Financing the Costs of Hormonal Imbalance Treatments for Women

ByAnja Solum, CEPF
Reviewed byMelinda Boyd, DCN, MPH, MHR, RD, FAND

Updated: March 15, 2024

ByAnja Solum, CEPF
Reviewed byMelinda Boyd, DCN, MPH, MHR, RD, FAND

Updated: March 15, 2024

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Hormonal imbalance can lead to significant health concerns if left untreated. Although some hormonal irregularities may resolve on their own, others persist and require medical intervention.

Treatment types often depend on the patient's specific situation. Many insurance plans cover parts of treatments, including diagnosis and follow-up consultations. Note that not all treatments or medications may be covered. Alternative funding options are available to help with treatment costs if your insurance doesn't cover everything or if you're uninsured.

What Is Hormonal Imbalance?

Hormonal imbalance, as defined by the Cleveland Clinic, occurs when the body has either too much or too little levels of certain hormones. In women, hormonal imbalances are often triggered during life stages and events like puberty, pregnancy, breastfeeding and menopause.

Common symptoms of hormonal imbalance include fatigue, constipation, diarrhea, depression and uneven body fat distribution. For women, hormonal imbalance can lead to irregular menstrual cycles, infertility, hormonal acne, diabetes, thyroid disorders, obesity and other health complications.

While these symptoms indicate hormonal imbalances, they can also signal other medical conditions. Therefore, seeking prompt medical advice is essential when experiencing a cluster of these symptoms. Self-diagnosis and treatment with over-the-counter products may not only be ineffective but can also lead to delays in proper care.

Diagnostic Costs for Hormonal Imbalance

Diagnosing hormonal imbalances starts with a consultation, whether with a general practitioner, gynecologist or endocrinologist. These professionals assess your symptoms to decide on the appropriate tests. They typically recommend a series of blood tests. More specialized tests like pelvic exams or ultrasounds might be recommended in some cases.

The costs of these tests can vary widely based on location, the specific lab chosen, and the number of hormones tested. Without insurance, the price for patients can range from $100 to $500 or even more, depending on the extent of testing. Many insurance schemes cover the diagnostic phase and the essential tests for identifying hormonal health concerns. Confirm with your insurance provider about coverage specifics and discuss with your health care provider before undergoing any tests.

Test Name
Estimated Cost Without Insurance

Blood Test

$5 - $2,682, based on the hormones tested.

Saliva Test

$49 - $420, based on the number of hormones analyzed.

Urine Test

$52 - $505.

Thyroid Function Test

$35 - $2,682, based on the specific tests and panels conducted.

Dynamic Endocrine Testing

$50 - $899, based on test complexity and quantity.

Source of Cost Estimation: Find Lab Test

EXPERT TIP: BE CAUTIOUS OF PREDATORY TESTING COMPANIES

“Be aware of predatory testing companies offering unvalidated or unreliable hormone tests. Such tests may not provide accurate or medically useful information. Discuss the recommended tests with your health care provider and confirm whether your insurance covers them. Be cautious if tests recommended by your provider aren't covered by insurance, as this could signal a lack of credibility. A health care provider should order tests that are targeted and necessary. Excessive testing, especially tests not covered by insurance or requiring high co-payments, can lead to unexpected and significant expenses.” — Melinda Boyd

Hormonal Imbalance Treatment Options and Expenses

Treatment for hormonal imbalances in women often depends on the cause and severity of the imbalance. Options can range from oral medications to injections. The expense for these treatments may vary based on treatment recommendations. Health insurance often covers some expenses, including initial consultations and follow-up visits. After receiving a treatment recommendation from your doctor, verify the coverage details with your insurance provider.

