Key takeaways:
Medicare may help cover menopause treatment if a healthcare professional determines that the therapy is medically necessary. Your specific Medicare plan and diagnosis will determine how your treatment is covered.
Medicare Part B covers office visits and medications administered in an outpatient setting. Since most menopause medications are prescribed for home use, your treatment will likely be primarily covered through your Medicare Part D prescription plan, whether you have original Medicare or a Medicare Advantage plan.
In most cases, natural treatments for menopause, over-the-counter options like vitamins and supplements, and incontinence supplies are not covered by Medicare.
Menopause is a stage of life marked by the end of your menstrual cycle. Perimenopause is the period leading up to menopause when your hormone levels begin to decline and you may start experiencing menopause symptoms. This process, which is a normal part of aging, usually begins in the 40s and lasts from about 4 years to as long as a decade.
People going through perimenopause or menopause can experience a number of symptoms that may affect their sleep, relationships, and work. Menopausal hormone therapy (MHT), previously known as hormone replacement therapy (HRT), can help treat perimenopause and menopause symptoms.
Medicare may cover menopause treatment when it’s considered medically necessary. Let’s look at when treatment is typically covered — and when it’s usually not.
Search and compare options
Does Medicare cover menopause treatment?
Medicare coverage for menopause treatment can work differently under original Medicare and Medicare Advantage.
Original Medicare
Original Medicare consists of Part A (hospital coverage) and Part B (outpatient benefits). Medicare Part B covers visits with healthcare professionals and related in-office treatments for menopause, such as injectable medications for osteoporosis.
Hormone therapy medications are typically covered by Medicare Part D prescription plans. With original Medicare, you have to enroll in a standalone Part D plan to get prescription medication coverage. Before enrolling in a prescription plan, you should check the formulary to see if and how your medications are covered. Formularies have tiers that affect how much you pay out of pocket, and MHT medications are often in upper tiers with higher costs. It’s important to note that some forms of MHT are considered experimental treatments and may not be covered.
Medicare Advantage
If you have Medicare Part C, a private alternative to original Medicare known as Medicare Advantage, you likely have prescription coverage included in your plan. If not, you will need a standalone Part D plan. Medicare Advantage plans also include Part A and Part B benefits that meet or exceed those offered by original Medicare.
Hormone therapy treatments for menopause
MHT can help relieve menopause symptoms such as hot flashes, brain fog, mood changes, and sleep issues. These medications can also treat longer-term conditions, including osteoporosis.
Hormone therapy treatments for menopause include:
Estrogen replacement medications such as Premarin, Estrace, Divigel, and Climara
Progestin (Prometrium, Provera)
Estrogen plus progestin (Prempro, Femhrt, Bijuva, Activella)
It’s important to discuss the risks of hormone therapy for menopause with your healthcare provider. These risks may include heart attacks, strokes, blood clots, and breast cancer.
Nonhormonal treatments for menopause
There are also prescription treatment options for menopause that don’t contain hormones. These include:
Brisdelle (paroxetine), which targets vasomotor symptoms such as hot flashes and night sweats
Intrarosa (prasterone), which targets vaginal symptoms such as dryness and pain during sex
Lynkuet (elinzanetant) for vasomotor symptoms
Osephena (ospemifene) for vaginal symptoms
Veozah (fezolinetant) for vasomotor symptoms
Does Medicare cover office visits for menopause?
Office visits for menopause are covered under Medicare Part B with original Medicare. In general, Medicare Part B helps cover the cost of outpatient services such as doctor visits. Medicare Advantage plans are required to offer benefits that meet or exceed those offered by original Medicare, but the out-of-pocket expenses associated with accessing care vary.
Does Medicare cover hormone replacement therapy for menopause?
HRT, now known as MHT, is typically delivered via prescription medications. These treatments may be covered by Medicare Part D prescription plans.
To find out which menopause treatments are covered by your Medicare prescription benefits, start by consulting your plan’s formulary, or list of covered medications. This will also help you understand your potential out-of-pocket costs. Formularies divide medications into categories called tiers. Higher-tiered medications generally have more costly copays.
