Does Cigna Cover TRT? What Cigna's 2026 Testosterone Rules Actually Say

Does Cigna cover TRT? Yes—Cigna has coverage criteria for testosterone replacement therapy, but payment depends on your plan and prescription. For new treatment of male hypogonadism, Cigna requires symptoms and two low morning tests on separate days; existing treatment has different record rules. Visits, labs, procedures, and clinic fees need separate coverage checks.

By TRT Provider Guide · Last verified: October 2026 (sources checked October 22, 2026) · Editorial research, not clinically reviewed

Last updated: October 22, 2026.

This page is for you if: you're an adult man with Cigna through your job or a Cigna plan you bought yourself, and you want testosterone covered, got denied, or are paying cash and wondering whether Cigna would be cheaper.

Start elsewhere if: your card says Medicare (start with Medicare's prescription-drug coverage guide), or you want children in the next year or so (read the fertility section below before choosing TRT).

Here's the part almost nobody tells you. Cigna doesn't have one rulebook for testosterone. It has several drug lists, and the same generic injection can have no approval mark on one list and fall under an approval policy on another. We put four of Cigna's own documents side by side so you can see exactly where that happens, and what it means for the call you make next.

A few things change the answer fast:

• Employer plans can add their own exclusions on top of Cigna's rules.
• Cigna marketplace plans (the ones you buy yourself) end December 31, 2026. Cigna is leaving that market nationwide.
• "Cigna Medicare" plans now belong to a different company.
• Compounded testosterone pellets are excluded under Cigna's compounded-medication policy; other compounds need a separate plan check. ⁴
• Online cash-pay TRT clinics may charge separately for care even if your plan covers a prescription filled elsewhere. ⁴⁰, ⁴¹

We'll cover each one.

Cigna TRT coverage at a glance

FDA-approved testosterone products

Compounded testosterone preparations

Built by TRT Provider Guide from Cigna Coverage Policies IP0350, IP0351, CNF620, and IP0251 and three 2026 Cigna drug lists. Your plan's own documents and applicable law control coverage. Sources

Jump to your free Cigna TRT checklist ↓: five questions, a cost worksheet, and a script for calling Cigna. No email needed.

TRT Provider Guide is the independent decision resource for testosterone replacement therapy — helping U.S. adults understand how low testosterone is evaluated, compare online and local care models and providers, and choose the next step that fits their health needs, fertility plans, budget, state, and care preferences, with every material claim verified and dated.

Educational information, not medical advice. A clinician decides whether testosterone treatment is right for you. Your plan decides what it pays for, under its own terms.

Jump to: Already on TRT? · Got denied? · Bought your own Cigna plan? · Cash vs. Cigna cost

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Does Cigna cover TRT?

Yes. Cigna's written coverage policies treat testosterone as medically necessary for men with primary or secondary hypogonadism who meet the criteria, subject to their plan's terms. The reviewed policies approve hypogonadism treatment for one year and use different records for new treatment and treatment already underway.

Hypogonadism is the medical name for low testosterone that comes with symptoms. It comes in two main types:

• Primary hypogonadism means the testicles don't make enough testosterone. Injury, chemotherapy, and Klinefelter syndrome are examples Cigna lists.
• Secondary hypogonadism means the brain and pituitary gland don't send the right signal. A pituitary tumor, trauma, or radiation can cause it.

Cigna's policies say the diagnosis rests on both symptoms and low blood levels. One without the other won't meet the criteria. ¹, ²

What Cigna excludes or handles separately

• Athletic performance. Both of Cigna's main testosterone policies name it as not covered. ¹, ²
• Non-FDA-approved drugs and compounded products. The checked Standard drug list generally excludes drugs the FDA hasn't approved. Cigna's separate compounded-medication policy allows limited coverage of some compounds and excludes compounded hormone pellets; the exact preparation and plan matter. ⁴, ⁵
• Medicines used for sexual dysfunction. Cigna's standard drug-list exclusions name this category, unless your plan or state law says otherwise. Testosterone is covered for hypogonadism, not as an erection medicine. ⁵

Where Cigna's rules come from

Four Cigna documents do the heavy lifting:

One rule sits above all of them. Cigna's own instructions say your plan document (the Summary Plan Description, Evidence of Coverage, or similar) takes precedence if it conflicts with a policy, subject to controlling federal or state coverage requirements. ¹

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Before you start: will testosterone affect your fertility?

Testosterone therapy can lower sperm production, so talk with a clinician about fertility before you start if you might want children soon, no matter who pays. Cigna's checked Standard drug list marks hCG (human chorionic gonadotropin) products as "optional coverage"; ask whether your plan covers the exact product and prescribed use.

That's why fertility belongs in the discussion before you start treatment. The Endocrine Society lists lower sperm production as a risk of treatment. Its guideline recommends against starting testosterone in men planning a pregnancy with a partner soon. ¹⁶, ¹⁷

The Cigna detail matters here. On Cigna's Standard 3-Tier drug list:

• hCG products (Pregnyl, Novarel) carry an "optional coverage" mark.
• MiloPhene (clomiphene citrate) carries the same mark. ²⁸
• Cigna's standard exclusions name "medications used for fertility," unless your plan or state law requires coverage. ⁵

So don't assume Cigna will pay for a fertility-related medicine just because it pays for testosterone.

