Does Priority Health Cover TRT? What Its 2026 Drug Lists and Prior Authorization Rules Require
Review Priority Health's 2026 commercial testosterone drug lists, injection-first authorization rules, Michigan appeals and separate care costs.
TRT Provider Guide · Last verified: (sources checked November 11, 2026; Priority Health's 2026 employer and individual drug lists we opened are labeled Current as of 11/1/2026, and its pharmacy prior authorization criteria are labeled Last revised August 01, 2026) · Editorial research
Last updated: .
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.
Affiliate disclosure: We may earn a commission if you use the tracked links to Male Excel or Hone on this page. That does not change the Priority Health documents quoted below, and official Priority Health, State of Michigan, and FDA links are not affiliate links.
Educational notice: This page explains plan documents. It is not medical advice, it does not diagnose low testosterone, and it is not a guarantee that Priority Health will approve or pay a claim.
The short answer
Answer capsule: Yes. Priority Health covers generic testosterone cypionate and enanthate injections on its 2026 commercial drug lists with no prior authorization. Gels, Kyzatrex, Aveed, and Testopel need prior authorization: symptoms, two total testosterone results of 300 ng/dL or less within 12 months, and a failed two-month injection trial.
The injection-first rule decides most requests. Priority Health's criteria say "needle phobia" or "needle fatigue" does not count as a reason to skip injections. In a March 2025 State of Michigan external review, the state upheld Priority Health's denial of testosterone gel for a member whose injections had worked for years. Brands such as Xyosted, Jatenzo, Tlando, Natesto, Testim, and brand Depo-Testosterone are non-formulary on both 2026 lists we opened.
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 to map your situation to the right care route and the questions to ask before you pay.
Who this page is for, and who it is not for
Best for: adults with commercial Priority Health coverage in Michigan, either through an employer group plan or an individual MyPriority plan, who want to know whether testosterone is covered, which forms need prior authorization, and what to do if a gel or pill request is denied.
Also useful for: people weighing a cash-pay online program against Priority Health coverage, and anyone who already uses injections and is thinking about switching formats.
Not the right starting point if:
- You have a Priority Health Medicare Advantage plan or other Medicare drug coverage. Priority Health posts separate Medicare drug lists, and Medicare rules differ. Start with Does Medicare cover TRT?.
- You have Priority Health Medicaid or another Medicaid plan. Priority Health posts a separate Medicaid drug list. Start with Does Medicaid cover TRT?. The cash-pay programs on this page are not a fit for government-program coverage.
- Your card shows a different insurer, even if your clinic is in Michigan. Blue Cross plans are covered on Does Blue Cross Blue Shield cover TRT?, and other payers have their own pages in TRT providers that take insurance.
What does Priority Health cover without prior authorization?
Answer capsule: Generic testosterone cypionate and generic testosterone enanthate injections. Priority Health's pharmacy criteria state that these two injections do not require prior authorization, and both 2026 commercial drug lists place them in the lowest generic tier. Every other testosterone product on the lists needs prior authorization or is non-formulary.
On the 2026 employer group Traditional drug list, testosterone cypionate (100 mg/mL and 200 mg/mL) and testosterone enanthate are Tier 1 with no restrictions printed on the row. On the 2026 Individual (MyPriority) drug list, the same two generics are Tier 1b, also with no restrictions printed. Both lists are labeled Current as of 11/1/2026.
Two details matter at the pharmacy counter:
- Brand Depo-Testosterone is non-formulary on both lists. The employer list says Priority Health requires an A-rated generic when one is available. If your prescription is written or filled as the brand, ask for generic testosterone cypionate.
- No prior authorization does not mean no rules. The pharmacy still needs a valid prescription, and testosterone is a Schedule III controlled substance. Your plan's own quantity rules and cost sharing still apply.
The employer list also warns that a drug on the approved list may not be included in your employer's prescription program. Check your coverage documents and riders if you get an unexpected rejection.
