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Is testosterone covered by insurance?

Testosterone prices and coverage vary by brand, form, and insurance plan. Here’s what to know about insurance, Medicare, Medicaid, and copays.
Wendy Wisner
By | Jul. 14, 2025 Medically reviewed by Gerardo Sison, Pharm.D.
Insurance card: Does insurance cover testosterone?

Key takeaways

  • Testosterone is usually covered by health insurance if you’ve been diagnosed with hypogonadism (low testosterone).

  • It can be more challenging to get coverage for testosterone for gender affirming care or menopause.

  • Many insurance companies will require prior authorization before covering testosterone. Others may require step therapy.

In this article:

Testosterone is a hormone produced by the body and is responsible for male sex characteristics. When testosterone hormone levels are low, a healthcare provider or doctor can prescribe synthetic or natural forms of testosterone to restore normal levels. Testosterone is sold both generically and under brand names like Aveed, Delatestryl, and Depo-Testosterone. Most of the time, testosterone is administered by injection, but it can also be taken as a tablet, gel, or patch.

Testosterone replacement therapy (TRT) is FDA-approved to treat males with hypogonadism  (lower than normal testosterone levels). It can also be used to treat conditions like delayed puberty and low testosterone levels caused by chronic illnesses and certain cancers. Testosterone is also prescribed off-label to provide gender affirming care for transgender males, and for women during menopause.

Does insurance cover testosterone?

Yes, health insurance does typically cover testosterone, says Pranav Dadhich, MD, a urologist focused on men’s health. “I prescribe various formulations of testosterone and treat a large number of patients with testicular hypofunction,” he shares. “However, there can be significant burdens and prior authorizations that delay prescription of the medication.”

It’s important to understand that health insurance coverage can be complicated, and coverage for testosterone treatment can vary based on a myriad of factors. Not only that, but testosterone copays and coinsurance may come into play, meaning that even when your health insurance company covers testosterone, there may be additional out-of-pocket expenses that you are responsible for. Additionally, some insurance companies may encourage you to try a generic version of testosterone before covered brand names, such as AndroGel, Testim, or Depo-Testosterone.

Here are some specific considerations to keep in mind when it comes to the question: Is testosterone covered by insurance?

Coverage based on testosterone formulation

Coverage can depend partly on the type of testosterone your healthcare provider prescribes, whether injections, gels, patches, or tablets. “Some of the newer formulations of testosterone (oral therapies) have lower rates of coverage and often require that a previous form of therapy (gels or injectables) have failed or resulted in some sort of complication,” Dr. Dadhich says.

Linda Khoshaba, NMD, FABNE, board-certified in naturopathic endocrinology and founder of Natural Endocrinology Specialists (NES), shares that in her experience, not all forms of testosterone are equally covered by insurance. “The delivery method absolutely matters when it comes to what insurance will pay for,” she says, noting that testosterone injections are typically the most affordable and most widely covered by insurance carriers.

“Gels and patches are more convenient for some people, but they tend to be more expensive and are sometimes only partially covered—especially if they’re brand-name,” Dr. Khoshaba explains. “Tablets are less commonly prescribed and often not covered at all.”

Coverage based on medical conditions

Whether or not your health insurance company covers testosterone also depends in part on what underlying condition your healthcare provider has diagnosed you with.

Typically, health insurance companies will cover testosterone when it’s prescribed for low testosterone levels (hypogonadism), says Dr. Dadhich. Often, your provider will need to provide documentation to your health insurance company that you have hypogonadism. “Most insurers require documentation of at least two morning testosterone levels that are low,” says Dr. Dadhich. “Some will require additional documentation of pituitary gonadotropins (hormones secreted by the pituitary gland that signal the cells in the testicle to make testosterone).”

The process of proving to your insurance company that you qualify for testosterone can be tedious and discouraging, Betsy Greenleaf, DO, triple board-certified urogynecologist and founder of International Pause Institute, says. “I have spent long, frustrating hours arguing with insurance companies that the patient’s testosterone is now normal because they are being treated,” she shares. “Occasionally, we would have to take people off hormones and then retest and then wait until it is low and then prescribe again.”

