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Insurance coverage for menopause care varies widely in the United States, with only two states mandating comprehensive benefits. The rest, in general, leave the decision of what types of treatment and who to cover in the hands of individual insurance companies, resulting in inconsistent access to treatments like hormone replacement therapy (HRT).
Interested in learning what menopause care options your state’s insurance plans provide? Read more about the complexities surrounding menopause insurance coverage, here.
Does Your State Offer Menopause Benefits? Our Map Can Help You Find Out
Hover over a state to see the benefits it provides.
“Insurance gets in my way of providing menopausal care every single day,” Dr. Heidi Snyder Flagg, FACOG, MSCP and Flow Space Advisory Council member, explains. “In fact, things are getting worse. From claim denials to failure to cover hormone therapy treatments and low reimbursement for the time and care needed to treat perimenopause and menopause. Our medical system is broken because of insurance companies.”
There are currently two types of health insurance: private and public. Private insurance is typically provided through an employer but can be paid for out of pocket. Public health insurance includes Medicaid and Medicare.
Medicaid is a joint federal and state program that provides health coverage for some people with limited income and resources. You must qualify to receive these benefits. Medicare is a federally funded health insurance program for people who are 65 or older, and some people under 65 with disabilities or certain conditions.
Regardless of what health insurance plan you are on, public or private, it varies state to state.
This is due to a combination of factors including differences in the local healthcare market, state regulations, the number of insurance providers competing in the area for patients, the cost of living, population demographics and the state's policies. All of this influences the overall cost of medical services and, ultimately, the price of health insurance premiums in each state.
Health insurance companies also only work with specific providers, so you will need to make sure you are receiving care from a medical professional who takes your insurance to ensure you are not paying out of pocket.
And in regards to menopause care, the coverage is even more convoluted.
From coverage for hormone replacement therapy (HRT) to diagnostic testing, mental health services and wellness programs, the availability and scope of benefits can vary widely depending on where you live and what plan you have, making it more and more difficult for doctors to provide the care they want.
Some private insurance companies are working to provide more menopause coverage.
While people historically think of menopause as only impacting the older workforce, it is currently also impacting millennial women.
Aetna
Covers Gennev's virtual menopause care services in all 50 states.
UnitedHealthcare
Works with Midi, a virtual care clinic for women over 40.
Healthfirst
Offers menopause-related benefits in its health insurance.
MyMenopauseRx
Offers insurance-covered virtual visits, FDA-approved therapies and board-certified guidance.
According to Carrot’s latest “Menopause in the Workplace” report, 32% of millennial women already report experiencing menopause symptoms.
With millennials and Gen X women comprising the majority of the workforce and navigating this transition simultaneously, employers have much to gain from offering menopause benefits, making a new emerging trend, employer-sponsored menopause benefits. In addition to providing accommodations like flexible work arrangements, leave options and work accommodations, some companies are providing personalized menopause care directly to their employees.
According to the Mayo Clinic, menopause costs an estimated $1.8 billion in lost working time per year in the United States. Dr. Asima Ahmad, co-founder and chief medical officer of Carrot Fertility, says recognizing this, the company identified an unmet need for age-inclusive fertility and lifelong hormonal benefits and saw an opportunity for employers to bridge the gap by offering meaningful support.
“Members begin by receiving a personalized Carrot Plan for menopause, which connects them with specialized experts, expert-led group sessions, virtual and in-person clinic visits with doctors who specialize in menopause care and educational resources to help with navigating the hormonal aging process,” she explains. “Additionally, members can use the financial benefit provided by their employer to cover hormone replacement therapy medications or other therapies to effectively manage menopause symptoms.”
She adds that if you’re interested in bringing this to a company you work at, speak with your HR Team.
“While there’s strength in numbers, we also often hear from customers that it only took one person speaking up at the company to drive change,” she says. “Don’t be afraid to go to your employer and see how you can work together, whether that be implementing comprehensive menopause benefits or even just creating a more flexible work schedule to manage menopause symptoms.”
Curious to learn more about what your state offers for insurance in regards to menopause care?
This state-by-state guide is designed to help you navigate menopause insurance. Whether you're comparing state policies, seeking clarity on covered treatments or looking to advocate for better benefits, this guide breaks down essential information, empowering you to make informed decisions for your health and well-being.
