Updated by the Progyny Editorial Team - June 2026.
If your doctor recommended prescription medicine to manage perimenopause and menopause symptoms, it's important to understand what your health plan covers and what your out-of-pocket costs may be. It's also helpful to know about services that may help you save on costs.
Find out what your health plan covers
Most insurance plans cover menopause hormone therapy in some form. The price you will pay depends on your prescription coverage.
To check your coverage, log in to your health plan's member portal or app. You can search for a medicine name to find out if it's covered and how much you'll pay out-of-pocket.
It's a great idea to discuss your options with your healthcare provider or pharmacist to find the most affordable option for you. There may be a generic version available or a payment assistance program to help with the cost.
Cost-saving options
If you don't have insurance coverage, or you find your insurance doesn't provide enough coverage, you have options to consider.
Prescription discount programs
Prescription discount programs may be used when insurance coverage isn't available, or if the program's discounted cash price is lower than your out-of-pocket cost with insurance. These programs cannot be combined with insurance.
Examples include:
To use these programs, search the program's website or app for the medicine and find the pharmacy with the lowest price. Obtain the discount coupon or code and ask your provider to send the prescription to the pharmacy of your choice. When you pick up your medicine, show the discount coupon or code to the pharmacist.
Manufacturer coupons
You may find digital coupons on the official manufacturer's website. Or ask your pharmacist if they have any manufacturer coupons available.
Payment assistance programs
Many drug companies offer programs that can help make prescriptions more affordable, even if you have insurance coverage.
- Payment assistance programs help eligible individuals access their medicine at little to no cost. Visit the drug manufacturer's website to fill out an eligibility application.
- Copay assistance programs help reduce your out-of-pocket expense if your copay is high with your insurance. Ask your healthcare provider or pharmacist for available options.
Final thoughts
There are many medicines that can help symptoms of perimenopause and menopause. It's helpful to:
- Understand your health plan's coverage
- Work with your healthcare provider and pharmacist to find affordable options
- Look into discount programs or coupons that may help with the costs
Your Progyny Care Advocate is also here to help you navigate your options.
Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.
