What is the cost and how does insurance work with bioidentical hormone therapy?
We all want better health care, but we can’t get there by doing things the same old way. The same old way is the system you and I probably have now – your insurance company tells you what they will pay for – then they tell you to take it or leave it. And each year you’re asked to take less and leave more. You don’t get what you want or need – you get what the insurance company wants or needs you to have!
Simply stated, we physicians at Exceed Hormone Specialists created our practice because we refuse to treat anyone by these old rules anymore. These rules are wrong for the patient and wrong for the doctor. Ours is a patient centered practice. We are invested in you, your health, and your vitality. We want you, the patient, to be just as invested in your care as we are.
But we also want you to have choices, real treatment choices, that are best for you. We want to talk with you, evaluate you completely and work together to choose what’s best for you. We don’t think an insurance company should change that decision. The insurance company should not be in the room!
At Exceed Hormone Specialists our approach is professional, thorough, and high touch. Our treatment is effective, proven, and tailored for you. Our goal is your vitality – living, not just surviving. The remaining issue for you is cost.
Exceed Hormone Specialists does not accept insurance assignment, either private or government. We do not file insurance claims. We are a direct pay practice and payment is expected at the time of service. We do not have billing or pre-certification staff. All contact with insurance companies is your responsibility. We will provide you with all necessary paperwork so that you can request out of network reimbursement from your private insurance company. Patients report some insurance coverage for lab studies.
Hormone Therapy Evaluation and Start Up
The cost will vary based on each patient’s needs and their treatment plan. Every new hormone patient will require comprehensive lab work. The initial lab work cost varies from $200 (women) to $275 (men). Later lab testing is not as expensive. Some lab costs are covered by insurance if you file a claim using our paperwork.
Initial complete evaluation, medical history, examination and formulation of a treatment plan is $400. Startup hormone pellets and insertion for women are about $400. Men require much larger doses of the most expensive pellets (testosterone) and startup pellet therapy for men will range from $400 – $750.
Ongoing Therapy Cost Estimate for Women
After the initial treatment and after hormone balance is achieved, the average number of visits ranges from 3 to 4 follow-up visits each year (usually 4 the first year then less thereafter as you are balanced and doing well). Your initial investment in hormone therapy, wholeness, and vitality will be paying you back.
Follow-up consultations are $200 for 30 minutes. Follow-up lab may or may not be necessary every visit but on average is $200 per visit – this varies depending on your specific plan of treatment.
Follow-up cost of hormones and insertion varies by patient but averages approximately $250. When compared to the cost of drugs to treat the individual symptoms of hormone deficiency, pellets are very cost effective.
Ongoing Therapy Cost Estimate for Men
After initial evaluation and hormone balance, the average number of visits for men is 2 per year. Men who are active or heavier may require 3 visits. Combined with exercise and weight control, you will be feeling younger, healthier, more active and motivated.
Follow-up consultations are $200 for 30 minutes. Some follow-up lab is necessary each visit to maintain optimum performance and cost of lab will average $275.
Cost of pellets and insertion on follow-up visits will vary and will average $350 – $700. Continued evaluation and recommendations will insure maximum benefit from the therapy.
Our Commitment to You
Physician specialists monitoring and tailoring therapy for your hormone, sexual, and other special needs
Uncompromised care – no insurance company dictating your choice of doctors, treatment or medication
Your improved sense of well-being, wholeness, and vitality
Value for your healthcare purchases – no 10 minute “hit and run” visits. Along with you, we’re invested in your health and our mission is to inspire your ability to achieve vitality.
How do I know if I’m a candidate for bioidentical hormone therapy?
In women, symptoms of hormone deficiency may vary from hot flashes and sleeplessness to night sweats, loss of energy, lack of interest in sex, foggy thinking and depression. If you have these symptoms you should be evaluated.
In men, hormone loss results in loss of sex drive, poor sex function, fatigue and loss of energy and motivation.
Individuals with symptoms need a complete evaluation including appropriate medical history, examination, lab studies, and a treatment plan.
What is bioidentical hormone pellet therapy?
Pure bioidentical hormones are precisely compressed into tiny pellets smaller than a Tic-Tac. These pellets are placed painlessly under the skin usually over the upper hip where they are uniformly released into the body.
What are the pellets made from?
They are made from plants: wild yams. These yams have the highest natural concentration of hormones. No known allergies are associated with yams. They are natural, bioidentical and exact replicas of what your own body makes.