The other unfortunate trend is that when a woman over 55 years old goes in for her annual exam and other issues are addressed (vaginal dryness, sexual health, bone health, hormone therapy), there is no additional reimbursement—it all falls under the “global fee” of the annual exam.
Currently, no state prohibits by law insurance coverage for menopause treatment, meaning that technically, every state should provide some level of coverage, but the specifics of what is covered and the level of coverage can vary greatly depending on the insurance plan and state regulations, with many plans not covering certain aspects of menopause management like hormone therapy.
As of right now only three states require by law menopause coverage for all insurance providers: California, Illinois and Louisiana. No other states are working towards providing more coverage, and in addition to reduced care, doctors are feeling the financial burden of this.
“No strides have been made or are being made,” Flagg tells Flow Space. “The other unfortunate trend is that when a woman over 55 years old goes in for her annual exam and other issues are addressed (vaginal dryness, sexual health, bone health, hormone therapy), there is no additional reimbursement—it all falls under the “global fee” of the annual exam.”
Because health insurance varies so much state by state, experts recommend reaching out directly to your insurance provider to learn what is covered by your plan and how much your deductible (a small fee paid at the time of service that covers the entire appointment) might be and if you even have one with that provider.
While care is still limited, there are small strides being made.
With the passage of the Affordable Care Act in 2010, insurance companies can no longer deny coverage for pre-existing conditions, which includes menopause symptoms. This means most plans should cover medically necessary treatments when prescribed by a healthcare provider.
Dr. Jessica Shepherd, MBA, author of Generation M and Flow Space Advisory Council member, says in the form of research and development, there are new medications on the market that allow women to consider treatments that are non-hormonal and are more likely to be covered by insurance.
“Also, there is much more research on the benefits of hormone replacement therapy and being able to reassure women that they are eligible for HRT,” she says.
Dr. Heidi Snyder Flagg
FACOG, MSCP and Flow Space Advisory Council member
Insurance coverage for menopause in Alabama depends on the specific plan and treatment. Many medications used to treat menopause are typically covered, like hormone therapy treatments and estrogen therapy, but treatments for sexual dysfunction are usually not. Coverage is ultimately determined by the insurance provider.
Alabama
(varies by plan and location)
Insurance coverage for menopause in Alaska depends on the specific plan and treatment, including hormone therapy treatments and estrogen therapy and visits with specialists. However, coverage varies by insurance plan and location due to Alaska’s rural area landscape. Some menopause services at Planned Parenthood in Anchorage may be covered by insurance, and Women's Care of Alaska in Anchorage provides comprehensive menopause care that is a preferred provider for many insurance plans, including Blue Cross, Aetna, Tricare, Multiplan, Cigna, UnitedHealthcare, Medicaid and Medicare. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Alaska
Insurance coverage for menopause in Arizona depends on the specific plan and treatment. Many health insurance plans cover medications used to treat menopause, but some treatments for sexual dysfunction may not be covered. Coverage is ultimately determined by the insurance provider.
“Limited access to care in states like Arizona, where I’m from, is standard,” Taylor Busack, a licensed health insurance broker, tells Flow Space. “This is for so many reasons, but mainly because there are so many regulations and loopholes insurance companies have to jump through. Your best bet is to shop around and find the best insurance based on your specific healthcare needs.”
(varies by plan and location)
Arizona
Insurance coverage for menopause in Arkansas depends on the specific plan and treatment. In general, health insurance plans cover many medications used to manage menopause symptoms, but not all. For example, Arkansas Blue Cross and Blue Shield does not cover estrogen replacement or estrogen-containing preparations. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Arkansas
Insurance coverage for menopause in California depends on the specific plan and treatment.
Many medications used to treat menopause are typically covered, like hormone therapy treatments and estrogen therapy, but treatments for sexual dysfunction are usually not. Coverage is ultimately determined by the insurance provider.
In Sept. 2024, Governor Gavin Newsom vetoed Assembly Bill 2467, which would have required all health insurance plans in California to cover menopause care, including evaluation and treatment options. He cited ambiguities in the bill and concerns for cost containment and bill implementation.