Formularies can also be revised at any time, so it’s important to be aware of any coverage changes. If you lose coverage for a treatment, you can ask your prescriber to recommend an appropriate medication that is on your formulary.
Another option is to check the GoodRx website or app for savings on both hormonal and nonhormonal prescription menopause treatments. Some pharmaceutical companies also offer copay savings cards to help offset medication costs. For uninsured or underinsured consumers, manufacturers may offer patient assistance programs.
Are there any menopause treatments not covered by Medicare?
If you’re considering a new menopause treatment, it’s important to check with your Medicare plan up front to see if it’s covered. There are some treatments that are typically not covered by Medicare. This includes natural treatments, incontinence supplies, and over-the-counter options like vitamins and supplements.
Does Medicare cover perimenopause treatment?
Your Medicare plan may offer similar coverage for perimenopause treatment and menopause treatment. Check with your plan and prescriber for guidance.
How can you check whether your Medicare plan offers menopause treatment coverage?
You can check if your Medicare plan covers menopause treatment by talking with your healthcare professional and looking at your summary of benefits and coverage. You can also speak with a Medicare representative to learn about your potential out-of-pocket costs, such as your deductible and copayments or coinsurance.
Frequently asked questions
Menopausal hormone therapy (MHT) is the most common type of treatment for symptoms associated with menopause and perimenopause. MHT may also help protect your bones and offer other health benefits. Hormone therapy for menopause comes in many different forms, including pills, patches, injections, and creams.
While MHT is the most common approach, nonhormonal menopause treatments, such as vaginal inserts and oral tablets, can help with symptoms such as vaginal discomfort, hot flashes, and night sweats.
The most effective menopause treatment will depend on your symptoms. Prescription medications can be helpful for vasomotor issues and vaginal changes. Over-the-counter menopause treatments like vitamins and supplements may offer some symptom relief — or help address a related condition, like hair loss. But it’s important to talk with a trusted healthcare professional about the potential benefits and risks. Unlike prescription medications, supplements are not FDA regulated, so quality and effectiveness can vary.
Many insurance options besides Medicare cover menopause treatment, including MHT medications. But the out-of-pocket costs for treatment may be high with some plans. HRT medications are often placed in upper tiers on insurance formularies, resulting in higher copays. Options like manufacturer copay savings cards and patient assistance programs could help make treatment more affordable.
Menopausal hormone therapy (MHT) is the most common type of treatment for symptoms associated with menopause and perimenopause. MHT may also help protect your bones and offer other health benefits. Hormone therapy for menopause comes in many different forms, including pills, patches, injections, and creams.
While MHT is the most common approach, nonhormonal menopause treatments, such as vaginal inserts and oral tablets, can help with symptoms such as vaginal discomfort, hot flashes, and night sweats.
The most effective menopause treatment will depend on your symptoms. Prescription medications can be helpful for vasomotor issues and vaginal changes. Over-the-counter menopause treatments like vitamins and supplements may offer some symptom relief — or help address a related condition, like hair loss. But it’s important to talk with a trusted healthcare professional about the potential benefits and risks. Unlike prescription medications, supplements are not FDA regulated, so quality and effectiveness can vary.
Many insurance options besides Medicare cover menopause treatment, including MHT medications. But the out-of-pocket costs for treatment may be high with some plans. HRT medications are often placed in upper tiers on insurance formularies, resulting in higher copays. Options like manufacturer copay savings cards and patient assistance programs could help make treatment more affordable.
The bottom line
Medicare covers a wide range of menopause treatments, but mostly through Part D prescription plans. This is true for both original Medicare (Part A and Part B) and Medicare Advantage (Part C), a private alternative to original Medicare.
Most Medicare Advantage plans include Part D coverage. If yours doesn’t — or if you’re enrolled in original Medicare — you will have to sign up for a standalone Part D plan to get prescription medication coverage.
Check your plan’s formulary to find out which prescription medications for menopause are covered. Medicare plans typically don’t cover natural treatments, incontinence supplies, or over-the-counter options like supplements and vitamins for menopause symptoms.
Why trust our experts?
References
Centers for Medicare & Medicaid Services. (2026). Your Medicare benefits. Medicare.gov.