Hormone Replacement Therapy (HRT)

HRT involves taking synthetic or bioidentical hormones (often estrogen) to counteract hormonal deficiencies. The choice of treatment method and its duration can influence the cost. Below are cost estimations for various treatment methods as provided by GoodRX:

  • Creams: The primary estrogen creams on the market include Premarin, with an average price of $518, and Estrace, priced at $171.
  • Gels: Estradiol gel formulations, such as Divigel, Elestrin and EstroGel, range from $40 for 30 packets to $285 for a 35g pump.
  • Injections: Estrogen injections — particularly for menopause — include Delestrogen, priced around $162 for a 20mg/ml dose and Dep-Estradiol, with monthly injections priced under $180.
  • Patches: Various estrogen patch brands are available. The generic Estradiol patch can come at a monthly cost of less than $40.
  • Tablets: Oral HRT medications have both generic and name-brand versions. The generic Estrace might cost $10 or less for a 90-day supply, whereas brand names can exceed $500.

Alongside these regulated treatment options, numerous non-regulated over-the-counter (OTC) products are marketed toward correcting female hormone imbalances. However, many of these OTC products are not always legitimate and can be a waste of money.

Before opting for any method, consult your health provider to determine the best fit. Although many insurance plans cover estrogen products, verify coverage specifics to avoid surprise costs.

Birth Control Pills

Birth control pills can help regulate menstrual cycles and stabilize hormone levels. Physicians commonly prescribe them for conditions such as polycystic ovary syndrome (PCOS). The cost largely depends on the brand but can range upwards of $2,000. The typical annual out-of-pocket expense averages $226 if you’re insured and $268 if you’re not insured.

Using Health Insurance for Treatment Costs

Health insurance can significantly reduce the out-of-pocket expenses for hormonal imbalance diagnostics and treatments. Here's how you can make the most of your health insurance:

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    Verify Coverage

    Not every treatment, medication or test may fall under your coverage. Always cross-check with your insurance provider before proceeding.

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    Monitor Out-of-Pocket Limits

    Know your out-of-pocket maximum. Once you reach this limit, the insurance company typically covers subsequent costs in full for the rest of the year.

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    Stay In-Network

    Opt for doctors or facilities in your insurance's network. Choosing in-network providers can lead to significant savings instead of using out-of-network providers.

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    Shop Around

    Periodically reviewing your plan and comparing it to others on the market might lead you to more affordable health insurance that still meets your needs.

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    Don't Hesitate to Appeal

    If the insurer denies a claim or doesn't cover treatment, consider appealing the decision. A comprehensive explanation from your health care provider can bolster your appeal.

Alternative Options to Fund Treatments

If insurance doesn't cover the full cost or if you're uninsured, there are other avenues to explore. You can also opt for generic medications to help you save money.

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    Medical Credit Cards

    These are credit cards specifically for medical expenses. They might offer promotional interest rates but read the terms carefully.

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    Negotiate Prices

    Some medical providers might reduce the cost if you discuss it with them, especially if you pay out-of-pocket.

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    Payment Plans

    Many hospitals and clinics offer payment plans, allowing you to distribute the expense over multiple months or years.

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    Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs)

    HSAs and FSAs let you set aside pre-tax money for medical expenses. They can be especially beneficial if you have a high-deductible insurance plan.

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    Nonprofit Organization

    Some organizations, such as the HealthWell Foundation, Patient Access Network Foundation or Patient Advocate Foundation, assist with medical bills. Check their websites to see their qualification requirements.

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    Government Programs

    Several government programs assist with medical bill payments by offering low-cost insurance options. These include Medicare, Medicaid and the Health Insurance Marketplace.

Additional Resources

For further insight, research and support related to hormonal health, consider exploring the following resources:

About Anja Solum, CEPF


Anja Solum, CEPF headshot

Anja Solum is a certified educator in personal finance and the Data Journalism Manager at MoneyGeek. For over six years, she has produced data analyses and studies for agency and in-house teams across multiple verticals.

Solum holds a bachelor's degree in communication arts from Florida International University. She's passionate about using data to tell compelling, informed stories that empower readers.


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