TRT Cost Breakdown

Complete TRT Cost Breakdown

The Five Cost Components

Every TRT program includes these five expenses:

1. Initial consultation and blood work ($150-600 one-time)
2. Ongoing physician/provider fees ($0-400/month)
3. Testosterone medication ($30-500/month depending on type)
4. Blood work monitoring ($150-300 every 3 months)
5. Additional medications if needed ($20-150/month)

How these are packaged varies dramatically between telehealth and traditional clinics.

---

Telehealth TRT Platforms (All-Inclusive Pricing)

Top Telehealth TRT Providers

1. Hone Health

• Cost: $199-279/month all-inclusive
• Initial: $99 consultation + $130 blood work
• Includes: Medication, quarterly labs, physician access, shipping
• Testosterone forms: Injections, creams
• Best for: Comprehensive care with ongoing support

2. Vault Health

• Cost: $129-249/month all-inclusive
• Initial: $0 consultation, blood work included in first month
• Includes: Medication, labs, telehealth visits, care coordinator
• Testosterone forms: Injections
• Best for: Budget-conscious, want personal coordinator

3. Maximus

• Cost: $329/month all-inclusive
• Initial: $49 blood work kit
• Includes: Medication, labs, physician consults, sexual health support
• Testosterone forms: Injections, enclomiphene option
• Best for: Men wanting fertility preservation options

4. TRT Nation

• Cost: $250-350/month
• Initial: Varies by state
• Includes: Medication, labs, physician oversight
• Testosterone forms: Injections primarily
• Best for: Personalized protocols

5. Game Day Men’s Health

• Cost: $199-399/month
• Initial: Consultation included
• Includes: Full hormone optimization, athletic performance focus
• Testosterone forms: Injections, peptides available
• Best for: Athletes, performance-focused

---

Telehealth Advantages

✅ All-inclusive pricing (no surprise bills) ✅ Lower total cost (typically $129-399/month everything included) ✅ Convenient (no office visits) ✅ Fast start (1-2 weeks from consultation to medication) ✅ Flexible (cancel or pause anytime) ✅ Discreet (medication shipped to door) ✅ Direct physician access (messaging, video calls)

Telehealth Disadvantages

❌ No insurance coverage (100% out-of-pocket) ❌ Virtual only (no in-person exams) ❌ Limited medication options (mostly injections/creams) ❌ Not HSA/FSA eligible (most platforms) ❌ State restrictions (not available everywhere)

---

Traditional Clinic TRT (Itemized Pricing)

Cost Components Breakdown

1. Initial Consultation

• Cost: $150-500
• Includes: Physical exam, medical history, initial labs ordered
• Usually: One-time fee

2. Initial Blood Work

• Cost: $150-600
• Tests: Total testosterone, free testosterone, estradiol, PSA, CBC, CMP
• Where: Lab (Quest, LabCorp) or in-office
• Insurance: May cover if symptomatic

3. Monthly Provider Fee

• Cost: $100-400/month
• Includes: Prescription management, dosage adjustments, monitoring
• Varies: By clinic, visit frequency
• Some: Charge per-visit ($75-150) instead of monthly

4. Testosterone Medication

• Injectable cypionate: $30-75/month (cheapest)
• Injectable enanthate: $40-100/month
• Topical gel (AndroGel): $150-500/month
• Compounded cream: $80-200/month
• Pellets (Testopel): $500-1,000 per 3-4 months
• Clomid/enclomiphene: $50-150/month (alternative)

5. Quarterly Blood Work

• Cost: $150-300 every 3 months
• Tests: Testosterone levels, estradiol, PSA, hematocrit
• Required: Monitor effectiveness and safety
• Insurance: May cover with diagnosis

6. Annual Additional Testing

• EKG: $50-150
• DRE/prostate exam: $100-200
• DEXA scan (bone density): $150-300
• Sleep study if needed: $500-2,000

7. Additional Medications (if needed)

• Anastrozole (estrogen blocker): $20-60/month
• HCG (fertility/testicular function): $50-150/month
• Gonadorelin (fertility alternative): $100-200/month

---

Traditional Clinic Total Monthly Costs

Injectable TRT (cypionate) WITHOUT insurance:

• Provider fee: $100-400/month
• Medication: $30-75/month
• Blood work: $50-100/month (quarterly average)
• Total: $180-575/month