If kids are a near-term goal, start with a urologist or a reproductive urologist rather than a TRT program. We cover the trade-offs in TRT and fertility.

The right TRT provider is not the same for every person — it depends on whether low testosterone has been properly evaluated, your symptoms and health history, your fertility plans, your state, your insurance or cash-pay preference, your treatment-format preference, your budget, and whether online or in-person care is the better starting point. Some situations belong with primary care, urology, endocrinology, reproductive urology, or urgent or emergency care when the symptoms warrant it. Because a general answer cannot resolve those for you, use TRT Provider Guide's Find My TRT Path tool if you are exploring online care; use the Cigna coverage checklist on this page to confirm insurance questions before you pay. The tool is educational and does not diagnose low testosterone or decide medical eligibility.

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What does Cigna testosterone prior authorization require?

For a new start, Cigna wants three things: ongoing symptoms of low testosterone before treatment, two testosterone blood tests drawn in the morning on two different days, and both results below the normal range printed on the lab report. For some products, Cigna also wants records showing that a preferred option was unsuitable. Hypogonadism approvals last one year.

Prior authorization (often shortened to "PA") means your doctor has to ask Cigna for approval before Cigna will pay for a drug. Here's what Cigna's policies and its own request forms ask for, and what that means for you. The reviewed policies specify total or bioavailable testosterone measurements for these coverage criteria. ¹, ², ³

Sources: Cigna IP0350, IP0351, CNF620, and Cigna's Testopel request form. ¹, ², ³, ⁹

"Low" means below your lab's range, not a magic number

People online argue about 300 ng/dL all day. Here's what Cigna actually says.

Its policies quote the American Urological Association, which calls a total testosterone below 300 ng/dL a "reasonable cutoff" for diagnosis. For a new start, the approval rule itself says both tests must be low "as defined by the normal laboratory reference values." ¹, ²

Labs set their own normal ranges, so the same number can be flagged low at one lab and normal at another. We can't tell you what your number means. Your clinician reads it alongside your symptoms.

Insurance approval and diagnosis aren't the same thing

Cigna's checklist is a payment rule. Your diagnosis is a medical judgment, and it can ask for more.

The Endocrine Society says a diagnosis needs symptoms or signs plus clearly and consistently low testosterone, measured with an accurate test. It calls for a repeat morning, fasting total testosterone test, a look for the cause, and a free testosterone test when needed. ¹⁶

Total testosterone is all the testosterone in your blood. Free testosterone is the small share that isn't bound to proteins and is ready for your body to use. Bioavailable testosterone is free testosterone plus the amount loosely bound to albumin, a blood protein. ⁴⁸

If your doctor orders the full workup, that isn't busywork. Ask the office to check that the specific records Cigna needs are included.

Who sends the request, and how long it takes

Your prescriber's office sends it, not you. Cigna accepts electronic requests through CoverMyMeds or Surescripts inside the office's records system. Phone and form options exist as backups. ¹⁰

Cigna's checked Standard drug-list FAQ says a standard prescription decision can take up to five business days. You and your doctor get a letter, and you can track the status in myCigna. Confirm your plan's deadline; urgent requests have a separate process. ⁵, ⁹

One more thing to know: an approval for the medicine doesn't promise payment for everything else. Cigna's own precertification guidance makes that point, which is why the checklist below splits your bills apart. ¹¹

Got your two morning results and a symptom note? Copy the doctor checklist ↓ It turns Cigna's requirements into a list you can hand to the office to check for missing records.

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Which testosterone does Cigna cover?

Cigna can cover FDA-approved testosterone, but the rules depend on which Cigna drug list your plan uses. On the checked Standard employer list, generic testosterone cypionate injections are Tier 1 with no approval mark; on the Cigna National Formulary, the same injection falls under a policy recommending prior authorization. Brand-product requirements vary by product and drug list.

A drug list (also called a formulary) is the list of medicines your plan covers, sorted into price tiers. A lower tier usually means a lower copay. Cigna runs several lists, and your plan uses one of them.

Same drug, different Cigna rulebooks

We checked how three 2026 Cigna drug lists and one Cigna policy treat the same products. These are the documents as printed, not answers about your personal plan.

Sources: ⁵, ⁶, ⁷, ³. "Quantity limit" means a cap on how much you can fill at once. A blank mark on a public list is not a promise that your plan needs no approval. A missing drug entry is not, by itself, a benefit exclusion.

What this means for you:

1. The generic injection has no approval mark on the three printed drug lists we compared.
2. Generic gel has different markers. It needs approval on the Standard and Virginia lists but shows no approval mark on the National Preferred abridged list.
3. If your plan uses the Cigna National Formulary, ask whether the CNF620 authorization policy applies even to generic cypionate. ³
4. Cigna's main injectable policy doesn't name generic cypionate. IP0351, effective October 15, 2026, names only Aveed, Azmiro, Testopel, and Xyosted. That version does not establish a generic-cypionate approval requirement. ²

Your plan's current drug list and member record control your next step. Don't choose or change a medicine from this comparison.

What Cigna asks you to try first, product by product

Step therapy means your plan requires a preferred medicine before covering another one. Here's how Cigna's policies set it up for initial hypogonadism treatment when the listed product and drug-list criteria apply. For the Azmiro, Xyosted, oral-testosterone, and Natesto trial rules below, the prescriber must report inadequate benefit or significant intolerance; a trial alone is not enough. Brand gels have the separate requirements shown in their rows.