Coverage for other medical conditions can vary from one insurance company to another. “Gender-affirming hormone therapy is more likely to be covered now than it used to be, especially with ACA (Affordable Care Act) plans, but it still depends on the insurer,” Dr. Khoshaba says. “Sometimes there’s more paperwork or extra hoops to jump through when it’s prescribed for gender-affirming purposes.”

As for women in menopause who are seeking testosterone, it’s usually not covered, and typically, patients end up paying for it out of pocket, Dr. Greenleaf says.

Coverage based on insurance type

The type of health insurance you have can also affect whether your testosterone prescription is covered. Here’s what to know, according to Dr. Khoshaba:

  • Employer-sponsored plans and most ACA marketplace plans cover testosterone, but what they cover and how much you have to pay out of pocket vary quite a bit.
  • Medicaid is state-specific. Some states reliably cover both hypogonadism and gender-affirming therapy, but others do not.
  • Some Medicare Part D plans cover testosterone, but usually only when it’s prescribed for low testosterone. Even then, you may need prior approval.

Other criteria for coverage

There may be other hurdles to pass through in order for your prescription to be covered.

For instance, often prior authorization is needed before your plan will cover testosterone. This is especially likely if you are asking for coverage for brand-name testosterone or less common formulations like gels, Dr. Khoshaba says.

Lastly, some insurance plans will require step therapy before prescribing testosterone. “This means you’ll have to try the cheaper version (like an injection) first before they’ll approve other forms,” Dr. Khoshaba explains.

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How much does testosterone cost with insurance?

Testosterone is Tier 2 on insurance plan formularies or drug lists, which means that it has a moderate copayment. But the way testosterone is categorized by insurance providers will vary based on whether you’re asking for a brand-name or a generic drug, the type of testosterone you’re asking for, and the specific criteria of the insurance plan.

While the cost with insurance varies from one company to another, testosterone therapy typically costs between $10 and $30 per month, according to Dr. Khoshaba. These costs usually come in the form of testosterone copayments or coinsurance fees. “Gels and patches can be much pricier—even with insurance, they might run over $100 a month depending on the brand and your plan’s copay structure,” she says. 

How much does testosterone cost without insurance?

Without insurance, testosterone can be pricey for some, with an average cost of $100 to $450 per month. As with insurance, how much you’ll pay depends on whether you’re buying a generic or brand version and what form of testosterone you’re looking to purchase.

For example, the out-of-pocket costs for testosterone cypionate, the generic version of Depo-Testosterone, are about $112 for two 1 ML of 200 MG/ML vials. Testosterone pills, which are prescribed less often than testosterone injections, can cost an average price of around $1000 to $2000 per month without insurance. Testosterone gels and creams cost between $400 and $1000 per month, and patches average about $800 per month.

“If you’re paying out of pocket because it’s not covered, those prices can jump quite a bit, so checking your plan’s drug list (called a formulary) is worth doing before you fill your prescription,” Dr. Khoshaba recommends.

Ways to save on testosterone

Although most insurance companies will cover your testosterone prescription, you might still find it difficult to pay for it. Luckily, there are different savings options that may be available. 

SingleCare coupons

SingleCare coupons can help you save on testosterone when you buy it without insurance. For example, while testosterone cypionate costs $112 for two vials, with a SingleCare coupon, you can pay as low as $35. 

Patient assistance programs

Some pharmaceutical companies offer patient assistance programs (PAPs) for people who can’t afford their medications. These programs may provide testosterone for free or at a reduced cost if you meet certain income or insurance requirements. Ask your provider or pharmacist if there’s a program for your specific testosterone product.

Talk to your healthcare provider about alternatives

While there aren’t other medications that can be used as alternatives to testosterone, if the type that you are interested in isn’t covered, you can ask your healthcare provider about switching to a different type—for example, trying a gel or patch instead of an injection. You can also inquire about coverage for a generic versus a brand-name version of testosterone.