Gel TRT WITHOUT insurance:

• Provider fee: $100-400/month
• Medication: $150-500/month
• Blood work: $50-100/month
• Total: $300-1,000/month

Pellet TRT WITHOUT insurance:

• Provider fee: $100-400/month
• Pellets: $125-250/month (quarterly average)
• Blood work: $50-100/month
• Total: $275-750/month

---

Traditional Clinic Total Monthly Costs WITH Insurance

Injectable TRT WITH insurance:

• Provider copay: $20-50/visit (~$50-100/month)
• Medication copay: $10-50/month
• Blood work copay: $0-50 (quarterly)
• Total: $60-200/month

Gel TRT WITH insurance:

• Provider copay: $20-50/visit
• Medication copay: $50-150/month (often higher tier)
• Blood work copay: $0-50
• Total: $70-250/month

Note: Insurance coverage requires:

• Testosterone <300 ng/dL on two separate morning tests
• Documented symptoms (fatigue, low libido, etc.)
• Prior authorization (1-2 weeks)
• In-network provider
• Medical necessity (not anti-aging/performance)

---

Traditional Clinic Advantages

✅ Insurance coverage (if qualified, reduces costs 50-80%) ✅ In-person care (physical exams, thorough evaluation) ✅ More medication options (pellets, diverse protocols) ✅ Established medical relationship ✅ HSA/FSA eligible ✅ Specialists available (endocrinologists, urologists)

Traditional Clinic Disadvantages

❌ Higher total cost without insurance ($350-1,000/month) ❌ Itemized billing (surprise fees common) ❌ Office visits required (time, travel) ❌ Insurance hassles (prior auth, limitations, denials) ❌ Less flexible (harder to switch or stop) ❌ Variable pricing (hard to compare)

---

Testosterone Medication Cost Comparison

Injectable Testosterone (Most Common)

Testosterone cypionate (generic):

• 200mg/mL, 10mL vial
• Cost: $30-75 (lasts 2-5 months depending on dose)
• Frequency: Weekly or bi-weekly injections
• DIY at home or clinic ($50-150/month for clinic injections)

Typical dosing: 100-200mg/week

• 100mg/week = 0.5mL/week = 20 weeks/vial = $1.50-3.75/week
• 200mg/week = 1mL/week = 10 weeks/vial = $3-7.50/week

Pros: Cheapest option, effective, flexible dosing Cons: Needles (injection anxiety), weekly administration

---

Topical Gels

AndroGel (brand name):

• Cost: $400-600/month without insurance
• Cost: $50-150/month with insurance (copay)
• Frequency: Daily application

Generic testosterone gel:

• Cost: $150-300/month without insurance
• Cost: $25-75/month with insurance
• Frequency: Daily application

Compounded gel:

• Cost: $80-200/month
• Custom strength/formulation
• Frequency: Daily application

Pros: No needles, daily routine, steady levels Cons: Expensive, skin irritation possible, transfer risk to others, insurance often denies

---

Topical Creams

Compounded testosterone cream:

• Cost: $80-200/month
• Custom strength
• Frequency: Daily or twice-daily

Pros: No needles, flexible application sites Cons: Expensive, daily application, transfer risk

---

Testosterone Pellets

Testopel (brand name):

• Cost: $500-1,000 per insertion
• Frequency: Every 3-4 months
• Procedure: In-office insertion under skin (hip/buttock)

Monthly equivalent: $125-300/month

Pros: Infrequent administration (every 3-4 months), steady levels Cons: Expensive, requires minor procedure, difficult to adjust dose, pellet extrusion risk

---

Nasal Gel

Natesto:

• Cost: $300-500/month without insurance
• Cost: $50-150/month with insurance
• Frequency: 3x daily (nasal application)

Pros: No needles, no skin transfer risk Cons: Very expensive, frequent dosing (3x/day), nasal irritation, rarely used

---

Alternative: SERMs (Not Testosterone)

Clomiphene or Enclomiphene:

• Cost: $50-150/month
• Mechanism: Stimulates body’s own testosterone production
• Frequency: Daily oral medication

Pros: Maintains fertility, oral medication, cheaper, preserves natural production Cons: Less effective than TRT, variable results, not true TRT, may cause mood issues

