Written by Jenna Lee - January 17, 2023
Yes, Aetna covers hormone replacement therapy (HRT)
If you are an Aetna policyholder, it is important to know that your insurance carrier does offer coverage for hormone replacement therapy (HRT). However, before you begin your treatment, you need to make sure that your plan includes coverage for the specific type of HRT that you require.
Aetna's coverage for HRT
Aetna covers several types of hormone replacement therapies including estrogen and testosterone replacement therapy, as well as progesterone androgenic hormone replacement therapy. However, the extent of coverage may vary based on different plans which Aetna offers. Therefore, it is recommended that you consult your policy before starting your HRT treatment.
Verification and requirements
Aetna requires proof of medical necessity for hormone replacement therapy. Generally, a blood test is required to test hormonal levels and base the assessment of the medical necessity. A physician will then evaluate your required dosage of hormones to be prescribed. In addition, the use of compounded HRT medications may require prior authorization from Aetna.
Coverage for transgender individuals
Aetna covers hormone treatment for transgender individuals as well. The company recognizes the need for both surgical and non-surgical treatments, including hormone therapy. Through its specific LGBTQ care programs, members can access a network of healthcare providers who are trained in treating transgender persons.
Benefits of HRT
However, it is important to understand that HRT may have some side effects too. The specific risks, benefits and potential side-effects associated with hormone replacement therapy vary widely, depending on the patient's individual medical history and the specific type of HRT prescribed.
Hormone Center HRT Clinic
If you are still unsure about the coverage of HRT, Hormone Center is a HRT clinic that provides a range of hormone replacement therapies. They have clinics across the country and offer individualized care with customized treatment plans. They accept Aetna, Cigna and other major insurance carriers, maximizing the coverage for the client.
Don't hesitate to reach out to Hormone Center for more information on how to get started with your hormone replacement therapy journey.