Does Insurance Cover Finasteride? Medicare, Hair Loss and BPH
Insurance rarely covers finasteride for hair loss: Medicare Part D excludes hair growth drugs by law. What is covered, and the cash price that often beats a copay.
By Julian Caraulani · Last updated
Cost
The same drug can be covered when it is prescribed for an enlarged prostate. Below: why hair loss is excluded, the one Medicare exception, how private plans differ, why the prescribed use decides coverage, and what you pay without insurance.
Coverage at a glance
| Route | Finasteride for hair loss | Finasteride for an enlarged prostate (BPH) | Source |
|---|---|---|---|
| Medicare Part D, standard coverage | Excluded by law | Can be covered as a Part D drug | CMS Part D manual, chapter 6 |
| Medicare Part D, enhanced plans | Possible as a "supplemental drug" | Can be covered | CMS manual, section 20.3 |
| Medicaid | States may exclude it | Depends on the state | 42 U.S.C. 1396r-8 |
| Employer and marketplace plans | Set by each plan's formulary | Set by each plan's formulary | Your plan's drug list |
| Online hair loss programs | Cash only | Not sold for BPH | Each program's own page |
Why hair loss is excluded
The rule starts in the Medicaid drug law. It lets states exclude certain drug uses, including "Agents when used for cosmetic purposes or hair growth." (42 U.S.C. 1396r-8(d)(2), via Cornell LII) Medicare Part D adopted that list. The CMS benefit manual says: "Part D does not cover drugs or classes of drugs, or their medical uses, which are excluded from coverage or otherwise restricted under section 1927(d)(2) of the Act." (CMS Part D manual, chapter 6)
Note the words "or their medical uses". The exclusion follows what the drug is prescribed for, not the molecule. That is why the same finasteride can be excluded for hair loss and covered for the prostate.
- FDA-approved and compounded
- No FDA warning letter found
- No state list published
The Medicare exception: enhanced plans
A Part D plan that offers enhanced alternative coverage may add excluded drugs back as an extra benefit. CMS says a sponsor "may only include coverage of drugs that would meet the definition of a Part D drug but for the application of section 20.1" (the excluded categories) "as a supplemental benefit under enhanced alternative coverage" (CMS Part D manual, section 20.3). Whether a plan does this for hair growth drugs shows only in its formulary, so check it before you assume either way.
Hair loss vs prostate: one molecule, two labels
There are two FDA-approved oral finasteride products. The FDA lists them: "Proscar was approved on June 19, 1992" and "Propecia was approved on December 19, 1997" (FDA alert on compounded topical finasteride).
- Propecia and its generics are for hair. The label says it "is indicated for the treatment of male pattern hair loss (androgenetic alopecia) in MEN ONLY" (DailyMed: Propecia label). This is the use insurers treat as cosmetic.
- Proscar and its generics are a higher-strength tablet "indicated for the treatment of symptomatic benign prostatic hyperplasia (BPH) in men with an enlarged prostate" (DailyMed: Proscar label). Prescribed for that, it is a medical use and can be covered.
Coverage follows the diagnosis your prescriber records. A prescription written for hair loss is billed as hair loss. We do not advise using the prostate strength for hair; the strength and use are for your prescriber to decide.
Private insurance: check the formulary
Employer and marketplace plans set their own drug lists, and a plan can treat hair loss as cosmetic even when it covers the same drug for the prostate. The only reliable answer is your plan's formulary or a call to the pharmacy benefit manager. Ask two questions: is generic finasteride covered for hair loss, and does it need prior authorization?
Even when a plan covers it, a copay can cost more than the cash price of the generic. Compare both before you fill.
What you pay without insurance
None of the online hair loss programs we track bill insurance. The visit is included in the monthly price at most of them:
- Cheapest online plan: Keeps, $14 a month (Finasteride 1 mg, billed every 3, 6 or 12 months).
- Our top-scored program: Ro, finasteride from $16 a month on a 12-month plan.
- Your own prescription at a cash pharmacy: Cost Plus Drugs lists finasteride at about $0.19 a tablet ($5.83 for 30) before shipping.
Every plan, with its billing terms, is in our finasteride cost guide and on the finasteride price page. For an HSA or FSA, two programs that sell hair loss treatment say they accept the cards: PeterMD and Rugiet. Your plan administrator decides what counts as eligible.
Questions
FAQ
Does insurance cover finasteride?
Rarely for hair loss. Medicare Part D excludes drugs used for cosmetic purposes or hair growth, Medicaid lets states do the same, and private plans set their own formularies. Finasteride prescribed for an enlarged prostate (the Proscar indication) is a medical use and can be covered. The online hair loss programs we track are all cash only.
Why is finasteride not covered by insurance for hair loss?
Federal drug law lists "agents when used for cosmetic purposes or hair growth" among the uses a program may exclude, and Medicare Part D excludes them outright. Private plans often follow the same logic and treat hair loss as cosmetic. The exclusion attaches to the use, not the drug, which is why prostate prescriptions are treated differently.
Is finasteride covered by Medicare?
Not for hair loss under standard Part D coverage, because CMS excludes agents used for hair growth. An enhanced Part D plan may add it back as a supplemental drug, so check your plan's formulary. Finasteride prescribed for benign prostatic hyperplasia can be covered as a regular Part D drug.
What does finasteride cost with insurance?
That depends on your plan's tier and copay, if it covers hair loss at all. Generic finasteride is cheap enough that the cash price often beats a copay: about $0.19 a tablet at Cost Plus Drugs with your own prescription, or from $14 a month at an online program with the visit included.
Can I use an HSA or FSA for finasteride?
Some programs accept the cards: PeterMD and Rugiet say so on their own pages. Whether finasteride for hair loss is an eligible expense is decided by your plan administrator under IRS rules, so ask before you pay. Card acceptance at checkout does not by itself make an expense eligible.
Is topical finasteride covered by insurance?
Almost never. Topical finasteride is compounded, and the FDA says there is no FDA-approved topical formulation, so it has no approved indication for a plan to cover. Programs sell it for cash, and at every program that sells both it costs more than the oral tablet. Our [hair loss price page](/cost/hair-loss) labels each one. The cheapest way to pay for finasteride is on our [finasteride price page](/cost/finasteride-price); the full ranking is on [Best men's health programs](/best).