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Is estradiol covered by insurance? | How much does estradiol cost without insurance? | How to get estradiol without insurance
Estradiol is a potent form of the female hormone estrogen. Healthcare providers prescribe estradiol to restore estrogen levels in menopausal and postmenopausal women when the ovaries stop producing estrogen. Hormone replacement therapy helps reduce menopausal symptoms such as hot flashes, vaginal dryness, and hair loss and prevents osteoporosis. The FDA has also approved estradiol as an end-stage breast and prostate cancer treatment. Generic estradiol comes in several forms: oral tablets, vaginal inserts, vaginal creams, gels, or steady-release skin patches. Healthcare providers use generic estradiol valerate or brand-name Depo-Estradiol (estradiol cypionate) for estradiol injections.
RELATED: Estradiol side effects and how to avoid them
What is the brand name for estradiol?
A host of prescription estradiol products are sold in pharmacies. Some are premium-priced, but a few are simply generic drugs with a brand name attached.
Tablets or creams are two forms that Estrace, one of the brand names of estradiol, comes in comes in. Both formulations are easily purchased in generic versions. Estradiol gel also comes as a generic, but brand-name versions include Divigel and Elestrin.
Skin patches are a convenient way to take estradiol since they slowly deliver the drug through the skin. These transdermal systems can be bought over the counter but are also sold as Alora, Vivelle-Dot, and Minivelle.
Vaginal inserts can be purchased as generic or brand-name products like Yuvafem or Vagifem. Imvexxy is a vaginal insert FDA-approved to treat painful sexual intercourse due to menopause-induced vaginal atrophy.
Vaginal rings such as Estring deliver continuous, small doses through the vaginal lining. Generic vaginal rings are not currently available.
A combined product of estradiol and progesterone reduces the risk of severe side effects of estradiol-only treatment, such as blood clots, heart attacks, strokes, and cancer. These include Activella and Mimvey (estradiol-norethindrone tablets), Combipatch (estradiol-norethindrone skin patches), and Climara (estradiol-levonorgestrel skin patches). Generic combinations of estradiol and progesterone are also available.
Is estradiol covered by insurance?
Most people with health insurance, Medicare Part D, and Medicaid will have coverage for generic estradiol as long as it’s prescribed for FDA-approved medical conditions. However, coverage may vary. Individual plans may not cover some formulations. Insurance plans are less likely to provide coverage for brand-name estradiol products.
While most insured patients can be confident about estradiol coverage, the out-of-pocket cost is harder to predict. Depending on the plan, estradiol tablets, and other forms can be placed in the lowest or higher copay tiers. Of course, different insurance plan policies will affect out-of-pocket costs, such as coverage gaps, deductibles, and coinsurance.
How much does estradiol cost without insurance?
For people paying cash price, a 30-day supply of estradiol tablets (30, 1 mg tablets) costs about $29 on average, or less than one dollar per tablet. At that price, a year of treatment costs over $300. Other formats, such as transdermal patches or estradiol gel, may cost more.
Generic estradiol or estradiol-progesterone combination drugs are the lowest-priced hormone treatments for menopausal and postmenopausal symptoms. The only cheaper alternatives are non-hormonal treatments. These other drugs treat the symptoms but not the underlying hormonal changes. They include antidepressants, blood pressure medications, and anticonvulsants. For osteoporosis, calcium supplements and bisphosphonates are the standard treatments. When choosing between hormone replacement and symptom-based medications, ask a healthcare professional for medical advice. There are trade-offs in effectiveness and side effects.
With a free coupon from SingleCare, a 30-day supply of estradiol tablets can cost as little as $2.
RELATED: Estradiol alternatives: What can I take instead of estradiol?
Compare Estrace (estradiol) prices to related drugs |
|||
|---|---|---|---|
| Drug name | Price without insurance of brand-name drug | SingleCare price | Savings options |
| Estradiol | $29 per 30, 1 mg tablets | $2 per 30, 1 mg tablets of generic estradiol | See latest prices |
| Brand-name estradiol
(Estrace) |
$435 per 1, 42.5 gm of 0.1 mg/gm cream | $2 per 1, 42.5 gm of 0.1 mg/gm cream of brand-name Estrace | See latest prices |
| Premarin | $261 per 30, 0.625 mg tablets | $203 per 30, 0.625 mg tablets of brand-name Premarin | See latest prices |
| Activella | $364 per 1, 28 tablets | $21 per 1, 28 tablets of brand-name Activella | See latest prices |
| Vivelle-Dot | $214 per 1, 8 patch box | $20 per 1, 8 patch box of brand-name Vivelle-Dot | See latest prices |
Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see the latest drug prices.
How to get estradiol without insurance
Although generic estradiol prices are generally lower than other generic prescription drugs, they are a significant added expense when totaled over several months of treatment. For people prescribed brand-name estradiol, the manufacturers may offer patient assistance programs to help defray the cost for uninsured patients. There are two problems with these programs. First, they don’t cover generic estradiol; second, not everyone can meet the eligibility requirements. Fortunately, a few strategies can help uninsured people save on generic estradiol. Start with a SingleCare prescription discount card.
1. Find discount prices through SingleCare
A 30-day supply of estradiol tablets can cost as little as $3 with a SingleCare savings card, but savings will depend on the participating pharmacy. Browse available discounts and participating local pharmacies on SingleCare’s estradiol coupons page. For more savings information, scroll to the FAQs section on this coupon page.
2. Find the lowest pharmacy price
The lowest price for 30, 15 mg estradiol tablets is about $6, well below the average retail price. However, price shopping for generic prescription drugs is time-consuming, so use SingleCare’s price history table for estradiol to quickly find the lowest price. Then go to SingleCare’s pharmacy finder page to find the nearest store.
3. Enroll in Medicaid
If purchasing lower-priced generic drugs like estradiol tablets is challenging, Medicaid or the Medicare Low Income Subsidy may be an option. These programs aim to reduce what people pay for medical care and drugs to zero or very close to it. Check your state’s Medicaid website for eligibility requirements, enrollment forms, and more information.
