Hormone Replacement Therapies (HRT) Using Implanted Pellets for Women and Delayed Puberty

This policy addresses coverage of hormone replacement therapy (HRT) for women and treatment of delayed puberty, requiring therapies to be FDA‑approved or supported by nationally recognized compendia or peer‑reviewed literature with dose, frequency, and duration consistent with authoritative sources. It covers conditions such as menopause/perimenopause (e.g., vasomotor and genitourinary symptoms), delayed or precocious puberty and other sex‑hormone disorders, but implanted testosterone and estrogen/estradiol pellets are considered experimental/investigational and not covered for non‑FDA‑approved indications (including female menopause); coverage is governed by the member’s benefit plan and applies to HCSC members in Ohio under applicable prescription drug policies.

"Therapies covered when proven effective for the relevant diagnosis based on peer‑reviewed scientific literature or authoritative compendia."