What does Priority Health require before it covers gel, Kyzatrex, Aveed, or Testopel?
Answer capsule: Prior authorization with three proofs for adult low testosterone: symptoms of androgen deficiency, two total testosterone results of 300 ng/dL or less within 12 months, and at least two months of injectable testosterone that did not improve symptoms. Aveed and Testopel also require a failed two-month generic gel trial.
Priority Health groups these products as "Testosterone Replacement Products" in its pharmacy prior authorization criteria for Employer Group and MyPriority plans, labeled August 2026 and Last revised August 01, 2026. The employer group Traditional criteria carry the same testosterone text, and so does the Medical Drug Prior Authorization Criteria for drugs given in a clinic.
Preferred agents: generic testosterone 1% and 1.62% gel (generic for AndroGel) and Kyzatrex (oral testosterone undecanoate capsule), both pharmacy-benefit drugs.
Non-preferred agents: Aveed (testosterone undecanoate injection) and Testopel (testosterone pellets), both medical-benefit drugs.
For hypogonadism, the member must have all of the following:
- Clinical signs and symptoms consistent with androgen deficiency. The criteria add that a request to treat fatigue or decreased libido with no other symptoms is not a covered benefit.
- A serum total testosterone result of 300 ng/dL or less on two different dates in the previous 12 months, before treatment. Lab results must be included or faxed with the request.
- A trial and failure of injectable testosterone for at least two months, with failure to improve symptoms. The criteria use testosterone enanthate 150 to 200 mg every two weeks as the example and allow a dose change after two months or more if symptoms fluctuate.
- For a non-preferred product (Aveed or Testopel): a trial and failure of, or intolerance to, generic topical testosterone for at least two months, with failure to improve symptoms and failure to raise total testosterone above 300 ng/dL.
The criteria close with this note: "Needle phobia" or "needle fatigue" is not considered an intolerance or contraindication to injectable testosterone therapy.
The front of the criteria manual adds one more rule. When criteria require trying other drugs first, only drugs the plan covers or prefers count. A non-formulary or non-preferred drug you used before will not satisfy the step.
The Priority Health testosterone ladder
The criteria also include a separate pathway for gender dysphoria. That pathway asks for documentation of the diagnosis and a trial of injectable testosterone, and we do not walk through it here.
Why won't Priority Health switch me from injections to gel?
Answer capsule: Because its criteria cover gel only after injections fail. In the March 2025 Michigan case, a member's injections had worked for 13 years, so the state found he did not meet the criteria for gel. Doing well on injections is the reason the switch was denied.
The State of Michigan order in File No. 233961-001, issued March 24, 2025 by the Department of Insurance and Financial Services (DIFS), lays out the situation:
- The member, covered by a Priority Health HMO Marketplace plan, had used testosterone injections for 13 years for hypogonadism "and has had good success."
- A new job meant travel out of the country, and he asked to switch to 1.62% testosterone gel. His doctor agreed and asked Priority Health to cover it.
- Priority Health denied the request and upheld the denial on internal appeal. Its letter said the criteria require failing a generic injectable first, and that "fail" means at least two months of use with no symptom improvement or no rise in testosterone. His records showed injections had worked since 2013.
- DIFS treated it as a contract question, not a medical one, and upheld Priority Health's decision.
Travel, convenience, and needle dislike are not reasons the criteria recognize. If you want gel or Kyzatrex through Priority Health, your doctor's records need to show a documented injection trial that did not improve symptoms, or a medical reason the criteria accept. If that does not describe you, two other paths exist: stay on covered injections, or pay cash for a different format. We cover the cash side in the section on when cash pay makes more sense, below.
Our pages on testosterone injections vs gel and TRT without needles compare the formats themselves.
What is on Priority Health's 2026 drug lists for testosterone?
Answer capsule: Generic cypionate and enanthate injections sit in the lowest tier with no flags. Several generic gels and Kyzatrex are covered with prior authorization. Most testosterone brands are non-formulary. The employer Traditional list and the Individual list follow the same testosterone pattern, with different tier names.
