced in different ways. Since the body is going through hormone changes, the individual may feel pain and a lot of discomforts. That’s why having hormone replacement therapy is vital in order to live a happy and healthy life.
To learn more about hormone replacement therapy and to find out how Medicare Advantage plans can help pay for the hormone therapy drugs, give us a call at 800-208-4974. One of our experienced insurance agents would be happy to help you choose the best plan for your needs.
Why Are Some Risks Of Hormone Replacement Therapy?
There is some risk when it comes to hormone replacement therapy. Since it is a pill increasing estrogen in the body, there can be serious drawbacks such as:
- Blood clots
Breast cancer - Stroke
- Heart disease
The older you are when you take these pills, the more likely you may experience some of those symptoms above. Also, depending on your dosage amount and frequency of your hormone therapy drugs, it may cause a deeper or lighter effect. It’s advised to speak with your doctor or a health care provider in order to mitigate the symptoms as much as possible.
Folks that are 65 or older are eligible for Medicare. Original Medicare Part A and Part B will provide coverage for bioidentical hormone replacement. This medical option can help treat hormone imbalances like menopause and thyroid. To learn more about Medicare coverage and other Medicare supplement options, give us a call at 800-208-4974 for a free consultation.
Testosterone is found in both male and female hormones, however as folks age, these levels decrease and can have an abnormal effect on the body. In order to mitigate that, testosterone pellet therapy was created. There are a number of requirements in order to have the cost of this therapy covered by Medicare, if you meet those requirements you will be able to get full coverage.
How Much Does Hormone Replacement Therapy Cost With Medicare?
Depending on the plan and company you go with, the general cost will vary. On average, monthly prescription costs for oral Hormone replacement therapy will cost around $130 or $240 per month or $1500 to $2500 annually.
This out-of-pocket cost can be covered with a Medicare Advantage or Part D plan, however, you must find the best plan that suits your needs. To learn which plan is best for you, give us a call at 800-208-4974. Our insurance team here at Bluewave Insurance will be able to guide you in picking the right plan.
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:
- Hospice care
- Dental Care
- Vision Care
- 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 800-208-4974. Our experienced insurance agents will be able to provide a free consultation and get you in the right direction.
Medicare Part D and Hormone Replacement Therapy
Medicare Part D, or the prescription drug plan may cover some medications that Original Medicare Part B doesn’t cover. Part B only covers drugs provided at a doctor’s office or hospital, which leaves a lot of other prescription drugs unaccounted for. For example, if the doctor requires you to go to a pharmacy to obtain a certain drug, Part B won’t cover that and that could leave you in $100s of dollars in drug cost.
With Medicare Part D, you’ll be able to get some coverage for unexpected expenses and save in the long-run from drug costs. As mentioned before, with Part D, this can help pay for the hormone replacement therapy drugs partially if not fully.
The monthly premiums on Medicare Part D will depend on your specific needs. Maybe you might need a lot of prescription drugs or you may need more than average. Prices will vary with the carrier and specific Part D plan.
To learn more about Medicare Part D, give us a call at 800-208-4974. One of our experienced insurance agents will be able to help you find the plan best suited for your needs.
Summary
Hormone replacement therapy is definitely a necessary treatment if you are suffering from discomfort due to hormone imbalance. With this treatment, you can get back to your normal life even during menopause or post-menopause. Medicare Advantage plans with prescription coverage may provide some coverage for Hormone replacement therapy, depending on the plan.
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If you have any questions on how to obtain Medicare coverage for hormone replacement therapy or how to sign up for a Medicare Advantage plan, give us a call at 800-208-4974. One of our licensed insurance agents will be able to assist you.
