Testosterone Replacement or Supplementation Therapy – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers injectable testosterone and Testopel for FDA‑listed replacement indications (primary and hypogonadotropic hypogonadism) and for gender‑affirming hormone therapy in adults, excludes compounded hormone pellets (and may limit coverage of new products like Azmiro™), requires FDA‑label dosing, and limits authorizations to 12 months. Coverage requires documented diagnosis and numeric labs—either two early‑morning total testosterone <300 ng/dL on separate draws (or calculated free/bioavailable testosterone <50 pg/mL if SHBG‑altering conditions), required follow‑up testing (within 6 months if <1 year on therapy, or within 12 months if ≥1 year), prescriber/endocrinology consultation for gender‑affirming use, and adherence to the policy’s continuation criteria (including specified “patient was male at birth” language where applied).

"Injectable testosterone and Testopel (testosterone pellets) are proven for replacement therapy in conditions associated with a deficiency or absence of endogenous testosterone, including primary hy..."