Sources: Cigna IP0350 and IP0351. ¹, ²

The employer topical-alternative pool is generic Axiron solution or generic Fortesta, Testim, or Vogelxo gel. The marketplace pool also includes specified generic AndroGel gels, but not the solution. These are named policy options, not instructions to try treatment. IP0351 also allows individual review of requests outside its listed dosing criteria.

No one should try a medicine just to satisfy a form. If you've already tried something, make sure your pharmacy history or chart shows it.

How to find your drug list name

• Online: log in to myCigna, open Prescriptions, and use Price a Medication. It shows your coverage, your cost, and any approval rules for your exact drug.
• On paper: your plan documents name the drug list (Standard, Performance, Value, Advantage, Legacy, Total Savings, National Preferred, or a state marketplace list).
• By phone: call the number on your ID card.

Cigna says it usually changes drug lists on January 1 and July 1. The checked July 2026 Standard document points to changes for January 1, 2027; check your current member record rather than assuming the printed list is the latest one. ⁵

Know which product your doctor has in mind? Check your exact drug in myCigna → You'll need your own login. Never enter your Cigna password on any other site.

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Does Cigna cover testosterone pellets or compounded testosterone?

Cigna can cover Testopel, an FDA-approved testosterone pellet, when your plan covers it and its approval criteria are met. Cigna's compounded-medication policy excludes compounded hormone pellets as experimental, investigational, or unproven. Other compounded preparations need a separate benefit and criteria check.

Testopel vs. "pellet clinics"

Cigna's policy lists Testopel 75 mg, an FDA-approved testosterone pellet. Its criteria address the product, records, and requested regimen; requests outside the listed dosing criteria can receive individual review. ²

Pellets get placed under the skin in an office, so expect more than one bill:

• the pellets themselves
• the in-office procedure (CPT code 11980)
• possibly a facility charge

Cigna lists J1073 for a 75 mg testosterone pellet, effective January 1, 2026, and CPT 11980 for insertion. Ask the billing office which codes and benefits apply to your claim. ²

A pellet clinic may offer compounded pellets instead. Before you book, ask two questions: "Is it Testopel?" and "Will you bill my Cigna plan for the pellets and the procedure?"

Compounded creams and custom injections

A compounded medicine is mixed by a pharmacy for a specific patient. The FDA doesn't approve compounded drugs, and it doesn't review them for safety, effectiveness, or quality before they're sold. ¹⁸

That's a different category from FDA-approved generics. It isn't a "generic version," and it isn't the same product. The online programs discussed below offer compounded formulas, so ask exactly what you'd get.

For other compounds, IP0251 has six conditions, including records showing why the FDA-approved prescription alternatives for the same route of use (up to five) did not work, caused significant intolerance, or cannot be used for a medical reason. The compound must also contain at least one FDA-approved prescription ingredient that the plan does not exclude. The policy says bulk chemicals do not meet Cigna's standard benefit definition of a prescription drug. A custom preparation is not automatically a covered alternative. ⁴

What about clomiphene or "natural TRT" pills?

Clomiphene, enclomiphene, and hCG are not testosterone, and they're not TRT. Each works differently and has its own rules. Clomiphene use for male low testosterone is off-label. hCG has an approved use for selected cases of hypogonadotropic hypogonadism. Compounded enclomiphene is not FDA-approved. ¹⁸, ²⁶, ²⁷

Cigna's checked Standard list marks MiloPhene (clomiphene citrate) as optional coverage. ⁵, ²⁸ Cigna also has a separate clomiphene benefit-exclusion override policy for male hypogonadotropic hypogonadism, with one-year approvals when applicable. An infertility exclusion does not answer every clomiphene coverage question. ²⁵

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Already on TRT? How to move your testosterone onto Cigna

Cigna has a separate approval path for men already taking testosterone. Your doctor must show you had symptoms before treatment and at least one low testosterone test from before you started. Cigna's February 2026 update to IP0350, its oral, topical, and nasal testosterone policy, removed an older lost-records criterion, so request the low pre-treatment lab report from your old clinic now.

This is the trap that catches cash-clinic switchers.

All three of Cigna's testosterone policies have a "currently receiving testosterone" path. It uses a different records rule from a new start: at least one low pre-treatment test plus a record of your earlier symptoms. ¹, ², ³

But you need that pre-treatment lab, the one from before your first dose. Your current on-treatment labs don't count for this.

And here's the 2026 catch. When Cigna revised IP0350 (effective February 15, 2026), it removed the "loss of records" criterion from that policy. ¹ If you can't produce the old lab, that specific exception is no longer available; ask your prescriber about the records and review options for your case.

What to request from your old clinic

• Your low testosterone lab report or reports from before treatment, with draw date, time, and reference range
• Your intake note listing symptoms
• Your prescription history (product, strength, dates)
• Your most recent on-treatment labs, including hematocrit (the share of your blood made of red cells) and PSA (prostate-specific antigen, a prostate blood test) if they were checked

Ask for these through the clinic's medical-records process. Most clinics have a form.

If you can't get your old labs

Talk to your new prescriber about next steps. Don't stop or change your testosterone on your own to create a new baseline. Stopping, changing, or restarting treatment is a medical decision that belongs with your clinician.