This table puts both lists side by side. Priority Health shows cost levels as dollar signs, not dollar amounts, so your copay or coinsurance comes from your own plan documents.
QL means quantity limit. PA means prior authorization. The Individual list prints "120 tablets per 30 days" on the Kyzatrex 200 mg row, while the employer list prints "120 capsules." Kyzatrex is a capsule.
Methyltestosterone is an older oral product, and it carries both prior authorization and a one-month supply limit on these lists. Ask your clinician why it would be chosen over the covered injections, gels, or Kyzatrex.
A summary of formulary changes effective January 1, 2027 for commercial group and individual members lists no testosterone changes in the version we opened. Priority Health says its lists change often, so re-check at fill time.
What if my testosterone product is not on the list?
Answer capsule: Your prescriber can ask for a formulary exception using Priority Health's pharmacy prior authorization form. The request has to explain why covered options will not work, and earlier trials of non-formulary drugs do not count toward step requirements.
The criteria manual says the same pharmacy request forms are used for drugs not on the approved drug list, for quantities above a listed limit, and for age limits. For uses, doses, or routes not approved by the FDA or recognized in CMS-accepted compendia, Priority Health asks for two published peer-reviewed articles supporting the request.
In practice, an exception for Xyosted, Jatenzo, Tlando, or Natesto will be judged against a plan that already covers generic injections, gels, and Kyzatrex. The stronger case is usually a documented reason the covered products failed or cannot be used, not a preference.
Does Priority Health cover Aveed and testosterone pellets?
Answer capsule: Possibly, under the medical benefit with prior authorization, but only as non-preferred products. The member must first fail at least two months of injections and at least two months of generic gel. Aveed and Testopel are given in a clinic, so they follow the Medical Drug List, not the pharmacy list.
Priority Health's medical drug criteria list Aveed and Testopel as non-preferred medical-benefit drugs and apply the same testosterone criteria described above, plus the gel step. Those requests go on Priority Health's medical (non-oncology) drug request form or its web form, not the pharmacy form. Ask your clinic whether it will bill the drug under your medical benefit and who will submit the request.
Cash-pay context for both is on Aveed cost and testosterone pellets cost.
What labs does Priority Health require for testosterone?
Answer capsule: For prior-authorized products, Priority Health asks for two total testosterone results of 300 ng/dL or less on two different dates within the previous 12 months, sent with the request. The criteria do not say the draws must be morning draws, but medical guidelines do, so ask your clinician to time them.
Priority Health's 300 ng/dL rule is a coverage rule. It is not a diagnosis. FDA-approved testosterone labels, such as the Xyosted prescribing information revised July 2025, tell prescribers to confirm hypogonadism before starting by making sure serum testosterone was measured in the morning on at least two separate days and was below the normal range. Morning draws on two different dates can meet that label instruction and Priority Health's two-date rule at the same time. Medical guidelines also look at symptoms and signs, not one number. Our two-test page compares how the American Urological Association and the Endocrine Society word it.
Three practical points:
- Two dates, one window. Both results must fall within the previous 12 months.
- "300 or less" is literal. The criteria do not offer a below-the-lab-range or free-testosterone alternative in the hypogonadism text we read.
- Symptoms must be broader than fatigue or low libido alone. The criteria exclude requests based only on those two symptoms.
Generic injections skip the prior authorization review, so Priority Health does not check these criteria before paying for them. Your prescriber still has to diagnose low testosterone properly. More detail is on Do you need two low testosterone tests for TRT? and What testosterone level qualifies for TRT?.
How do I submit a Priority Health testosterone prior authorization?
Answer capsule: Your prescriber submits Priority Health's pharmacy prior authorization form by fax or uses electronic prior authorization (ePA). The form asks for the diagnosis, the medical reason, every drug tried with dates, and supporting chart notes and labs. Priority Health replies to the prescriber's office by fax.
