Let’s take a look at how someone with health insurance would go about getting a prescription for finasteride and minoxidil for male pattern hair loss, using a traditional brick-and-mortar physician’s office.
For context, this would be the health insurance coverage for a typical 40-year-old man using a high deductible health insurance plan. The monthly premium is $296. Note that the deductible is $8,300 for the year.
Before hitting this deductible, insurance will cover 0% of doctors visits or specialists visits. Also, note that there is no coverage for medication costs until the deductible is met.
Traditional Process
- If you don’t already have a primary care doctor, log on to your health insurance portal to look and see which doctor is covered and in-network in your plan. (5 minutes)
- Contact each doctor’s office to see if they are taking new patients. (15 minutes)
- Make an appointment with the doctor’s office. If you’re lucky, maybe they’ll have an opening available in the next 1-2 weeks. Not uncommon for new patients to have a 3-6 week wait for the first available appointment.
- On the day of your appointment, go to the doctor’s office. Spend 15-25 minutes getting there, hopefully not longer than that, whether you walk, bike, train, or drive. Pay for any parking charges possibly. (15-25 minutes, 30 to 50 minutes round trip)
- Check in at the front desk. Fill out and sign consent forms (10 minutes)
- Wait in the waiting room (5-30 minutes)
- Get your name called by the nurse where they take you to get vital signs, brief intake questions in the exam room, then wait for the doctor to see you (10 minutes)
- Doctor enters the room, asks medical questions, looks at your head / hair, comes up with a diagnosis and treatment plan (15 minutes).
- If you’re unlucky the doctor you’re seeing isn’t comfortable diagnosing or treating hair conditions and will have you see a dermatologist or hair specialist instead and create a referral for you. You leave the visit with no prescription
- You have to contact your insurance to see if the dermatologist is in your network, then go back to step 2 or 3 but for the dermatologist. You are still stuck paying for this office visit for the referral. ($150-$300 out of pocket)
- Prescription for finasteride and minoxidil are sent to your pharmacy. The medications are separate and you’ll need to pay for both medicines separately.
- Go to pharmacy and wait in line to get the medicine (10 minutes)
- Since you haven’t met your deductible yet, your insurance is going to charge you the full retail price of $40 for finasteride (3-month supply) and $42 for minoxidil (3-month supply)
- You log on to GoodRx or Cost Plus pharmacy to see if you can pay out of pocket for a cheaper price and try to get pricing info for these two medicines. (15 minutes)
- The Cost Plus pricing is much better, so you ask the pharmacy to cancel this prescription. You contact your doctor’s office to request they send the prescription to Cost Plus pharmacy instead (15 minutes)
- OR you use the GoodRx coupon for a discounted price off retail and just fill it there at your regular pharmacy
- OR your pharmacy says they’ll cover the cost of finasteride first but won't cover minoxidil. You'll need to try finasteride first for 6 months, then if it's not helpful, have your doctor resubmit a prescription and fill out some prior authorization forms before minoxidil will be covered. (Wait another 6 months, plus a week give or take for insurance to review the prior authorization process)
- Depending on your doctor’s preferences, they may want to see you back in 6 months for a follow-up visit ($150-$300) or they may be comfortable doing a year-long prescription before they see you again to renew your prescriptions ($150-$300 each year just in doctor’s office visits). If you’re lucky, they may just refill your finasteride and minoxidil prescriptions once a year at your physical / preventative visit (which is usually covered by your insurance and no out of pocket costs).
Running totals for brick-and-mortar doctor with insurance:
- Cost: $150-$350 each office visit. Depending on your doctor, they’ll want to see you at least once every year. If you’re unlucky and your primary doctor wants you to see a specialist, tack on another $150-$300.
- Medications:
- Cheapest - $17 total for a 3-month supply of both finasteride and minoxidil if you use Cost Plus pharmacy, plus shipping
- Average cost at your local pharmacy using GoodRx - $40 total for a 3-month supply of both finasteride and minoxidil
- Time and energy: 170 minutes
$8-$22 on average for monthly; retail $25-141
$19-$60 for 3-month supply; retail $25-$350
The following screenshots are from the Cost Plus pharmacy website
GoodRx coupons for minoxidil
$10-19 for minoxidil 2.5mg monthly - retail price $15-26
$16-26 for 3-month supply - retail price $25-42
Cost Plus pharmacy pricing for minoxidil:
Hims Process
- Go to the Hims website, click on hair loss treatments
- Answer the questions about your hair loss (15 minutes)
- Submit your information and wait for the doctor to review your info and message you if they have any questions. You’re free to carry on with the rest of your day as you don’t actually sit there and wait for the doctor to review.
- Submit 2 photos of your head / hair if the doctor asks you for them (5 minutes)
- Wait the 5-7 business days to have the personalized combo finasteride and minoxidil tablets sent directly to your house
Running totals for Hims:
- Costs: $175 for a 5-month supply ($35/month)
- Time and energy: 20-25 minutes
Summary:
You can possibly get the finasteride and minoxidil for a cheaper price using your insurance, but at the cost of a significantly higher upfront time and energy consumption. The medication cost savings will also be offset by any doctor’s office visits you have to pay ($150-$300). If you are a high medical services user, and meet your deductible, you can then probably get the treatments and office visits fully covered. Most people don’t meet their deductible at all for the year, or if they do, it’s not until late in the year and you’re left trying to sneak in doctor’s appointments before the New Year.