What to check before moving a cash prescription onto Cigna

• Ask whether the clinic bills your plan for visits and other services.
• Check whether your exact prescribed product is covered and which pharmacy you must use.
• Check your plan's network and prior-authorization requirements.

Ask whether your current prescriber can support a covered prescription through your plan. If not, an in-network clinician can review your old records and discuss the available options.

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Does it matter which Cigna plan you have?

Employer plans, Cigna plans you bought yourself, and plans with "Medicare" on the card follow different rules. Cigna will stop offering individual and family medical plans on January 1, 2027. It sold its Medicare plans to Health Care Service Corporation (HCSC) in March 2025.

If you bought your own Cigna plan: what changes in 2027

Cigna sold individual and family medical plans in 11 states for 2026:

• Arizona, Colorado, Florida, Georgia, Illinois, Indiana
• Mississippi, North Carolina, Tennessee, Texas, Virginia ¹³

It's leaving that market nationwide, effective January 1, 2027. Cigna's own notice says its 2026 individual and family drug lists reflect coverage available through December 31, 2026. ¹⁴

If that's you, your 2026 benefits still depend on your plan's terms and any required approval. Your new plan will have its own drug list and its own approval rules. Don't assume a Cigna approval will carry over; ask the new plan about transition coverage.

What helps right now:

• Ask your doctor's office for copies of your lab reports and any approval letters while you're still a Cigna member.
• When you shop for a 2027 plan, look up your exact testosterone product on each plan's drug list before you enroll.
• Check that your current prescriber is in the new plan's network.

Cigna's 2026 marketplace change list also added prior authorization for the named generic 1% and 1.62% gels starting January 1, 2026. ⁸

What about Cigna Medicare?

Cigna sold its Medicare Advantage, Part D drug plans, and Medicare supplement business to Health Care Service Corporation. The sale closed March 19, 2025. ¹⁵

If your card says Medicare, Medicare's rules and your plan's formulary apply, not the employer policies above.

Transgender and gender-diverse members

Cigna's testosterone policies include a separate criterion for masculinizing hormone therapy. Coverage varies by plan and by state and federal rules. ¹, ² The hypogonadism checklist on this page doesn't apply to that care. Ask your treating team and plan for the matching policy.

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Does Cigna cover the doctor visits, blood tests, and clinic fees?

A testosterone prescription, the doctor visits, the blood tests, and any clinic membership are separate bills. Approval for the medicine doesn't confirm that Cigna will pay for the others. Check each one: visits and labs usually fall under your medical benefit, with plan-specific cost sharing; the drug may fall under your pharmacy or medical benefit, depending on the product and setting.

This is where people get surprised. They hear "Cigna covers testosterone" and assume the whole program is paid for. It usually isn't that simple.

A clinic saying "we work with Cigna" doesn't settle your bill. Ask which charges it sends to Cigna, which ones are cash, and which ones your plan has actually confirmed.

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Your Cigna TRT checklist: what to confirm before you pay

Five answers settle most Cigna TRT questions: your drug list name, whether your exact product needs approval, whether your doctor and lab are in network, what your share will be, and what records your doctor needs. Get them in writing or note who told you and when.

We built this checklist from Cigna's own policies, forms, and member instructions. It's free and works on paper. Nothing to sign up for.

Step 1: Pin down your plan and prescription

Step 2: Collect the paperwork Cigna asks for

• For a new start: two low pre-treatment morning testosterone reports from different days, each showing the time and the lab's normal range
• A chart note listing your symptoms before treatment
• If already on TRT: at least one low pre-treatment lab report
• If a preferred-product rule applies: records of what you tried and why it was unsuitable, or the evidence for an exception

Never invent a symptom, a past trial, or an allergy to meet a form. False information can put your safety and coverage at risk.

Step 3: Call Cigna with this script

"I want to check coverage for a testosterone prescription before I pay for care. What drug list does my plan use? Is [exact product] covered, at what tier, and does it need prior authorization or a step therapy trial? Is Dr. [name] in my network, and is [lab name] in network? Are testosterone blood tests covered under my medical benefit, and do they count toward my deductible? What would my share be for the prescription at [pharmacy]? Does my plan offer external review if a medical-necessity request is denied?"

If you're calling about a denial, add: "What's the exact reason, who needs to act, and what are my deadlines for an internal appeal and any external review?"

Step 4: Estimate your full first-year cost

Use the visit and lab schedule your clinician actually plans, not a guess. If your year crosses into a new plan year, or your deductible resets, split the math into two periods.

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Cigna denied my testosterone. What now?

A testosterone denial can involve missing paperwork or a coverage rule, including missing required lab reports, missing symptom notes, or an unmet preferred-product requirement. Ask the office which issue applies and how to supply supporting records. You can also appeal within the applicable deadline, and eligible medical-necessity denials may qualify for an outside reviewer.

Start with the exact reason. It's in your denial letter or in myCigna. "Needs prior authorization" at the pharmacy counter doesn't by itself tell you whether a request was submitted or denied. Ask the pharmacy and your prescriber's office what approval is missing for that exact fill.

Resubmit or appeal?

• Resubmit when Cigna asks the office for missing information, following the instructions for that request.
• Appeal when you disagree with the denial. You can include additional supporting records.

