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Why is testosterone replacement not covered by insurance?

Optimal Male TRT does not accept insurance. Why? Because insurance does not cover testosterone replacement, unless the patient's level is extremely low, however, many men feel symptoms at "low normal" levels making it necessary to replete levels with testosterone injections for optimal wellness.

Why do insurance companies not cover Testosterone Replacement Therapy, also known as TRT? First, when considering Testosterone Replacement Therapy, it is important to understand that the #1 priority of insurance companies is to make a profit, which means the patient is NOT the priority. As is typical with insurance companies, they have a high tendency to process approvals for the least expensive medications at the lowest possible doses; and anything falling outside of those parameters, will not be covered.

So, why would they ever do such a thing? PROFIT! They simply don't want to pay for it. While the doctor may find that a patient has significantly low Testosterone levels and thus recommends Testosterone by weekly injection, along with necessary ancillary medications such as HCG and Anastrozole, the insurance company will reject coverage 100% of the time. Hormones providers are not encumbered by insurance guidelines for prescribing and dosing, This allows the provider to treat the patient correctly.

Will insurance cover my lab work?

While Optimal Male TRT does not accept insurance, we are happy to give you a superbill, or itemized bill, in order to present to your insurance company to try to get reimbursed for lab work.

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