---

Cost Comparison by Scenario

Scenario 1: Budget-Conscious, No Insurance

Best option: Telehealth injectable TRT

Provider: Vault Health

• Monthly cost: $129-199/month all-inclusive
• Includes: Injections, labs, physician access
• Annual cost: $1,548-2,388
• 10-year cost: $15,480-23,880

Why: Cheapest all-inclusive option, no surprise fees, everything bundled

---

Scenario 2: Have Good Insurance, Low Testosterone

Best option: Traditional clinic injectable TRT with insurance

Provider: In-network endocrinologist or urologist

• Provider copay: $20-50/visit (monthly average $50-75)
• Medication copay: $10-30/month (cypionate)
• Lab copay: $0-50 (quarterly average $15/month)
• Monthly cost: $75-155
• Annual cost: $900-1,860
• 10-year cost: $9,000-18,600

Why: Insurance covers 50-80%, lowest total out-of-pocket cost

Requirements:

• Testosterone <300 ng/dL (confirmed on two tests)
• Documented symptoms
• Prior authorization approved
• In-network provider

---

Scenario 3: Want Convenience, Higher Budget

Best option: Telehealth comprehensive TRT

Provider: Hone Health or Maximus

• Monthly cost: $199-329/month all-inclusive
• Includes: Everything (medication, labs, consultations, optimization)
• Annual cost: $2,388-3,948
• 10-year cost: $23,880-39,480

Why: Maximum convenience, no office visits, comprehensive care, predictable costs

---

Scenario 4: Want Fertility Preservation

Best option: Traditional clinic or Maximus (HCG protocol)

Costs:

• Base TRT: $200-400/month
• HCG addition: $50-150/month
• Sperm banking (before starting): $500-1,500 one-time
• Total: $250-550/month + initial banking

Why: HCG maintains testicular function and fertility while on TRT

---

Scenario 5: Insurance Denied or Testosterone >300 ng/dL

Best option: Telehealth injectable TRT

Provider: Vault Health, Hone Health, or TRT Nation

• Monthly cost: $129-279/month
• Why: No insurance anyway, telehealth provides best value
• Traditional clinic without insurance: $350-900/month (much more expensive)

---

Insurance Coverage Details

What Insurance Typically Covers

✅ Covered IF:

• Testosterone <300 ng/dL on two separate morning tests
• Documented symptoms (fatigue, low libido, ED, etc.)
• Medical necessity determined by provider
• Traditional in-person clinic (not telehealth)
• FDA-approved testosterone products

✅ Covered services:

• Provider visits (copay $20-100)
• Blood work (copay $0-50)
• Testosterone medication (copay $10-150 depending on type/tier)

What Insurance Typically Does NOT Cover

❌ Not covered:

• Testosterone >300 ng/dL (“normal” range)
• Anti-aging purposes
• Athletic performance enhancement
• Telehealth TRT services
• Compounded medications (often)
• HCG for fertility maintenance
• Pellet therapy (many plans)
• “Optimization” vs treatment

Insurance Prior Authorization

Process:

1. Provider orders two morning testosterone tests
2. Results show <300 ng/dL both times
3. Provider documents symptoms
4. Submit prior authorization to insurance
5. Insurance reviews (1-3 weeks)
6. Approval or denial

Common denial reasons:

• Testosterone not low enough (<300 ng/dL threshold)
• Insufficient symptom documentation
• Wrong provider type
• Trying non-preferred medication
• Lack of medical necessity

If denied:

• Appeal with additional documentation
• Try different medication (cheaper tier)
• Switch providers
• Pay out-of-pocket or use telehealth

Insurance Cost Examples

Good insurance (low deductible, comprehensive coverage):

• Monthly out-of-pocket: $50-100
• Annual out-of-pocket: $600-1,200
• Insurance pays: $3,000-6,000/year

Average insurance (moderate deductible, standard coverage):

• Monthly out-of-pocket: $100-200
• Annual out-of-pocket: $1,200-2,400
• Insurance pays: $2,000-4,000/year

Poor insurance (high deductible, limited coverage):

• Monthly out-of-pocket: $200-400 (until deductible met)
• Annual out-of-pocket: $2,400-4,800
• May be cheaper to use telehealth