Don't let a resubmission make you miss the deadline to appeal. ³⁰

For employer plans, Cigna's general description of its single-level internal appeal process says to start by calling the number on your ID card within 180 calendar days of the initial payment or denial notice. It lists 30 calendar days for pre-service medical-necessity appeals. Confirm the required submission and deadline for your plan. If your situation requires urgent care, ask about expedited review. ¹²

If the internal appeal fails, an eligible denial involving medical judgment may qualify for independent external review. Its decision is binding on the plan or insurer, subject to applicable legal remedies. Self-funded status alone does not remove external-review rights: non-grandfathered group plans generally must provide them for eligible denials. Check your denial notice and plan documents for the applicable process and deadline. ²⁹, ³¹

If you fill it without approval

With a valid prescription, you may be able to pay cash for the medicine. But the checked Standard drug-list FAQ says a fill without required approval is paid at full price and doesn't count toward the deductible or out-of-pocket maximum. Ask your plan whether later approval or a claim submission changes your result. ⁵

Before you do that, compare the available cash and coupon prices in the cost section below.

Have your denial letter in hand? Use our full testosterone denial and appeal guide → It walks through appeal letters, the records reviewers look for, and expedited review.

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Is TRT cheaper with Cigna or with cash?

If your Cigna plan covers generic testosterone cypionate, compare your plan's actual price with a cash quote for the same prescription; Tier 1 alone doesn't tell you which is cheaper. Visits and blood tests may involve a deductible, copays, or coinsurance. Include those charges and any membership fee when comparing the full cost of care.

Program and coupon prices checked October 22, 2026. Program figures are provider-stated public prices, not personal quotes. The models assume 12 paid membership months; follow-up labs and consultations are listed as included in Hone Plus and Premium, and Hone states shipping is included. Exact prescription costs remain separate. Coupon prices change often. ³⁶, ³⁷, ³⁸

Three things people miss:

• Coupon payments usually don't count toward your Cigna deductible. Ask Cigna before you assume they will.
• HSA and FSA money can generally pay for prescription medicines. Male Excel says its plans are FSA/HSA eligible; confirm the specific charges with your account administrator. ²², ⁴⁷, ⁴⁹
• A low drug price isn't the whole bill. You still need a prescriber and monitoring, and those cost money on every route.

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Can you use Cigna at an online TRT clinic?

It depends on the clinic and the bill: online care does not, by itself, decide Cigna coverage. Male Excel and Hone charge cash for their services, but Hone allows requests to use an outside pharmacy, where your plan's prescription benefit may apply. Check the clinician's network status, the exact drug, and who will handle any prior authorization before you book.

Male Excel says plainly that it doesn't accept insurance. ³³ Hone says it does not accept insurance for its services and does not complete prior authorizations. Its outside-pharmacy option does not include that work, so confirm who can supply the records and submit a request before counting on Cigna to pay. ⁴⁰, ⁴¹

Two legal points, briefly:

• Testosterone is a Schedule III controlled substance in the U.S. That means it requires a valid prescription. ²⁰
• Telemedicine prescribing is under a temporary rule. Through December 31, 2026, a federal rule lets DEA-registered clinicians prescribe controlled medicines like testosterone through audio-video telemedicine without an in-person visit first. They must still meet federal and state conditions. ²¹ That rule is about prescribing, not insurance, and it doesn't promise access in every state.

If you want to compare online programs against local care, our guides to TRT providers that take insurance and online vs. local TRT care lay out the trade-offs.

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If Cigna won't pay, or your Cigna plan is ending

Some men can't get Cigna to pay. Others are losing their Cigna marketplace plan in 2027, or would rather have a dedicated TRT team and a posted price than the paperwork. A cash program can fit then, but only if your low testosterone has been properly evaluated and you're not trying to have children soon.

Don't use a cash program instead of Cigna if:

• Your low testosterone hasn't been properly evaluated. Get properly evaluated first, through primary care, urology, or endocrinology.
• You want children soon. Start with a reproductive urologist; see TRT and fertility.
• Your plan covers generic cypionate and you're fine with in-network visits. Compare your full in-network estimate before paying for a cash program.

What we actually verified — October 22, 2026

Sources checked: Male Excel's pricing, test-kit, FAQ, terms, and guarantee pages; Hone's current membership, lab, insurance, pharmacy, state-availability, billing, and cancellation pages, alongside its TRT product page.

Verified document findings: Male Excel posts a testosterone-plus-thyroid price, not a testosterone-only quote. Hone's current help pages list both Plus and Premium for men's TRT, charge separately for confirmatory testing, and describe the cypionate price per vial. The cost table above shows the arithmetic and the remaining unknown charges. ²², ³², ³⁶, ³⁷, ³⁸, ³⁹

Provider-stated, not independently confirmed: the prices, service inclusions, state availability, pharmacy relationships, refill processes, and refund terms summarized below. A public statement does not prove a particular patient's access, service experience, or final bill.

Product and pharmacy disclosures found: Male Excel identifies its cream as compounded and names AnazaoHealth Corp. and WellDyneRx-FL as pharmacy partners. Hone's advertised cypionate product is compounded and not FDA-approved; its Plus page also identifies compounded cream and troches. ³³, ³⁷, ⁴²

Not established by this review: a personal quote, the exact clinician and dispensing pharmacy assigned to a reader, their individual licenses for that reader's state, or Male Excel's product-specific approval status for an injectable prescription. We did not buy care, complete checkout, contact support, or test service quality.

