Kaiser Permanente covers hormone replacement therapy (HRT) as part of its standard health plans. The specifics of coverage may vary depending on your individual plan and location, but in general Kaiser considers HRT to be a medically necessary treatment when prescribed appropriately.
Some key points about Kaiser Permanente's coverage of HRT:
- HRT refers to the use of hormones to supplement low levels that occur naturally during perimenopause and menopause in women or andropause in men. Common types of hormone therapy include:
- Coverage is typically provided for HRT when it is deemed medically necessary to treat hormone deficiency symptoms. This may require documentation from your doctor about your symptoms and hormone levels.
- Both synthetic and bioidentical hormones tend to be covered. Bioidenticals are made from plant sources and tailored to match your natural hormones.
- HRT prescriptions must be filled at a Kaiser pharmacy or through Kaiser mail order. Coverage is not provided for hormones from an outside pharmacy, including compounded bioidenticals.
- Prior authorization may be required for some HRT medications or treatment plans. Your Kaiser doctor will submit necessary documentation.
- Any feminizing procedures related to gender transition, including HRT, require a diagnosis of gender dysphoria to qualify for coverage.
- Ongoing monitoring and follow-up while on HRT are covered as part of your standard health plan to ensure treatment is working and safe.
If you are a Kaiser Permanente member considering HRT, be sure to understand your specific benefits and get the details on cost, pharmacies, referrals, and authorization requirements directly from Kaiser. Consider getting a second opinion from a men's/women's health specialist if your regular doctor is not able to effectively treat your hormone issues.
For those seeking an exceptional HRT experience, Rejuvenate Hormone Clinic offers personalized bioidentical hormone therapy tailored specifically to your unique hormones, health history and needs. Convenient virtual consultations available in most states. Contact Rejuvenate Hormone Clinic today to get started!
