How Often Does Insurance Deny Hormone Replacement Therapy?


When you’re considering hormone replacement therapy (HRT), one of the first things that may come to mind is the cost. After all, who can afford to pay hundreds of dollars every month for something they may not even need? Fortunately, there are a number of ways to get around insurance companies’ hesitation about covering HRT. In this blog post, we will discuss some of the most common methods and how often they work.

What is hormone replacement therapy?

Hormone replacement therapy (HRT) is a treatment regimen consisting of taking hormone supplements to replace the natural hormones that are lost during menopause or other medical conditions. HRT has been shown to be effective in reducing symptoms of menopause, such as hot flashes, mood swings, and dry skin.

However, insurance companies can often deny coverage for HRT due to factors such as age and pre-existing health conditions. If you are denied coverage for HRT by your insurance company, it is important to discuss the option with a doctor who can provide you with a personalized treatment plan.

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The Different Types of Hormone Replacement Therapy

There are a variety of types of hormone replacement therapy (HRT) available, each with its own benefits and drawbacks. Here’s a look at the main types of HRT:

1. Oral contraceptives: Oral contraceptives work by preventing ovulation and thereby preventing an egg from being released from the female reproductive system. This type of HRT is generally considered to be the safest and most effective, but it can also be expensive and may not be covered by insurance.

2. Hormone patches: Hormone patches release small amounts of hormones directly into the bloodstream over time. This type of HRT is considered to be less effective than oral contraceptives but may be more convenient for some people because it does not require daily administration.

3. Hormone injections: Hormone injections consist of a long, thin needle that is inserted into a vein in your arm. This type of HRT is considered to be more effective than hormone patches but can also cause serious side effects, such as blood clots and strokes.

4. Human chorionic gonadotropin (HCG): HCG is a hormone produced during early pregnancy that is sometimes used as treatment for women who cannot conceive or who are struggling to become pregnant. HCG therapy works by tricking the body into thinking it’s pregnant, which can help increase fertility rates in women who have difficulty getting pregnant naturally.

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Pros and Cons of Hormone Replacement Therapy

Hormone replacement therapy (HRT) has been shown to be effective in treating many conditions, including menopause, osteoporosis, and some types of cancer. However, insurance companies often deny patients coverage for HRT due to a number of potential risks.

One of the main concerns with HRT is that it can increase the risk of developing breast cancer. Studies have consistently shown that HRT increases the risk of developing breast cancer by around 50%, and patients who use HRT are three times as likely to develop breast cancer as those who do not use HRT. Additionally, HRT can also increase the risk of other ovarian cancers.

Another concern with HRT is that it can worsen sleep apnea. According to the National Sleep Foundation, approximately 25% of women over the age of 50 have sleep apnea, which is an disorder where people stop breathing at night due to obstruction from tissues in the throat. When taken together, these two issues – breast cancer and sleep apnea – are known as estrogen-related diseases.

Finally, there are a number of potential side effects associated with HRT use, including blood clots and strokes. Blood clots are especially a concern with hormone replacement therapy because it increases blood flow to the legs and lungs. Strokes are also a concern because they can lead to lasting disabilities or death.

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How Often Does Insurance Deny Hormone Replacement Therapy?

There are a number of ways that insurance companies can deny coverage for hormone replacement therapy (HRT). Some of the most common reasons why HRT may be denied include if it is considered a cosmetic treatment, if the patient has had previous claims for HRT that were not approved, or if the patient’s health is in question. It is important to contact your insurance company to find out specific policies regarding HRT coverage.


After reading this article on how often insurance denies hormone replacement therapy, you will have a much better understanding of why it can be so difficult to get approved. After all, hormones are considered medical devices and thus must meet certain criteria in order to be covered by insurance. This information will help you make an informed decision about whether or not to try hormone replacement therapy and increase your chances of being approved.