HRT by state, and where the law actually changes something

HB 5295, 103rd General Assembly (Public Act 103-0703)

Group and individual accident and health policies and managed care plans must cover medically necessary hormonal and non-hormonal therapy for menopausal symptoms, across every FDA-approved route of administration including oral, transdermal, topical and vaginal rings. A second Illinois law signed in June 2026, HB 5492, adds a six-month dispensing requirement for hormone therapy from 2028.

Applies to: Plans amended, delivered, issued or renewed on or after January 1, 2026

[Reported]The legislature's own site refused every connection we attempted, so this rests on legislative reporting rather than the bill text. McDermott Law analysis of the Illinois HRT coverage law

HB 392, 2024 Regular Session

Medicaid and state-regulated commercial plans must cover treatment for menopause and perimenopause. The clause that matters most in practice is the second one: plans may not require prior authorization, step therapy or a fail-first trial before approving hormone replacement therapy. Louisiana is the only state we found that removes the prior-authorization hurdle outright.

Applies to: Enacted in the 2024 Regular Session

[Verified August 15, 2026] We reached the primary source. Louisiana Legislature, HB 392 bill information

A5278, the New Jersey Menopause Coverage Act

Carriers must cover medically necessary treatment for a diagnosis of perimenopause or menopause. The named categories go wider than drugs: hormonal and non-hormonal therapy, pelvic floor physical therapy, bone health care, preventive care and patient education.

Applies to: Signed January 2026

[Reported]The legislature's own site refused every connection we attempted, so this rests on legislative reporting rather than the bill text. Ms. Magazine, state menopause legislation roundup, January 2026

HB 3064, 2025 Regular Session

State-regulated individual, family and group plans must cover treatment for perimenopause, menopause and postmenopause, and so must the plans run by the Oregon Educators Benefit Board and the Public Employees' Benefit Board. Hormone therapy, antidepressants and osteoporosis prevention are named specifically.

Applies to: Plans issued, renewed or extended on or after January 1, 2026

[Reported]The legislature's own site refused every connection we attempted, so this rests on legislative reporting rather than the bill text. Ms. Magazine, state menopause legislation roundup, January 2026

HB 1971, 2025

State-regulated plans must reimburse a twelve-month supply of hormone therapy dispensed at one time, where the medication stores safely at room temperature and the patient and the prescriber agree a full year is appropriate. Read the limit carefully: this is a dispensing rule, so it does not oblige a plan to start covering menopause treatment it was already excluding.

Applies to: Plans issued or renewed on or after January 1, 2026

[Verified August 15, 2026] We reached the primary source. Washington State Legislature, HB 1971 bill summary

State Medicaid coverage of menopause hormone therapy, state by state

We could not establish this for the 50 states individually. Two things are true and both matter: estradiol is an inexpensive generic that sits outside the optional drug-exclusion categories most state programs use, so coverage is broadly available and this was never the live state-by-state fight that GLP-1 coverage became, and separately no provider on our roster accepts Medicaid at all. Louisiana is the one state where we found Medicaid named directly in a menopause statute.

State Medicaid prior-authorization criteria for testosterone

Not established per state. Testosterone is a controlled substance and state programs commonly gate it behind documented hypogonadism, but we did not source the criteria for 51 jurisdictions and will not summarise what we did not read.

Whether each state requires an in-person visit before telehealth care begins

Not established per state. The general position is that most states let a clinician establish care over synchronous video, and a handful attach conditions. Alabama, for one, requires an in-person visit or a referral once telehealth passes four encounters in twelve months for the same unresolved condition. We are not publishing a 51-row table on this until we have read each statute, because a wrong yes or no here would send someone to the wrong provider.

Which roster providers are licensed in each individual state

This does not exist in structured form anywhere, including at the providers themselves. Most publish a count where a list would be useful, and where a platform sells more than hormone care its advertised state count usually belongs to another product line rather than to the hormone one. What we can show is exactly that, and we do, below.

Population aged 45 to 64 per state

Dropped. The Census Bureau API now requires a key we do not hold, and we were not going to approximate a number we could not pull.