(varies by plan and location)
California
Insurance coverage for menopause in Colorado depends on the specific plan and treatment. Some insurance plans in the state may cover the full or partial cost of hormone therapy, if prescribed by a healthcare provider, but other forms of hormone therapy like creams, gels and patches are typically not covered. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Colorado
Insurance coverage for menopause in Connecticut depends on the specific plan and treatment. Many medications used to treat menopause are typically covered, like hormone therapy treatments and estrogen therapy, but treatments for sexual dysfunction are usually not. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Connecticut
Insurance coverage for menopause in Delaware depends on the specific plan and treatment. Many medications used to manage menopause are covered by all the major health insurance providers in the state, but medications or treatments for sexual dysfunction are not. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Delaware
Insurance coverage for menopause in Florida depends on the specific plan and treatment. One of the state’s large health insurance plans, MyHealth, provides access to healthcare services and preventive care benefits that cover some menopause treatments like hormone therapy if deemed medically necessary by a healthcare provider. But it does not cover bioidentical hormone replacement therapy (BHRT) because it does not cover "holistic" or "natural" treatments. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Florida
Insurance coverage for menopause in Georgia depends on the specific plan and treatment. Georgia Medicaid and the State Health Benefit Plan (SHBP) may cover some menopause care, depending on the type of care and the patient's eligibility. This includes hormone therapy, if deemed medically necessary by a healthcare provider, and does include all preventive screenings like mammograms and cervical cancer. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Georgia
Insurance coverage for menopause in Hawaii depends on the specific plan and treatment. Most medications under the state’s healthcare programs cover all medically necessary menopause treatments, as well as breast exams. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Hawaii
Insurance coverage for menopause in Idaho depends on the specific plan and treatment. Idaho Medicaid, the state’s largest health insurance provider, may only cover some medically necessary menopause treatments, but it depends on the patient’s needs. They may also cover routine breast and cervical cancer screenings. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Idaho
In Illinois, state health insurance is required to cover all medically necessary hormonal and non-hormonal therapies for menopause symptoms. This includes hormonal therapy like oral, transdermal, topical and vaginal ring treatments, along with non-hormonal therapy, such as antidepressants, clonidine, gabapentin and ospemifene. They also cover an annual menopause health visit for women over 45.
“Hormonal changes can bring on complications that affect our overall health and well-being” State Senator Linda Holmes (D-Aurora), who led the charge in getting this bill passed, said in a press release. “Menopause therapies are prescribed regardless of the onset reason, and they will now be covered either way.”
(full care)
Illinois
Insurance coverage for menopause in Indiana depends on the specific plan and treatment. Indiana Medicaid covers prescription and some over-the-counter medications for menopause care, as well as lab and X-ray services and mental health care. This includes medications prescribed by an Indiana Medicaid enrolled practitioner. Private insurance in the state may not, as coverage is ultimately determined by the provider.
(varies by plan and location)
Indiana
Insurance coverage for menopause in Iowa depends on the specific plan and treatment, and likely will only cover some menopause-related care. Iowa Medicaid may cover hormone therapies but is dependent on the patient’s age and if their doctor deems it medically necessary. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Iowa
Insurance coverage for menopause in Kansas depends on the specific plan and treatment. State health insurance in Kansas may cover menopause care, including hormone therapy, but coverage may vary depending on type of hormone therapy. Most insurance providers in the state do cover many medications used to manage menopause symptoms, including antidepressants and blood pressure medications. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Kansas
Insurance coverage for menopause in Kentucky depends on the specific plan and treatment. Kentucky’s Medicaid coverage does not explicitly cover any menopause-related care, but it does cover all breast and cervical cancer screenings. Most insurance providers in the state do cover many medications used to manage menopause symptoms, but coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Kentucky
In Louisiana, Medicaid covers all menopause care, including hormonal and non-hormonal treatments, counseling and preventive care. This coverage applies to both inpatient and outpatient care. Experimental or investigational drugs, procedures or equipment are not included.
State Rep. Aimee Freeman (D-New Orleans) brought the legislation to the floor after doctors in the state complained they couldn’t get hormone replacement therapy covered by Medicaid for some of their patients experiencing menopause and perimenopause. The bill passed and as of August 1, 2024, every provider in the state is mandated to provide menopause care that includes hormone therapy.