The Priority Health pharmacy prior authorization form for Commercial (Traditional) and Commercial (Individual/Optimized) plans lists fax numbers 877.974.4411 (toll free) and 616.942.8206. It has urgent and non-urgent checkboxes. Urgent means the standard review time could seriously jeopardize the patient's life, health, or ability to regain maximum function. A routine testosterone request is usually non-urgent.
Bring this to the visit so the request is complete the first time:
- The exact product and strength you want covered, and why.
- Two total testosterone results of 300 ng/dL or less from different dates in the last 12 months.
- Notes describing your symptoms and signs, not only fatigue or low libido.
- Your injection history: the product, dose, start and stop dates, and what happened. The form has a table for this.
- For Aveed or Testopel, your generic gel history with dates and follow-up testosterone results.
Priority Health's criteria manual also says coverage may stop after approval if you are not taking the medication as prescribed, if there is no clinically significant improvement, or if you no longer meet the initial criteria.
What can I do if Priority Health denies testosterone?
Answer capsule: Start with Priority Health's internal appeal, using the steps in your denial notice. If the final answer is still no, Michigan law lets you ask DIFS for an external review within 127 days of the final decision. DIFS will compare the denial with your plan's written criteria.
The DIFS appeal guide says:
- Insurers must decide internal appeals within 30 calendar days for a pre-service denial and 60 calendar days for a post-service denial.
- You can file a DIFS external appeal online or on paper within 127 days of the insurer's final adverse determination. A doctor, spouse, or other person can represent you.
- An expedited external appeal is completed within 72 hours. It is only for pre-service denials where you need care immediately, it must be filed within 10 days of the plan's final decision, and it needs a letter from your treating physician.
- A person who disagrees with the DIFS decision has 60 days to seek judicial review in circuit court.
Know what DIFS will look at. In the 2025 testosterone case, the director decided the appeal by reading the plan's criteria, without sending it to an independent medical reviewer. If your records do not show a failed injection trial, an appeal is unlikely to change the result. A complete new request may be the better move. Your denial letter will say which external review applies to your plan, so check it if your coverage is through a self-funded employer plan.
The general playbook for denials, including what to ask for in writing, is on testosterone prior authorization.
What will testosterone cost with Priority Health?
Answer capsule: Generic injections land in Priority Health's lowest-cost generic tier, so they are usually the cheapest covered option. The drug lists show cost levels only as dollar signs. Your actual copay, coinsurance, and deductible depend on your plan, so ask Priority Health for a price on the exact product.
We are not going to guess a Priority Health copay. The lists use $ to $$$$$ symbols, and Priority Health tells members to check coverage documents for amounts. What the lists do show:
- Generic injections: Tier 1 (employer Traditional) or Tier 1b (Individual). Lowest generic tier, no prior authorization.
- Generic gels: Tier 2 with prior authorization.
- Kyzatrex: Tier 3 with prior authorization and quantity limits.
If your plan has a deductible that applies to prescriptions, you may pay more until it is met. Ask for the price at your pharmacy before you fill, and compare it with a pharmacy discount price. Background on cash drug prices is on testosterone cypionate cost, testosterone enanthate cost, testosterone gel cost, and Kyzatrex cost.
The drug is only one bill. Visits and labs are billed under your medical benefit with their own cost sharing.
Can you use Priority Health with an online TRT clinic?
Answer capsule: Usually not for the program itself. The two online programs we list first are cash-pay and do not bill Priority Health. Hone says a member can move a commercially made prescription to a local pharmacy and use insurance there, but it will not handle prior authorizations.
Both programs serve Michigan:
- Male Excel says it does not accept insurance and that treatment is self-pay. Its FAQ adds that, because it does not accept insurance, it does not provide letters of medical necessity. Its pricing page, checked November 11, 2026, shows a $99 one-time at-home hormone test and consultation, then a required Proactive Healthcare Membership of $79 a month on the annual plan paid upfront or $99 a month paid monthly. Medication is billed separately, usually every 60 days. Its pricing FAQ puts common starting-dose medication at $95 to $132 a month. Male Excel's own page says its topical testosterone is compounded and not FDA-approved. Michigan is not on Male Excel's list of states where it does not prescribe hormone treatment.
