Questions About Bioidentical Hormone Therapy Insurance Coverage

Hey all you Menopause Maniacs! I hope everyone is doing well, and hasn’t robbed their local gas station for all the Snickers and BBQ Lays… I know I wanted to from time to time.

A lot of you have been asking about insurance issues lately, so I went straight to the source at BodyLogicMD and got some answers for you. The main questions you’ve asked are why doesn’t BodyLogicMD bill our bioidentical hormone therapy treatments directly to insurance and what are the overall costs involved in treating menopause and andropause.

So here’s the gist, in the simplest way possible.

Most of us have insurance, and most of us have a co-pay with that insurance. In addition to that co-pay, we all have deductibles. When it comes to lab work your deductible most likely applies, meaning you pay the full price until your deductible is met. If you see the doctor as well, your usual co-pay applies also.

Secondly, a lot of the time lab work isn’t covered at all because it’s outside of your “standard lab allowance” – or what-the-hell-ever!  We find out, after we’ve had these labs taken, of course, that they aren’t covered and we pay out of pocket.

Additionally, the lab charges your insurance company an inflated price, which can be three times what they would charge if you didn’t file with insurance – so it’s rip off going through them in the first place!

What BodyLogicMD has done is negotiate a cash price for the same labs that your primary hospital or doctor use. Basically, the female hormone test panel that BodyLogicMD uses would cost $2,000 at your regular doctor. At a 20 percent co-pay  (that’s assuming you paid your deductible already) that’s $400.00 – that’s if your insurance company decides to cover the test! If you haven’t paid your lab deductible for the year, you could potentially pay the full $2,000. Scary.

Too often insurance companies pull some archaic rule out of some big book and decide to apply it to you randomly – leaving you frustrated AND with a big bill for the “uncovered test.”

BodyLogicMD’s price is $450. It is what it is – no funny business.  So, in my mind, hormone therapy at BodyLogicMD is worth it.

So, while it might seem intimidating to bypass insurance for these tests, financially speaking, BodyLogicMD’s prices are a much better value without any of the “unknowns” that your insurance provider is famous for.

Hope this helps!

Judy B.

 

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  • This article was very interesting. It’s good to know as much as possible about insurance as a whole.