(full care)
Louisiana
Insurance coverage for menopause in Maine depends on the specific plan and treatment. Maine's Medicaid program will cover hormone therapy for menopause care if it's deemed medically necessary by a healthcare provider. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Maine
Insurance coverage for menopause in Maryland depends on the specific plan and treatment, and likely will only cover some menopause-related care. Maryland Medicaid may cover hormone therapies but is dependent on the patient’s age and if their doctor deems it medically necessary. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Maryland
Insurance coverage for menopause in Massachusetts depends on the specific plan and treatment. MassHealth and Blue Cross Blue Shield of Massachusetts (Blue Cross) in Massachusetts offer health insurance coverage for menopause care that includes medications used to manage menopause and hormone therapy. Other providers may not cover all menopause-related care. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Massachusetts
Insurance coverage for menopause in Michigan depends on the specific plan and treatment. Michigan Medicaid may cover menopause care, including hormone therapy and other treatments for menopause symptoms, such as non-hormonal treatments and GLP-1 weight loss medications. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Michigan
Insurance coverage for menopause in Mississippi depends on the specific plan and treatment. Mississippi Medicaid and its managed care program Mississippi CAN may cover menopause care for eligible low-income individuals, while private insurance providers in the state do cover all preventive screenings like breast and cervical cancer. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Mississippi
Insurance coverage for menopause in Montana depends on the specific plan and treatment. In Montana, state health insurance plans may cover menopause care through Medicaid or the VA Montana Health Care program. These programs may cover hormonal and non-hormonal therapies but only if deemed medically necessary by a healthcare provider. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Montana
Insurance coverage for menopause in Nebraska depends on the specific plan and treatment. Original Medicare doesn't cover hormone therapy, but Medicare Part D or Medicare Part C may cover some or all of the cost in the state. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Nebraska
Insurance coverage for menopause in Nevada depends on the specific plan and treatment. Nevada's Medicaid program may cover menopause care, including hormone therapy, but only if deemed medically necessary by a healthcare provider. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Nevada
Insurance coverage for menopause in New Hampshire depends on the specific plan and treatment. Most medications used to manage menopause are covered by private and public health insurance, like hormone therapy, and all providers in New Hampshire cover preventive screenings, including those related to menopause, if the care is provided by an in-network provider. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
New Hampshire
Insurance coverage for menopause in New Jersey depends on the specific plan and treatment. New Jersey's state health insurance program, NJ FamilyCare, covers most menopause care through women's health services like hormone therapy, but some treatments for sexual dysfunction may not be covered. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
New Jersey
New York State health insurance plans must cover medically necessary menopause treatments, including hormonal and non-hormonal therapies if prescribed by a healthcare professional. This coverage applies regardless of the cause of menopause. Some health insurance plans may cover referrals to specialists for issues related to menopause, like bone loss, urinary incontinence and depression. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
New York
Insurance coverage for menopause in North Carolina depends on the specific plan and treatment. Health insurance plans in North Carolina, including Medicaid and the state health plan, may cover some menopause care but only if deemed medically necessary by a healthcare provider. This does not include medication for sexual dysfunction. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
North Carolina
Insurance coverage for menopause in North Dakota depends on the specific plan and treatment. Providers in the state cover most medications for menopause, and North Dakota Medicaid covers medical and surgical services, supplies, drugs, X-rays and lab tests for diagnosis and treatment. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
North Dakota
Insurance coverage for menopause in Ohio depends on the specific plan and treatment. Health insurance plans in Ohio, including Medicaid and the state health plan, may cover some menopause care but only if deemed medically necessary by a healthcare provider. This does not include medication for sexual dysfunction. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Ohio
Insurance coverage for menopause in Oklahoma depends on the specific plan and treatment. Medicaid in the state may cover menopause care which include tests, scans and exams, as well as medications and hormone therapy, but is dependent on the patient’s age and needs. Annual well-woman exams, bone density scans and mammograms are covered. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Oklahoma
Insurance coverage for menopause in Oregon depends on the specific plan and treatment.