---

Hidden and One-Time Costs

Initial Setup Costs (First 1-3 Months)

Consultation: $0-500 Initial comprehensive blood work: $150-600

• Total testosterone
• Free testosterone
• Estradiol
• PSA
• Complete blood count
• Comprehensive metabolic panel
• Lipid panel
• Thyroid panel (TSH, free T4)

First prescription: $30-500 (depending on type)

Total initial investment: $180-1,600

---

Ongoing Hidden Costs

Quarterly blood work: $150-300 every 3 months ($50-100/month average) Annual physical exam: $100-300 Annual EKG: $50-150 DRE/prostate exam: $0-200 DEXA scan (if needed): $150-300 every 1-2 years

Side effect management:

• Anastrozole (high estrogen): $20-60/month
• HCG (fertility maintenance): $50-150/month
• Blood donation (high hematocrit): $0-50 per donation

Injection supplies (if DIY): $5-15/month

• Needles, syringes, alcohol wipes

Total hidden costs:

• Year 1: $600-1,500
• Ongoing: $600-1,200/year

---

Fertility Preservation Costs (Before Starting TRT)

Sperm banking:

• Initial analysis: $150-300
• Sperm freezing: $500-1,500
• Annual storage: $200-500/year

Why: TRT suppresses sperm production (6-12 months to recover after stopping)

If planning future children: Bank sperm before starting TRT

---

Cost-Saving Strategies

1. Choose Injectable Testosterone

Injectable cypionate: $30-75/month vs Gels: $150-500/month vs Pellets: $125-300/month equivalent

Savings: $100-400/month by choosing injections

Overcome injection anxiety:

• Start with smaller needles (25-27 gauge)
• Use auto-injectors
• Have clinic teach technique
• Watch YouTube tutorials
• Gets easier after 2-3 times

---

2. Use Telehealth If No Insurance

Telehealth: $129-399/month all-inclusive vs Traditional clinic without insurance: $350-900/month

Savings: $200-500/month

When telehealth makes sense:

• No insurance coverage
• High deductible plan
• Insurance denied
• Want convenience
• Testosterone >300 but symptomatic

---

3. Maximize Insurance Coverage

If testosterone <300 ng/dL:

• Use in-network provider
• Get prior authorization
• Choose generic cypionate (lowest tier)
• Document symptoms thoroughly
• Follow insurance requirements

With good insurance: $50-150/month Without insurance: $180-575/month

Savings: $130-425/month with insurance

---

4. Use GoodRx for Medications

If paying out-of-pocket at traditional clinic:

Testosterone cypionate 200mg/mL 10mL:

• Retail: $150-300
• GoodRx: $30-75
• Savings: $75-225

Anastrozole (if needed):

• Retail: $50-100/month
• GoodRx: $10-20/month
• Savings: $30-80/month

Note: Can’t use GoodRx with insurance simultaneously

---

5. Compare Compounded vs Brand Name

Compounded testosterone:

• Often cheaper ($30-100/month)
• Custom formulations
• Not FDA-approved (same ingredients, different manufacturing)

Brand name:

• FDA-approved
• Insurance may require brand first
• More expensive

Check with provider about compounded options

---

6. DIY Injections vs Clinic Injections

Clinic injections: $50-150/month (weekly) DIY at-home: $5/month supplies

Savings: $45-145/month by self-injecting

Learning curve: 1-2 supervised sessions, then easy

---

7. Bundle Services with Telehealth

Telehealth all-inclusive: $199/month (medication + labs + consultations)

vs Paying separately:

• Provider: $100/month
• Medication: $50/month
• Labs: $50/month (quarterly average)
• Consultations: $50/month
• Total: $250/month

Savings: $50+/month with bundled telehealth

---

Total Cost Examples (First Year)

Example 1: Telehealth Injectable (Hone Health)

Initial:

• Consultation: $99
• Blood work: $130
• First month: $199
• Total initial: $428

Monthly ongoing: $199

Year 1 total: $428 + ($199 × 11) = $2,617

---

Example 2: Traditional Clinic with Insurance

Initial:

• Consultation copay: $50
• Blood work copay: $25
• First prescription copay: $20
• Total initial: $95

Monthly ongoing:

• Provider visits: $50/month average
• Medication: $20/month
• Labs: $10/month average
• Total: $80/month

