Insurance coverage explorer
Coverage matrix for 6 major insurers × 6 treatment categories. Coverage tiers update quarterly. Always verify directly with your plan — formulary changes happen.
| Insurer | HRT (FDA-approved) | HRT (compounded) | GLP-1 (Wegovy/Zepbound) | GLP-1 (compounded) | PCOS (metformin/spironolactone) | Thyroid (levothyroxine) |
|---|---|---|---|---|---|---|
| Aetna Plan-tier varies by employer-funded vs ACA marketplace. | Full | Not covered | Prior auth | Not covered | Full | Full |
| BCBS (Blue Cross Blue Shield) Federation of 36 independent plans; coverage varies by state. | Full | Varies | Prior auth | Not covered | Full | Full |
| UnitedHealthcare | Full | Not covered | Prior auth | Not covered | Full | Full |
| Cigna | Full | Varies | Prior auth | Not covered | Full | Full |
| Kaiser Permanente Closed network — must use Kaiser providers. | Full | Not covered | Partial | Not covered | Full | Full |
| Medicare Part D Coverage depends on chosen Part D plan. | Full | Not covered | Not covered | Not covered | Full | Full |
Coverage legend
Aetna — detailed coverage
HRT (FDA-approved)
Full — Most generics tier 1; brand-name tier 2-3.
HRT (compounded)
Not covered — Compounded products excluded under most plans.
GLP-1 (Wegovy/Zepbound)
Prior auth — BMI ≥30 or ≥27 with comorbidity. PA required.
Prior auth: Aetna PA portal
GLP-1 (compounded)
Not covered — Excluded across plans.
PCOS (metformin/spironolactone)
Full — Generics covered. Tier 1.
Thyroid (levothyroxine)
Full — Tier 1 generic.
BCBS (Blue Cross Blue Shield) — detailed coverage
HRT (FDA-approved)
Full — Generics tier 1; preferred brands tier 2.
HRT (compounded)
Varies — BCBS Federal covers if medically necessary; commercial plans usually not.
GLP-1 (Wegovy/Zepbound)
Prior auth — PA required. Some plans require step therapy.
Prior auth: CoverMyMeds or Blue e-Portal
GLP-1 (compounded)
Not covered — Federation policy excludes compounded GLP-1s.
PCOS (metformin/spironolactone)
Full — Both generics tier 1.
Thyroid (levothyroxine)
Full — Tier 1.
UnitedHealthcare — detailed coverage
HRT (FDA-approved)
Full — Generic estradiol patch + oral progesterone tier 1.
HRT (compounded)
Not covered — Compounded HRT not on formulary.
GLP-1 (Wegovy/Zepbound)
Prior auth — PA + step therapy via phentermine or orlistat first.
Prior auth: OptumRx PA
GLP-1 (compounded)
Not covered — Excluded.
PCOS (metformin/spironolactone)
Full — Tier 1.
Thyroid (levothyroxine)
Full — Tier 1.
Cigna — detailed coverage
HRT (FDA-approved)
Full — Generics tier 1.
HRT (compounded)
Varies — Some employer plans cover; ACA marketplace plans usually not.
GLP-1 (Wegovy/Zepbound)
Prior auth — PA + BMI documentation.
Prior auth: ExpressScripts PA
GLP-1 (compounded)
Not covered — Excluded.
PCOS (metformin/spironolactone)
Full — Tier 1.
Thyroid (levothyroxine)
Full — Tier 1.
Kaiser Permanente — detailed coverage
HRT (FDA-approved)
Full — Generics fully covered for in-network patients.
HRT (compounded)
Not covered — Kaiser does not stock compounded products.
GLP-1 (Wegovy/Zepbound)
Partial — Covered with criteria; lifestyle program enrollment may be required.
GLP-1 (compounded)
Not covered — Excluded.
PCOS (metformin/spironolactone)
Full — Generics full coverage.
Thyroid (levothyroxine)
Full — Generic full coverage.
Medicare Part D — detailed coverage
HRT (FDA-approved)
Full — Generic estradiol + progesterone tier 1 in most Part D formularies.
HRT (compounded)
Not covered — Compounded products universally excluded.
GLP-1 (Wegovy/Zepbound)
Not covered — Medicare prohibits coverage of weight-loss drugs (statutory).
GLP-1 (compounded)
Not covered — Excluded.
PCOS (metformin/spironolactone)
Full — Tier 1.
Thyroid (levothyroxine)
Full — Tier 1.
How to verify your coverage
- Call the number on your insurance card.
- Ask: “Is [medication name] on the formulary? What tier? Is prior auth required?”
- Request a formulary lookup from your provider's billing team.
Coverage shown above is current as of 2026-05. Formularies change quarterly.