What benefits can I expect from bioidentical hormone therapy?
If your hormone levels are low or out of balance, you can expect that hormone replacement will make a dramatic difference in your energy level, comfort level and enjoyment of life – hormone balance can make you vital.
Many women applaud hormone therapy for:
• eliminating hot flashes and night sweats
• improving their sexual life
• increasing their energy level and sense of wellness
• increased clarity and motivation
• reducing mood swings and reducing anxiety and depression
• reducing body fat and enhancing the ability to “get in shape”
Men can expect similar significant improvement in these areas:
• improved energy and less fatigue at day’s end
• improved sexual drive
• improved sexual function
• decreased body fat and increased lean muscle
• improved motivation and drive
My sex drive is almost gone. Will hormone replacement help me?
Yes. Normal hormone levels are essential for good sex drive and sexual activity and enjoyment. If low hormones are the problem, nothing else will help. Correcting your hormone balance should make a big difference.
How long will it take for me to begin feeling the effects of the hormone treatment?
Most patients report a quick response within a few days.
Do women still need estrogen in their hormone replacement therapy?
Of course! Estrogen as estradiol is the most important hormone for women. One reason it is so important is that it offers long term protection for the cardiovascular system, insures good bone health and protects against other age-related problems that begin in women after menopause. The body does not produce estradiol after menopause, so replacing it is very important.
As a woman, do I need to take any other hormones with the estrogen?
Women who still have a uterus need to take progesterone to protect the lining of the uterus. This is an easy treatment.
Do I have blood tests done with each treatment?
Usually not. You need blood tests at the start, then 4 weeks later to check your dosing, then each year. If your situation changes, additional tests may be done.
Does insurance cover the procedure and pellets?
Only your insurance company can answer that question completely. Generally insurance does not cover effective pellet hormone therapy. They may cover a minor part of costs or have the cost go towards your health plan deductible.
Why are male pellets more expensive?
Men only need one hormone, testosterone, and they need it in much larger doses than in women. The testosterone pellets are more complex, therefore more expensive to create, and more of them are needed in men.
How long will the treatment be effective?
Each treatment restores hormones for 3 – 6 months, depending on the individual. Generally, women require another dose in 3 – 4 months, and men can usually wait 5 – 6 months.
Your body’s circulation distributes the hormone; so that people who are more active, under more stress, or live in hot climates will require more frequent treatments.
Is the therapy FDA approved?
The ingredients in the pellets are all FDA approved. The distribution of the pellets is FDA controlled. The particular way hormones are administered is not regulated by the FDA.
Are there any side effects?
Side effects for both women and men are uncommon. This is especially true of bioidentical hormones and is one of the reasons we recommend bioidentical pellet therapy. Side effects are much more common with the use of synthetic hormone replacement.
Women may notice temporary breast tenderness with the first insertion. Minor hair growth or mild acne can occur with testosterone therapy.
In men, testosterone can decrease sperm count and testicle size and may aggravate prostate symptoms.
What if I am already on hormone replacement of some sort like creams, patches, and pills?
This is not a problem. Your physician will be able to determine your current situation and future needs and place you on the correct pellet therapy even if you are now on hormone medications.
Does it matter if I am on birth control?
Your physician can determine your need for hormone replacement, even if you are currently on birth control.
What if I have had breast cancer?
Breast cancer survivors and those women with a family history of breast cancer may be able to use hormone pellets. Each case must be evaluated carefully and individually by your physician before therapy. Please call for a consultation.
Why doesn’t my current doctor suggest bioidentical hormone replacement therapy?
Excellent management of hormone issues requires physicians to be up-to-date in this particular medical area. Many physicians do not focus daily on hormone issues and instead use primarily synthetic prescription hormones.
Tailored bioidentical hormone therapy requires special training both in recognizing and evaluating certain symptoms as well as additional training in endocrinology. The specialized pellet insertion technique requires hands-on training.
Will I need extra vitamins or supplements?
You may, depending on your particular situation. Your physician will discuss this with you. The hormone replacement will correct your hormones but your weight management and nutrition are important to maximize the hormone benefit.
Monday-Thursday: 8am to 5pm
We’d love to hear from you. For any information or to schedule your free one-on-one consultation, call 901.312.7899 or fill out the form below.
7512 SECOND STREET, GERMANTOWN, TN 38138
P. 901.312.7899 | F. 901.312.7893 | INFO@EXCEEDHS.COM