Year 1 total: $95 + ($80 × 11) = $975

---

Example 3: Traditional Clinic WITHOUT Insurance

Initial:

• Consultation: $300
• Blood work: $400
• First prescription: $50
• Total initial: $750

Monthly ongoing:

• Provider: $200/month
• Medication: $50/month
• Labs: $75/month average
• Total: $325/month

Year 1 total: $750 + ($325 × 11) = $4,325

---

Example 4: Gel TRT WITHOUT Insurance

Initial:

• Consultation: $300
• Blood work: $400
• First prescription: $300
• Total initial: $1,000

Monthly ongoing:

• Provider: $200/month
• Gel: $300/month
• Labs: $75/month average
• Total: $575/month

Year 1 total: $1,000 + ($575 × 11) = $7,325

---

Long-Term Cost Projections

10-Year Cost Comparison

Telehealth injectable (Vault Health @ $149/month):

• 10 years: $17,880
• 20 years: $35,760

Telehealth comprehensive (Hone Health @ $249/month):

• 10 years: $29,880
• 20 years: $59,760

Traditional clinic with good insurance (@ $100/month):

• 10 years: $12,000
• 20 years: $24,000

Traditional clinic without insurance (@ $325/month):

• 10 years: $39,000
• 20 years: $78,000

Gel TRT without insurance (@ $575/month):

• 10 years: $69,000
• 20 years: $138,000

---

Lifetime Commitment Reality

TRT is lifelong therapy:

• Stopping reverses all benefits within 3-12 months
• Natural production suppressed while on TRT
• 10-30+ year commitment for most men
• Budget $15,000-80,000 over lifetime depending on method

Consider:

• Can you afford this for decades?
• What if insurance changes?
• What if prices increase?
• Emergency fund for TRT costs

---

Making Your Decision

Choose Telehealth Injectable TRT If:

✅ No insurance coverage for TRT ✅ Insurance denied or won’t cover ✅ Testosterone >300 but symptomatic ✅ Want convenience/no office visits ✅ Want predictable all-inclusive pricing ✅ Budget $150-250/month

Best platforms: Vault Health ($129-199), Hone Health ($199-279)

---

Choose Traditional Clinic with Insurance If:

✅ Testosterone <300 ng/dL confirmed ✅ Have good insurance coverage ✅ Insurance provides prior authorization ✅ Want in-person care ✅ Budget $75-200/month with insurance

Find: In-network endocrinologist or urologist

---

Choose Traditional Clinic without Insurance If:

✅ Want comprehensive in-person care ✅ Need specialized protocols (pellets, HCG, etc.) ✅ Have higher budget ($350-900/month) ✅ Want established medical relationship ✅ Prefer traditional medical setting

---

Start with Lowest Cost Option First:

Step 1: If testosterone <300 ng/dL → Try insurance-covered traditional clinic Step 2: If insurance denies or testosterone >300 → Switch to telehealth Step 3: Choose injectable form (cheapest, most flexible) Step 4: Add HCG or other medications only if needed

---

The Bottom Line

TRT costs vary 10x depending on choices:

Cheapest option:

• Telehealth injectable: $129-199/month
• Traditional clinic with good insurance: $75-150/month
• 10-year cost: $15,000-24,000

Most expensive option:

• Traditional clinic gel without insurance: $575+/month
• 10-year cost: $69,000+

Best value for most men:

1. If testosterone <300 + insurance: Traditional clinic with insurance ($75-150/month)
2. If no insurance or denied: Telehealth injectable ($129-249/month)
3. If want comprehensive care: Telehealth all-inclusive ($199-329/month)

Cost-saving priorities:

1. Use insurance if qualified (saves 50-80%)
2. Choose injectable form (saves $100-400/month vs gels/pellets)
3. Use telehealth if no insurance (saves $150-650/month vs traditional clinic)
4. DIY injections at home (saves $45-145/month)
5. Use GoodRx for out-of-pocket medications (saves $75-225)

TRT is a significant financial commitment—budget for 10-30 years and choose the option you can sustain long-term.

---

This pricing guide provides 2025 cost estimates for TRT based on market research. Prices vary by location, provider, and insurance. Consult healthcare providers and insurance for specific pricing. TRT requires medical supervision. Last updated: February 2025.