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Key takeaways
Testosterone replacement therapy (TRT) is usually covered by health insurance if you’ve been diagnosed with hypogonadism (low testosterone).
It can be more challenging to get coverage for TRT for gender affirming care or menopause.
Many insurance companies will require prior authorization before covering TRT. Others may require step therapy.
Testosterone is a hormone produced by the body in both males and females. More testosterone is produced in males, which results in male sex characteristics. When testosterone hormone levels are low, a healthcare provider can prescribe testosterone replacement to restore normal levels. Testosterone is sold both generically and under brand names like AndroGel, Testim, Fortesta, Vogelxo, and Depo-Testosterone. Testosterone replacement may be prescribed as a topical gel or solution, injection, pellet, oral tablet, or patch.
What is testosterone replacement therapy?
Testosterone is a hormone responsible for male sex characteristics. When levels are low, a healthcare provider may prescribe testosterone replacement therapy (TRT) to restore them.
Testosterone is available in generic and brand-name versions. It comes in several forms, including:
- Injections
- Gels
- Patches
- Tablets
- Testosterone pellets
Testosterone treatment is FDA-approved to treat male hypogonadism, or low testosterone. The symptoms of testosterone deficiency, or low T, may include erectile dysfunction, low energy, less muscle mass, and a decreased sense of well-being.
TRT treatment may also be part of the treatment plan for delayed puberty or for improving low T in chronic illness or certain cancers. In some cases, it’s prescribed off-label for gender-affirming care or for women during menopause.
Because uses vary, testosterone insurance coverage also varies.
Does insurance cover TRT?
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.”
Health insurance coverage can be complicated, and coverage for TRT can vary based on many factors. Copays, coinsurance, and deductibles may also come into play, meaning that even when your health insurance covers testosterone, there may be additional out-of-pocket expenses that you are responsible for. Additionally, some insurance companies may require you to try a generic version or a different form of testosterone before brand names such as AndroGel or Testim are covered.
Coverage based on insurance type
The type of health insurance you have can affect whether your testosterone prescription is covered. According to Linda Khoshaba, NMD, FABNE, founder of Natural Endocrinology Specialists, here are some things to consider about TRT coverage:
- Employer-sponsored plans and most ACA marketplace plans cover testosterone replacement. 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 TRT, 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 overcome for your prescription to be covered.
For instance, prior authorization is often 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, Khoshaba says.
Lastly, some insurance plans will require step therapy before prescribing testosterone. That means you may need to try a more cost-effective form of treatment before other formulations are prescribed.
What do insurers look for? Proving medical necessity
Whether or not your health insurance company covers testosterone also depends in part on your diagnosis.
Typically, health insurance companies will cover testosterone when it’s prescribed for low testosterone levels (hypogonadism), says Dadhich. Often, your provider will need to provide documentation such as lab tests to your health insurance company. “Most insurers require documentation of at least two morning testosterone levels that are low,” Dadhich explains. Some will require additional lab work, as well.
The process of proving to your insurance company that you qualify for testosterone can be tedious and discouraging, says Betsy Greenleaf, DO, triple board-certified urogynecologist and founder of International Pause Institute. “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. “Sometimes there’s more paperwork or extra hoops to jump through when testosterone is prescribed for gender-affirming purposes,” says Khoshaba.
And for women in menopause who are seeking testosterone, it’s usually not covered, and typically, patients end up paying for it out of pocket, Greenleaf says.
How does the method impact coverage?
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,” Dadhich says.
Linda Khoshaba agrees 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 more 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,” Khoshaba explains. “Tablets are less commonly prescribed and often not covered at all.”
What if insurance denies coverage for testosterone?
If testosterone replacement is not on the drug formulary for your insurance plan, you and your physician will typically need to file a pre-authorization or prior authorization request. That may require:
- The healthcare provider filing forms with the insurance company to request testosterone for a qualifying medical condition.
- If the request is approved, your prescription will be covered by insurance. However, you may still be limited to particular forms of testosterone or to generic medications. And you will likely still have a copay or deductible.
- If the request is denied, the healthcare provider may be able to file an appeal.
- You may also choose to fill the prescription without insurance and still save money, such as using a SingleCare coupon for testosterone. In some cases, the cost may be lower than an insurance copay would be.
How much does testosterone cost with insurance?
Testosterone is Tier 2 on many insurance plan formularies, 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 form of testosterone prescribed, 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 Khoshaba. These costs usually come in the form of 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 replacement can be pricey, 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,” Khoshaba recommends.
Save up to 80% on Testosterone Cypionate with SingleCare
Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.
Ways to save on TRT
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 little 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.
So, is testosterone covered by insurance?
In most cases, yes—especially when prescribed for hypogonadism. But testosterone insurance coverage depends on your diagnosis, formulation, and health plan. Prior authorization, step therapy, and testosterone copays are common.
Before filling your prescription:
- Check your formulary.
- Confirm your copay.
- Compare prices with a free SingleCare coupon.
A few minutes of research could help you save significantly on your testosterone prescription.
The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of 3/13/26. Prices vary by pharmacy.
- Testosterone information, U.S. Food and Drug Administration (2025)
- Influencers of generic drug utilization: a systematic review, Research in Social and Administrative Pharmacy (2018)
- Testosterone injection, U.S. Department of Veterans Affairs (2025)
- Understanding drug tiers, Patient Advocacy Foundation (2025)