- Hone says in its help center that it does not accept insurance. Its membership overview, updated September 29, 2026, lists the men's TRT Plus plan at $135 a month and Premium at $155 a month, with medication billed separately. Its state table, updated September 4, 2026, shows Plus and Premium available in Michigan.
Hone's "Can I use my own pharmacy?" article, updated September 4, 2026, says members can transfer a prescription to a local pharmacy, which then bills them directly. It says commercially made medications are easier to fill at retail pharmacies, while compounded medications usually need a compounding pharmacy. It also says Hone does not help with prior authorizations or insurance processing.
That creates a narrow possibility for Priority Health members. Generic cypionate and enanthate need no prior authorization on Priority Health's lists. If a Hone clinician prescribes a commercially made generic injection, you could ask a local pharmacy to run it through your Priority Health pharmacy benefit. We have not confirmed that Priority Health will pay every such claim from an outside prescriber, so call the number on your card first. Hone's membership fee is still yours to pay either way. Details on paying with pre-tax funds are on TRT providers that accept HSA or FSA.
When does cash pay make more sense than Priority Health coverage?
Answer capsule: When you need something Priority Health will not cover for you, such as a non-injection format without a failed injection trial, or you want one program to run your testing and follow-up. If covered generic injections fit you, insurance is usually the cheaper route.
Compare first-year costs. A Male Excel first year at published prices is about $2,190 to $2,630 on the annual membership plan, or $2,430 to $2,870 paying monthly. That is the $99 start, 12 months of membership, and $95 to $132 a month in medication, before shipping and any dose change. A Priority Health generic injection at a Tier 1 or Tier 1b copay will usually cost far less for the drug, though you still pay your plan's share for visits and labs.
Male Excel does not use your Priority Health benefit. If low cost is your main goal and you are fine with injections, your Priority Health doctor and a generic injection are the better fit. But because Male Excel is outside insurance, there is no Priority Health step-therapy rule standing between you and a format choice. Its clinicians decide between injections and cream based on your evaluation, without a two-month injection trial required by a plan. Keep the tradeoff in view: Male Excel's cream is compounded and not FDA-approved, and a prescription is never guaranteed.
Cash pay can be the better fit when:
- You want a non-injection format and your records will not show a failed injection trial.
- You do not have a local prescriber who will manage testosterone and its monitoring.
- You want testing, follow-up, and refills run by one program, and you accept paying for that.
- You are between plans or waiting on a coverage decision and want a clinician to evaluate you now.
Does that sound like your situation? Start with Male Excel's published program and pricing, then compare Hone's membership. Neither one makes Priority Health pay for the visit or the medication. If you are not sure which care route fits, Find My TRT Path asks about your situation first.
See Male Excel's pricing and start the at-home test
How do I check my own Priority Health testosterone coverage?
- Confirm your plan type: employer group, individual MyPriority, Medicare, or Medicaid. This page covers only the first two.
- Open the drug list that matches your plan at priorityhealth.com. Employer groups can have their own list, and the employer list notes that a listed drug may be excluded by your employer's riders.
- Find your exact product and strength. Write down the tier and any PA, QL, or SP flag.
- If you are starting treatment, ask your prescriber whether a generic injection fits you. It is the only testosterone route on these lists with no prior authorization.
- If you want gel, Kyzatrex, Aveed, or pellets, ask your prescriber to document your symptoms, two qualifying labs, and your injection history before sending the request.
- Ask whether a clinic-given product will be billed under your medical benefit, which has its own criteria.
- Call the member number on your card for your copay or coinsurance on the exact product, and ask about visit and lab costs too.
- If you are denied, follow the internal appeal steps in the letter, then the DIFS external review steps above if needed.
What should you settle with your doctor first?
