The cost of hormone replacement therapy varies significantly depending on the formulation you use, whether you have insurance coverage, which provider you choose, and whether you require ongoing lab monitoring. Understanding the full cost picture before you start helps you choose a program that is sustainable long-term.
Medication Costs
The cost of HRT medication depends heavily on the specific formulation and whether generics are available.
Estrogen
| Formulation | Brand | Generic Available | Monthly Cost (Without Insurance) |
|---|---|---|---|
| Estradiol patch | Vivelle-Dot, Climara | Yes | $30–$80 |
| Estradiol gel | Divigel, Estrogel | Limited | $60–$120 |
| Estradiol spray | Evamist | No | $100–$180 |
| Oral estradiol tablet | Estrace | Yes | $20–$50 |
Progesterone
| Formulation | Brand | Generic Available | Monthly Cost (Without Insurance) |
|---|---|---|---|
| Oral micronized progesterone | Prometrium | Yes | $20–$60 |
| Compounded progesterone cream | Various | N/A | $40–$100 |
Consultation Costs
Initial consultations typically include a comprehensive intake review, lab evaluation, and prescription if appropriate. Follow-up visits are typically shorter and less expensive.
- Telehealth initial consultation: $50–$150 (many programs include this in a monthly membership)
- In-person OB/GYN or internist: $150–$300 without insurance; varies widely with insurance
- Menopause specialist (NCMP): $200–$500 for initial visit at specialty practices
- Follow-up visits: $50–$150
Lab Costs
Most providers require baseline hormone labs before prescribing and periodic monitoring during treatment.
- Basic hormone panel (FSH, estradiol, progesterone): $50–$150
- Comprehensive panel (including testosterone, thyroid, metabolic): $100–$300
- Bone density screening (DEXA): $100–$300 (often covered by insurance for women 65+)
Total Monthly Cost Ranges
| Scenario | Estimated Monthly Cost |
|---|---|
| Insurance (generic medication covered) | $0–$30/month |
| Telehealth all-inclusive membership | $50–$120/month |
| Self-pay (generic meds + periodic follow-up) | $60–$150/month |
| Specialty compounded formulations | $100–$250/month |
Insurance Coverage for HRT
Most FDA-approved HRT formulations are covered under standard health insurance plans with a prescription, though coverage varies by plan and formulary. Generic estradiol patches and oral progesterone are typically Tier 1 or Tier 2 drugs. Brand-name gels and sprays may require prior authorization or have higher cost-sharing.
Medicare Part D covers most HRT medications. Medicaid coverage varies by state.
How to Reduce HRT Costs
- Ask about generic alternatives — generic estradiol patches are significantly cheaper than brand-name equivalents with the same active ingredient
- Use GoodRx, Mark Cuban's Cost Plus Drugs, or other discount programs for cash-pay medications
- Consider telehealth platforms with all-inclusive membership pricing that bundles consultation, prescription, and follow-up
- Check your FSA/HSA eligibility — HRT prescriptions qualify for FSA/HSA reimbursement
Frequently Asked Questions
Is HRT expensive without insurance?
Not necessarily. Generic estradiol patches and oral progesterone are among the most affordable medications available. The total monthly cost can be under $50 for generic formulations, especially when using discount programs. Specialty compounded formulations and brand-name products cost significantly more.
Do telehealth HRT providers save money?
Often yes. Telehealth programs frequently offer bundled pricing that includes consultation, prescription, and follow-up at predictable monthly rates — sometimes more affordable than in-person specialty care, especially without insurance coverage for specialist visits.
Find Affordable HRT with Transparent Pricing
Our comparison evaluates HRT providers on cost transparency, what is included in monthly pricing, and whether lab costs are bundled — so you can make an informed financial decision alongside a clinical one.
Compare HRT Providers →