Compounded testosterone is usually not covered by insurance because compounded medications are not FDA-approved and generally are not included on insurance formularies. Retail testosterone products, however, often have a coverage pathway for men when documentation,...
If your insurance suddenly stops covering a medication, it does not automatically mean you must stop treatment. Most mid-year coverage problems fall into a few categories: formulary changes, new prior authorization requirements, pharmacy network restrictions, or...
Prior authorization is now a routine part of Medicare Advantage coverage. In 2024 alone, Medicare Advantage plans processed nearly 53 million prior authorization determinations, with about 4.1 million fully or partially denied. The important part: when denials were...
Persistent night sweats while on HRT usually mean your regimen needs adjustment. The issue may be underdosing, poor absorption, timing, undertreated progesterone, low testosterone, or a non-hormonal trigger such as thyroid dysfunction, alcohol, or medication side...
Testosterone pellets and weekly injections are both recognized hormone delivery methods for women, but they work very differently in the body. Pellets offer convenience with infrequent dosing, while injections provide lower cost, easier dose adjustments, and more...
UnitedHealthcare generally covers FDA-approved hormone replacement therapy for women, including estradiol, progesterone, and vaginal estrogen, when prescribed for a documented medical indication and filled through a network pharmacy. What changes between plans is the...