A coverage decision is not a diagnosis. Testosterone is a Schedule III controlled substance, and it needs a real evaluation, follow-up labs, and monitoring.
- Fertility: testosterone can lower sperm production, and that effect may not fully reverse. If you want children now or later, raise it before you start. See Does TRT affect fertility?.
- Blood pressure and heart health: In February 2025, FDA required class-wide labeling changes for testosterone products. FDA said labels should add the TRAVERSE cardiovascular safety trial results, keep the limitation of use for age-related hypogonadism, and remove Boxed Warning language about an increased risk of adverse cardiovascular outcomes. It also required blood-pressure warnings: product-specific data where ambulatory blood pressure studies were done, and a new increased-blood-pressure warning for products that lacked one. See TRT and blood pressure.
- Age-related low testosterone: FDA labels keep a limitation of use for age-related hypogonadism. Testosterone is approved for men with low testosterone tied to an associated medical condition.
- Gels: topical testosterone carries a boxed warning about secondary exposure, where transferred gel can affect children and women.
This page does not tell you to start, stop, or change testosterone, and it does not interpret your labs. Review the current label for your exact product with a clinician. More background is on FDA-approved testosterone products.
What we actually verified
Verified on November 11, 2026:
- Priority Health 2026 Formulary, employer-sponsored large group (Traditional) plans, labeled Current as of 11/1/2026: every testosterone row in the table above, the tier legend, and the A-rated generic and employer-rider notes.
- Priority Health 2026 Individual (Optimized) drug list, labeled Current as of 11/1/2026: the same testosterone rows and the T1a/T1b tier legend.
- Priority Health Pharmacy Drug Prior Authorization Criteria for MyPriority Plans and for Employer Group Traditional Plans, both labeled August 2026 and Last revised August 01, 2026: the Testosterone Replacement Products criteria, preferred and non-preferred agents, the injection note, and the manual's rules on step trials and discontinuation.
- Priority Health Employer Group and MyPriority Medical Drug Prior Authorization Criteria, Last revised August 01, 2026: Aveed and Testopel as non-preferred medical-benefit drugs under the same testosterone criteria.
- Priority Health Summary of Formulary Changes effective January 1, 2027: no testosterone entries in the version opened.
- Priority Health pharmacy prior authorization form (last reviewed 01/2026): fax numbers, urgent definition, and required sections.
- State of Michigan DIFS order, File No. 233961-001, March 24, 2025, and the DIFS health insurance appeal guide.
- FDA's February 28, 2025 class-wide testosterone labeling statement and the Xyosted prescribing information revised July 2025 (section 2.1, confirming the diagnosis with two morning measurements).
- Male Excel's public pricing page and FAQ, and Hone's help-center membership overview (updated September 29, 2026), state availability table (updated September 4, 2026), insurance search results, and pharmacy-transfer article (updated September 4, 2026).
What we could not confirm: the dollar copay or coinsurance for any Priority Health plan; whether a specific employer group uses a custom list or riders that change these rows; how long a Priority Health testosterone approval lasts, because the testosterone criteria do not state a duration; and whether Priority Health pays a pharmacy claim for a generic injection written by an out-of-network telehealth prescriber.
What we did not do: examine anyone, read anyone's labs, submit a Priority Health claim or request, or enroll with a provider. A clinician has not reviewed this page. Our process is described in How We Review TRT Providers.
Priority Health and TRT: frequently asked questions
Does Priority Health cover TRT?
Yes, on its 2026 commercial drug lists. Generic testosterone cypionate and enanthate injections are covered with no prior authorization. Generic gels and Kyzatrex are covered with prior authorization, and Aveed and Testopel are non-preferred medical-benefit drugs. This answer does not apply to Priority Health Medicare or Medicaid plans.
Does Priority Health require prior authorization for testosterone injections?
No, for generic testosterone enanthate and generic testosterone cypionate. Priority Health's criteria say they do not require prior authorization. Brand Depo-Testosterone is non-formulary, and the plan requires an A-rated generic when one is available.