Male Excel: if you want a dedicated TRT team and a posted price

Male Excel doesn't bill Cigna or any other insurer. If using your Cigna benefits is your priority, check whether an in-network clinician can prescribe a covered product and what your full cost would be.

But because Male Excel skips insurance, it skips Cigna's paperwork too. There's no Cigna prior authorization, no Cigna step therapy, and no waiting on a Cigna drug-list decision for that cash purchase. Male Excel says the membership includes one dedicated medical provider, unlimited e-visits, and unlimited messaging with its support team. Its posted injectable testosterone-plus-thyroid price produces a $2,727 subtotal for 12 months, plus shipping and any other charges not included in that model. ²², ³²

Know before you start:

• The posted price is a starting price. Male Excel says your cost changes if your dose changes. The listed injectable price includes thyroid medicine; ask why it would be part of your care and whether a testosterone-only price is available. ²²

• Its pricing page doesn't label each product as FDA-approved or compounded. Ask which one you'd get. Its cream is a compounded formula. Its FAQ names AnazaoHealth Corp. and WellDyneRx-FL as pharmacy partners; ask which pharmacy would fill your exact prescription. ³³

• Its goal differs from Cigna's. Male Excel says it aims for what it calls "optimal" levels, which is a different target from the criteria insurers use to decide coverage. That marketing term is not a universal diagnosis or treatment target.

• Bring your available pre-treatment lab reports and ask whether a clinician will review them. Starting an intake doesn't guarantee a prescription; a clinician makes that call.

• Testing and follow-up need their own check. The $99 starting price includes an at-home blood-spot kit and online consult. The public pages do not establish that this includes two separate early-morning diagnostic tests. Ask what repeat testing is required, what it costs, and whether your prior results can be used. Male Excel says follow-up blood testing may be needed at six or 12 months. ³², ³³

• It is not available in every state. Its FAQ excludes Alabama, Alaska, Arkansas, Connecticut, Hawaii, Idaho, Louisiana, Minnesota, Mississippi, New Hampshire, and Rhode Island. Confirm availability for your current location before paying. Its terms also warn that an in-person exam may be required under applicable rules. ³³, ³⁴

• Cancellation is not a medication refund. Male Excel advertises no contract and cancellation at any time, but prescriptions are billed on a 60-day cycle and prescription sales are final. Confirm the next charge and shipment cutoff in writing. A separate 90-day guarantee applies only to eligible membership fees and has conditions and a claim deadline; it does not refund medication. ²², ³³, ³⁴, ³⁵

Non-testosterone option

Its oral option, Triclozene, isn't testosterone. It's clomiphene with thyroid medicine. Male Excel also lists selenomethionine, a form of selenium, and describes Triclozene as an oral compound. The compound is not FDA-approved, and clomiphene use for male low testosterone is off-label; this is a separate treatment discussion, not an interchangeable form of TRT. ¹⁸, ²², ²⁶, ³³

Does a posted price and one dedicated provider fit what you want more than using your insurance? See Male Excel's current TRT pricing →

Want to compare a different testing and membership setup? Hone Health posts two men's TRT membership options, with medication priced separately.

Hone Health: if you want to compare two testing and membership options

Hone's Premium route starts with a $65 lab test of about 50 blood markers. A physician consult follows. Premium is $155/month, but it is not the only TRT membership: Plus is $135/month, with a $45 initial test. The $25/month Basic tier does not include TRT care. ³⁶, ³⁷, ³⁸

Know before you start:

• Confirmation costs extra. For Plus, Hone lists $45 for in-lab confirmation or $80 at home when TRT is considered. Premium lists a $25 confirmatory panel. Follow-up labs and consultations are listed as included. Ask the clinician to confirm the required timing and whether any tests fall outside the plan. ³⁷, ³⁹
• Medication is separate. Current help pages list testosterone cypionate from $28 per vial; the public marketing page's monthly starting price is not enough to calculate your prescription's annual cost. Shipping is listed as included. ²³, ³⁷, ³⁸
• Its advertised cypionate product is compounded. That product is not FDA-approved. Hone also offers compounded testosterone cream and troches; those are separate formulations, not FDA-approved generic substitutes. An outside-pharmacy prescription may have different product and cost options, subject to the clinician and pharmacy. ³⁷, ⁴¹, ⁴²
• Cigna paperwork is not included. Hone says it does not complete prior authorizations. Sending a prescription to your pharmacy does not make the membership an insurance-covered service. ⁴⁰, ⁴¹
• State availability differs by membership. Hone publishes separate Plus and Premium state lists. For example, its men's chart lists Hawaii and South Dakota for Plus but not Premium, and New York for Premium but not Plus. Check the current list and the exact treatment before paying. ⁴³
• Membership and prescription billing are separate. Hone advertises no long-term commitment, but canceling one does not automatically cancel the other. Its help pages give conflicting descriptions of when membership cancellation takes effect, so get the end date and pending-order status in writing. Its published policy excludes refunds for partial membership months and processed or shipped prescriptions. ³⁶, ⁴⁴, ⁴⁵, ⁴⁶

Non-testosterone options

Hone also sells clomiphene and enclomiphene. Those aren't testosterone and aren't TRT. Clomiphene use for male low testosterone is off-label; compounded enclomiphene is not FDA-approved. These require their own clinical and fertility discussion. ¹⁸, ²⁶, ³⁷, ³⁸

If those testing and membership options fit, see Hone Health's current lab and membership pricing →

Before paying either clinic, ask how to get copies of your lab results, visit notes, and prescription history, including after cancellation. Confirm the actual clinician's credentials, license for your state, follow-up schedule, refill timing, and route for urgent questions; a membership page cannot establish those for your case.

