Does Insurance Pay for Hormone Clinics?

Does Insurance Pay for Hormone Clinics?

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Many people visit hormone clinics with the goal of looking and feeling better. As age-related decreases in natural hormone production occur, symptoms such as dry skin, declining libido, and even hair loss set in. It also becomes harder to lose stubborn pads of fat that accumulate at or around the midsection. Surprisingly, hormone therapy can also have a positive impact on a person’s overall health. In addition to looking and feeling more robust, an individual with balanced hormones may have a lesser likelihood of developing high blood pressure, arterial plaque, heart disease, macular degeneration, and diabetes among many other things.

For women, hormone therapy might additionally assist in preventing osteoporosis, osteoarthritis, and problems with general bone density loss. For these and other reasons, some health insurance plans will cover some or all of the treatment that policyholders receive at hormone clinics. Every insurance plan is different, and every insurance company has its own rules concerning what they will and will not pay for. In general, lower-priced plans tend to have fewer perks and thrills, and even though these plans come with cheaper premiums, you’ll usually pay a lot more to use them. Higher-priced plans tend to provide more access to alternative medicines and clinical services, and more of a person’s individual treatment costs will be covered.

If you’re interested in receiving hormone therapy at a licensed hormone clinic, it’s best to start by calling your insurer directly to discuss your plan benefits. No matter what plan type you have, there are several costs that you may have to pay out of your own pocket. These include:

  • The plan deductible
  • Copayments
  • Prescription fees

If your health insurance plan was secured from your employer, you also have the option of speaking with human resources to find out which services are available to you. If you have a health insurance savings account as part of your employment benefits, you may be able to work with your employer to get your hormone treatments approved.

Important Factors to Consider When Using Insurance for Hormone Therapy

Certain factors will have a definite impact on whether or not you’re able to use your insurance for hormone therapy. For instance, most insurance companies will only pay for medical treatments that are FDA-approved. Many bioidentical hormone therapies have yet to receive FDA approval. More often than not, these treatments will need to be paid for out-of-pocket. However, when patients have health insurance savings accounts through their employers, getting approvals to use the available funds for bioidentical hormone therapy may be possible with or without FDA approval. There are two primary health insurance plan types. These are HMO plans and PPO plans. HMO plans or Health Management Organization plans restrict policyholders to only working with professionals within defined provider networks.

Apart from medical emergencies, if you choose to receive services at any clinic or from any professional who’s not within your HMO network, the resulting charges must be paid by you. Conversely, a PPO plan or Preferred Provider Organization plan will allow you to choose from both in-network providers and facilities and providers and facilities that lie outside of your plan’s network. Notwithstanding this fact, you may still be required to look for FDA-approved hormone therapies to ensure that your treatments are covered. When hormone therapy is determined to provide a generous array of general health benefits, it is frequently considered a covered treatment. To prove that hormone therapy is key for improving your health or necessary for preventing serious health issues, it may be necessary to get a referral to the hormone clinic of your choice from your general doctor.

One easy way to determine whether or not your treatments at a hormone clinic are covered is by speaking with the clinic itself. Most hormone clinics have a list of insurances that they’re willing to accept. Speaking with someone at the place where you wish to receive treatment may be easier than speaking with your employer or your insurance company about these services. After all, many of the reasons people seek hormone therapy are both sensitive in nature and personal. If you’re ready to start hormone therapy but have health insurance questions, we can answer them. Call us today at 205-352-9141 to find out about our accepted payment methods or to schedule a consultation appointment.

Be sure to utilize the following payment options. We also accept all major credit and debit cards.

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