Does Priority Health cover testosterone gel?
Yes, with prior authorization. Several generic 1% and 1.62% gels are Tier 2 with PA, and some have quantity limits. Priority Health requires symptoms, two total testosterone results of 300 ng/dL or less within 12 months, and at least two months of injections that did not improve symptoms. Needle phobia or needle fatigue does not count as a reason to skip injections.
Does Priority Health cover Kyzatrex or other testosterone pills?
Kyzatrex is a preferred product at Tier 3 with prior authorization and quantity limits, under the same injection-first criteria as gel. Jatenzo and Tlando are non-formulary on both 2026 lists we checked. Methyltestosterone is Tier 4 with prior authorization.
Can I switch from testosterone injections to gel with Priority Health?
Only if your records show the injections failed after at least two months, or another medical reason the criteria accept. In a March 2025 Michigan external review, the state upheld Priority Health's denial of gel for a member whose injections had worked for 13 years. Travel and convenience were not enough.
What testosterone level does Priority Health require?
For prior-authorized products, 300 ng/dL or less on two different dates in the previous 12 months, with the lab results sent in. The criteria also require symptoms beyond fatigue or decreased libido alone. That is a coverage rule, not a diagnosis.
Will Male Excel or Hone bill Priority Health?
No. Male Excel says it does not accept insurance and does not provide letters of medical necessity. Hone says it does not accept insurance and does not help with prior authorizations. Both serve Michigan, and both say HSA or FSA funds may be usable, depending on your plan administrator.
Sources
- Priority Health. 2026 Formulary, Employer-sponsored large group (traditional) plans, Current as of 11/1/2026. PDF
- Priority Health. 2026 Individual (Optimized) approved drug list, Current as of 11/1/2026. PDF
- Priority Health. MyPriority Plans Pharmacy Drug Prior Authorization Criteria, August 2026, Last revised August 01, 2026. PDF
- Priority Health. Employer Group Traditional Plans Pharmacy Drug Prior Authorization Criteria, August 2026, Last revised August 01, 2026. PDF
- Priority Health. Employer Group and MyPriority Plans Medical Drug Prior Authorization Criteria, August 2026, Last revised August 01, 2026. PDF
- Priority Health. Summary of Formulary Changes for Commercial Group and Individual Members, effective January 1, 2027. PDF
- Priority Health. Pharmacy Prior Authorization Form, Commercial (Traditional) and Commercial (Individual/Optimized), last reviewed 01/2026. PDF
- State of Michigan, Department of Insurance and Financial Services. Order, File No. 233961-001 (Priority Health), March 24, 2025. PDF
- State of Michigan, Department of Insurance and Financial Services. Appealing a Decision Made by Your Health Insurer. michigan.gov
- U.S. Food and Drug Administration. XYOSTED (testosterone enanthate) injection prescribing information, revised July 2025, section 2.1. accessdata.fda.gov
- U.S. Food and Drug Administration. FDA issues class-wide labeling changes for testosterone products, February 28, 2025. fda.gov
- Male Excel. Pricing page, pricing FAQ, and general FAQ, checked November 11, 2026. Male Excel · Direct sources: pricing and pricing FAQ · general FAQ
- Hone Health help center. Hone Health Membership Overview (updated September 29, 2026), Hone Health Service Availability by State (2026) (updated September 4, 2026), Do You Accept Insurance?, and Can I use my own pharmacy? (updated September 4, 2026). Hone · Direct sources: membership overview · state availability · insurance · own-pharmacy policy
Related reading
- TRT providers that take insurance
- Testosterone prior authorization: denials and appeals
- Do you need two low testosterone tests for TRT?
- Testosterone injections vs gel
- TRT without needles
- Testosterone cypionate cost
- Testosterone gel cost
- Kyzatrex cost
- Does Blue Cross Blue Shield cover TRT?
- Does Medicare cover TRT?
- Does Medicaid cover TRT?
- Male Excel cost
- Hone TRT cost
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