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How we checked Cigna's testosterone rules

On October 22, 2026, we read Cigna's current testosterone coverage policies, its compounded-medication policy, three of its 2026 drug lists, its request forms, and its member instructions for drug lists, approvals, and appeals. We checked medical points against the Endocrine Society, FDA, and DEA. We separated Cigna's written rules from our own guidance.

What we read:

• Cigna Coverage Policies IP0350 (effective June 15, 2026), IP0351 (effective October 15, 2026), CNF620 (reviewed September 23, 2026), and IP0251
• Cigna's Standard 3-Tier, National Preferred 5-Tier (abridged), and Premiere Virginia 4-Tier drug lists for 2026
• Cigna's Testopel request form and electronic request instructions
• Cigna's member appeals page and the federal external-review rules

What's original here: we built the drug-list comparison and the step therapy table by putting those documents side by side. No single Cigna document shows it.

What we didn't do: we didn't log in as a Cigna member, submit a prior authorization, or get a personal price quote. Nothing here is a coverage decision for you.

Our provider sections follow How We Review TRT Providers. That method separates verified facts, provider-stated facts, customer-experience signals, and our editorial conclusions, and it separates the calculable cost from charges that still need a personal quote.

We don't include testimonials on insurance pages. A customer quote can't prove what a plan covers.

Read our editorial standards and privacy policy, or send a correction if a policy or price has changed.

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Frequently asked questions about Cigna and TRT

Your plan's drug list, the exact prescription, and whether treatment is new or already underway change the answer. These questions explain the written rules; your member record supplies the coverage decision and price.

Does Cigna cover TRT therapy?

Cigna has coverage criteria for primary or secondary hypogonadism, subject to your plan. New treatment requires pre-treatment symptoms and two low early-morning tests on separate days; current treatment uses symptoms and at least one low result from before treatment. Hypogonadism approvals last one year under the reviewed policies. ¹, ², ³

Does Cigna require prior authorization for testosterone?

It depends on the product and drug list. Generic testosterone cypionate shows no approval mark on the checked Standard, National Preferred abridged, and Virginia lists; CNF620 recommends prior authorization. Generic gel and Xyosted have different markers across the checked lists. Ask about your exact prescription. ¹, ², ³, ⁵, ⁶, ⁷

What testosterone level does Cigna require?

The reviewed hypogonadism criteria do not use one fixed number. The required pre-treatment result or results must be low by the lab's own normal range. Its policies mention the American Urological Association's 300 ng/dL cutoff as background, not as the approval rule. ¹, ²

Does Cigna cover testosterone injections?

Cigna can cover injections under a covered benefit. Generic testosterone cypionate is Tier 1 on the checked Standard list. Initial-treatment criteria for Xyosted and Azmiro include an intramuscular cypionate or enanthate alternative where the preferred-product rule applies; the rule requires inadequate benefit or significant intolerance reported by the prescriber. ², ⁵

Does Cigna cover testosterone gel?

Cigna can cover gel, but the checked lists differ on prior authorization. The Standard and Virginia lists mark the listed generic gels PA and quantity limit; the National Preferred abridged list shows quantity limits without a PA marker. The applicable brand-gel rule requires a matching-generic trial and an inactive-ingredient difference the prescriber says would cause a significant allergy or serious adverse reaction. ¹, ⁵, ⁶, ⁷

What is the Cigna Testopel prior authorization?

It's Cigna's approval process for Testopel pellets. The form distinguishes initial treatment from treatment already underway and asks for the relevant pre-treatment symptoms and lab records, along with the requested dose, frequency, and duration. ², ⁹

Does Cigna cover compounded testosterone?

Cigna's compounded-medication policy excludes compounded hormone pellets as experimental, investigational, or unproven. Other compounds have separate benefit and medical-necessity conditions, so ask about the exact preparation. Compounded drugs are not FDA-approved. ⁴, ¹⁸

Does Cigna cover testosterone testing?

Blood tests usually fall under your medical benefit, with plan-specific cost sharing and network rules. Ask whether the exact tests are covered and the specific lab is in network before your draw. ⁵, ¹¹

How long does a Cigna testosterone approval last?

One year for hypogonadism. Renewals use the "currently receiving testosterone" path, which needs your pre-treatment records. ¹, ², ³

Does Cigna cover TRT for low testosterone from aging?

Age alone doesn't decide it. Cigna's reviewed adult hypogonadism criteria ask for symptoms and the required low pre-treatment results; they do not make age alone an approval route. In June 2026, the FDA asked makers to update older labeling language about age-related low testosterone. That request does not establish that every product label has changed, and it doesn't decide your Cigna coverage. ¹, ², ¹⁹

Is Cigna leaving the marketplace in 2027?