Oregon's health insurance plans, including the Oregon Health Plan (OHP), cover reproductive health care and preventive services, which includes services related to menopause like hormone therapy and estrogen therapy. Annual well-woman exams, bone density scans and mammograms are covered. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Oregon
Insurance coverage for menopause in Pennsylvania depends on the specific plan and treatment. Some medications and treatments for menopause are covered like hormone therapy if deemed medically necessary by a healthcare provider, but non-hormonal treatments and treatments for sexual dysfunction are not covered. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Pennsylvania
Insurance coverage for menopause in Rhode Island depends on the specific plan and treatment. Medicaid and HealthSource RI may cover menopause care services like hormone therapy, but is dependent on the patient’s need which is determined by a healthcare provider. Treatment for perimenopause and post-menopause symptoms may also be covered. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Rhode Island
Insurance coverage for menopause in South Carolina depends on the specific plan and treatment. South Carolina's state health plan covers evidence-based services for menopause care, including well visits and some medications. Many medications used to treat menopause symptoms are covered, but medications for sexual dysfunction may not be. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
South Carolina
Insurance coverage for menopause in South Dakota depends on the specific plan and treatment. South Dakota Medicaid covers a physical exam, a clinical breast exam, a pelvic exam, immunizations and screenings for cholesterol, diabetes and certain types of cancer. It is not required to cover any menopause-related care or treatments for sexual dysfunction. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
South Dakota
Insurance coverage for menopause in Tennessee depends on the specific plan and treatment. The state's Medicaid program, TennCare, may cover menopause care for low-income individuals. The extent of coverage depends on the provider. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Tennessee
Insurance coverage for menopause in Utah depends on the specific plan and treatment. Medicaid may cover hormone therapy and other medications but only if deemed medically necessary by a healthcare professional. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Utah
Insurance coverage for menopause in Vermont depends on the specific plan and treatment.
Health insurance in Vermont covers medically necessary menopause treatments, including hormonal and non-hormonal therapies. This includes counseling and treatment options for perimenopausal and menopausal women. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Vermont
Insurance coverage for menopause in Texas depends on the specific plan and treatment. State health insurance programs, like Healthy Texas Women and Medicaid, may cover menopause care. Healthy Texas Women offers free women's health services that include preventive care, which can include some menopausal care. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Texas
Insurance coverage for menopause in Virginia depends on the specific plan and treatment. Some in-state plans may cover hormone therapy in full or in part, while others may not. Annual screenings are covered, along with preventive screenings like mammograms and pelvic exams. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Virginia
Insurance coverage for menopause in Washington depends on the specific plan and treatment. Medicaid in Washington, also known as Apple Health, may cover some women's health services, including family planning and well-woman visits. However, it doesn't specifically cover menopause care, and care is dependent on a patient’s age and the plan they have. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Washington
Insurance coverage for menopause in West Virginia depends on the specific plan and treatment. West Virginia Medicaid may cover hormone therapy and other medications but only if deemed medically necessary by a healthcare professional. It does cover preventive services like screenings for breast and cervical cancer. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
West Virginia
Insurance coverage for menopause in Wisconsin depends on the specific plan and treatment. Medicaid in Wisconsin covers a wide range of reproductive health care services, including family planning and pregnancy-related care, but it does not explicitly cover menopause care. It is solely dependent on the insurance plan. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Wisconsin
Insurance coverage for menopause in Wyoming depends on the specific plan and treatment. Medicaid may cover hormone therapy and other medications but only if deemed medically necessary by a healthcare professional. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Wyoming
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Insurance coverage for menopause in Minnesota depends on the specific plan and treatment. Medicaid may cover menopause care that's been induced by a hysterectomy, and it does cover prescription drugs that are needed for menopause treatment, as prescribed by a healthcare provider. Private plans within the Minnesota Health Insurance Exchange (MnSure) are expected to cover counseling for adults, which can include anxiety or depression caused by menopause. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
Minnesota
Insurance coverage for menopause in Missouri depends on the specific plan and treatment. Missouri's Medicaid program, MO HealthNet, may cover some menopause-related services for uninsured women, including medications used to manage menopause, but does not cover treatments for sexual dysfunction. Coverage is ultimately determined by the insurance provider.
“Historically speaking, states have never provided coverage for any form of sexual dysfunction for women, but have for men,” Busack says. “That’s another complaint I’ve heard from many women.”
(varies by plan and location)
Missouri
Insurance coverage for menopause in New Mexico depends on the specific plan and treatment. New Mexico has the largest percentage of women on a state Medicaid program, known as Centennial Care in New Mexico, and it covers medical services for menopause care, including prescription drugs and hormonal and non-hormonal therapies. Coverage is ultimately determined by the insurance provider.
(varies by plan and location)
New Mexico
