The global prevalence of testosterone deficiency ranges between 10-40%. Testosterone helps with red blood cell formation, muscle and bone health, sperm formation, and sexual function in males.
However, testosterone levels can decline due to trauma, stress, infections, and aging. Having low testosterone can affect your physical and emotional health. Luckily, you can get treatment with testosterone replacement therapy.
But is testosterone replacement therapy covered by insurance? Below is a guide that highlights testosterone replacement therapy (TRT) treatments and TRT insurance coverage.
How Testosterone Replacement Therapy Works
Testosterone replacement therapy is only available with a prescription. If you experience symptoms consistent with low testosterone levels, your doctor will assess your medical history. They will also perform physical exams and blood tests before providing a prescription.
Some doctors may ask for imaging studies and additional tests like follicle-stimulating hormone and luteinizing hormone tests. This helps them determine the cause of the low testosterone levels. Once they are done, they will prescribe a treatment plan.
Your testosterone replacement therapy treatments can be administered in several different ways, including:
Injectables
Testosterone injections are given in the muscle every two to four weeks. They provide a burst of testosterone that can last for several weeks. The dosage and frequency of the treatment will depend on your individual needs.
Cheek or Buccal Patches
For buccal patches, you will need to place them above your upper teeth and they will release testosterone over 12 hours. These patches typically contain 30 mg of testosterone. Ensure you apply them twice each day—around 12 hours apart.
Topical Testosterone
You can get a steady supply of testosterone through topical patches or gels. When you use topical treatments, avoid skin-on-skin contact with other persons for at least 6 hours after application.
Testosterone Pellets or Implants
The doctor will insert small, rice-sized pellets under your skin every three to six months. These pellets slowly dissolve, releasing testosterone into the bloodstream over time.
Oral Testosterone
Oral testosterone therapy is typically administered in the form of testosterone capsules or tablets that are taken by mouth. The dosage and frequency of treatment will depend on the individual patient's testosterone levels and symptoms.
It’s often taken twice daily. Your doctor will recommend the best dosage for you.
Intranasal Testosterone
Apply testosterone nasal gel to the inside of both of your nostrils three times a day at intervals of 6–8 hours. Your dosage can be 11 mg per application across both nostrils, leading to a total dosage of 33 mg per day.
How Much Does Testosterone Replacement Cost?
The costs of TRT can vary depending on the type of treatment you’re prescribed. You can expect to pay anything from $20-$1,000 per month. Other factors that can affect cost include:
- Your location
- Administration method
- Whether there’s a generic version of the treatment available
- Availability of TRT insurance
Does Health Insurance Cover Testosterone Replacement Therapy?
Yes, testosterone replacement therapy insurance is available. Most health insurance providers will cover your testosterone replacement therapy costs as long as you can demonstrate a need. Some insurers may approve treatment costs if you have certain health conditions:
- Kallman’s Syndrome
- A pituitary tumor
- Klinefelter’s Syndrome
Depending on your health care plan and insurance company, coverage for the treatment may include full payments or copayment. To know whether insurance can cover your TRT treatments, speak with one of our experts today.
Reap the Benefits of Testosterone Replacement Therapy
When low testosterone levels interfere with your preferred lifestyle, physical ability, and sexual health, PeakPerforMAX offers hormone therapy that helps you get your life back. You may also need TRT insurance to get your treatments affordably.