Yes. Cigna won't offer individual and family medical plans anywhere starting January 1, 2027. Job-based Cigna plans aren't part of that change. ¹⁴

Does Cigna Medicare cover testosterone?

Cigna sold its Medicare plans to HCSC in 2025, so those members should check Medicare rules and their current plan's formulary. See Medicare's prescription-drug coverage guide ¹⁵

Does Cigna cover testosterone for women?

This page covers adult men with hypogonadism. Cigna's policy notes that pill, gel, and nasal testosterone labels don't include women. Its National Formulary policy reviews one breast-cancer use of testosterone enanthate separately. Ask your plan and clinician about your situation. ¹, ³

Is Express Scripts the same as Cigna?

Express Scripts is part of The Cigna Group and fills many Cigna members' home-delivery prescriptions. If Express Scripts runs your pharmacy benefit for a non-Cigna plan, your own plan's rules apply, not the Cigna policies on this page. ⁵

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Cigna has coverage pathways for TRT. Having the required pre-treatment labs, symptom notes, and drug list name ready helps your prescriber's office address the right criteria. If you're already on treatment, request your low pre-treatment lab report now. And if you bought your own Cigna plan, plan for January 1, 2027.

Still considering online care? Use our free Find My TRT Path tool to explore online-program options.

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Sources

All sources checked October 22, 2026.

1. Cigna Coverage Policy IP0350, Testosterone (Oral, Topical, and Nasal) Products, effective June 15, 2026.
2. Cigna Coverage Policy IP0351, Testosterone (Injectable) Products, effective October 15, 2026.
3. Cigna National Formulary Policy CNF620, Testosterone (Injectable) Products Prior Authorization Policy, reviewed September 23, 2026.
4. Cigna Coverage Policy IP0251, Compounded Medications, effective December 15, 2025.
5. Cigna Healthcare Standard 3-Tier Prescription Drug List, coverage starting July 1, 2026; Cigna document 595200y, hosted by SchoolCare.
6. Cigna Healthcare National Preferred 5-Tier Prescription Drug List, abridged, coverage starting July 1, 2026.
7. Cigna Healthcare Premiere Virginia 4-Tier Prescription Drug List, Individual and Family Plans, 2026.
8. Cigna Healthcare, 2026 Individual and Family Plan Prescription Drug List Changes.
9. Cigna Testopel prior authorization request form, version 111525.
10. Cigna Commercial Drug Prior Authorization Forms.
11. Cigna Healthcare, Precertification.
12. Cigna Healthcare, How to File an Appeal or Grievance.
13. Cigna Healthcare, Affordable Health Insurance Plans; 2026 state availability.
14. Cigna Healthcare, Individual and Family Plans Drug List; notice of the January 1, 2027 market exit.
15. The Cigna Group, completion of the Medicare and CareAllies sale to HCSC, March 19, 2025.
16. Endocrine Society, Testosterone Therapy in Men with Hypogonadism clinical practice guideline.
17. Endocrine Society, Hypogonadism in Men patient resource.
18. U.S. Food and Drug Administration, Understanding the Risks of Compounded Drugs.
19. U.S. Department of Health and Human Services, requested updates to testosterone therapy product labels, June 18, 2026.
20. U.S. Drug Enforcement Administration, Controlled Substances, alphabetical list.
21. Federal Register, Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications, December 31, 2025.
22. Male Excel, Hormone Treatment Costs.
23. Hone Health, Online Testosterone Replacement Therapy.
24. GoodRx, Testosterone Cypionate prices; product, concentration, and quantity-specific examples.
25. Cigna Coverage Policy BEO002, Clomiphene Benefit Exclusion Overrides Policy, effective July 15, 2026.
26. DailyMed, Clomid prescribing information, updated January 31, 2025.
27. DailyMed, Pregnyl prescribing information, updated December 2, 2025.
28. DailyMed, MiloPhene prescribing information, updated October 7, 2025.
29. 29 CFR §2590.715-2719, Internal claims and appeals and external review processes.
30. HealthCare.gov, Internal appeals.
31. HealthCare.gov, External review.
32. Male Excel, At-Home Hormone Test.
33. Male Excel, Frequently Asked Questions.
34. Male Excel, Terms & Conditions.
35. Male Excel, Excel Advantage Guarantee Terms & Conditions.
36. Hone Health, Membership Overview: Basic, Plus, and Premium.
37. Hone Health, Plus Membership: Men's Hormone Replacement Therapy with Labs.
38. Hone Health, Premium Membership: Full Clinical Insight for Men.
39. Hone Health, Men's Lab Schedule on the Premium Plan.
40. Hone Health, Do You Accept Insurance?
41. Hone Health, Can I Use My Own Pharmacy?
42. Hone Health, Testosterone Cypionate product page.
43. Hone Health, Service Availability by State, 2026.
44. Hone Health, Order Cancellation and Refund Policy.
45. Hone Health, Membership Fee and Medication Billing.
46. Hone Health, Membership Frequently Asked Questions.
47. Internal Revenue Service, Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans.
48. Endocrine Society, full clinical practice guideline, Testosterone Therapy in Men With Hypogonadism, JCEM, 2018; terminology and diagnostic evidence.
49. Internal Revenue Service, Publication 502, Medical and Dental Expenses; prescribed medicines and drugs.