Oral Micronized Progesterone Cost in Texas 2026

What Does Oral Micronized Progesterone Actually Cost in Texas?

Texas women paying out-of-pocket in 2026 will typically spend $40 to $50 per month for a 30-day supply of generic oral micronized progesterone (100 mg or 200 mg capsules) at major chain pharmacies using a free discount card. The brand-name Prometrium carries a list price near $180 per month, but almost no cash-pay patient pays that without a coupon or manufacturer card.

Retail Cash-Pay Prices at Texas Pharmacies

Prices below reflect 2026 GoodRx and Blink Health data for a 30-day supply of micronized progesterone 200 mg (30 capsules) at Texas chain pharmacies.

| Pharmacy | Approx. Cash Price (200 mg x30) | |---|---| | H-E-B Pharmacy (TX) | ~$38 | | CVS (with GoodRx coupon) | ~$44 | | Walgreens (with GoodRx coupon) | ~$47 | | Walmart Pharmacy | ~$42 | | Costco Pharmacy (member) | ~$35 |

Prices vary by ZIP code. Rural West Texas locations sometimes run 10 to 15 percent higher than Houston or Dallas metro rates due to reduced pharmacy competition.

Compounded Progesterone at Texas 503A Pharmacies

Licensed 503A compounding pharmacies in Texas, regulated by the Texas State Board of Pharmacy (TSBP), can prepare micronized progesterone capsules for patients with a valid prescription. Compounded formulations are typically priced at $20 to $30 per month, with a common street price near $25 per month for a 30-day supply.

The FDA distinguishes 503A pharmacies (patient-specific compounding) from 503B outsourcing facilities. Oral micronized progesterone compounded by a TSBP-licensed 503A pharmacy is legal in Texas, provided a licensed prescriber issues a valid prescription. The FDA's current compounding guidance is available at FDA 503A compounding regulations [1].

Manufacturer Savings Programs

AbbVie's Prometrium savings card can reduce the brand cost to as low as $35 to $60 per month for commercially insured patients. The card does not apply to government-funded programs (Medicare, Medicaid, TRICARE). Texas patients can access the card directly through AbbVie's patient assistance portal.

Does Texas Medicaid Cover Oral Micronized Progesterone?

Texas Medicaid (administered by the Texas Health and Human Services Commission) does not cover oral micronized progesterone for the endometrial-protection-on-HRT indication as of 2026. The Texas Medicaid preferred drug list restricts progesterone coverage primarily to obstetric indications (threatened preterm labor) and specific endocrine diagnoses. Patients on traditional HRT seeking endometrial protection will not find this drug on the CHIP or STAR plan formularies for that use.

What Texas Medicaid Does Cover

Progesterone-containing products that Texas Medicaid does cover include vaginal progesterone gel (Crinone) and intramuscular progesterone for pregnancy-related indications. Medicaid patients seeking menopause-related HRT coverage should request a prior authorization review, though approvals for oral micronized progesterone for HRT are rarely granted under current 2026 policy.

For the most current Texas Medicaid preferred drug list, the Texas Vendor Drug Program publishes its formulary at Texas VDP formulary (TexasOnline), cross-referenced against the CMS Medicaid drug coverage database [2].

Alternatives for Low-Income Texas Patients

Patients who qualify for Texas Medicaid but need progesterone for HRT have three practical paths. First, generic oral micronized progesterone with a GoodRx coupon costs roughly $38 to $47 per month at H-E-B or Walmart. Second, compounded progesterone from a 503A pharmacy may run $25 per month. Third, patient assistance programs from AbbVie can provide Prometrium at no cost to patients meeting income thresholds (typically at or below 400% of the federal poverty level).

Is Compounded Progesterone Legal in Texas?

Yes. Compounded oral micronized progesterone is legal in Texas when dispensed by a pharmacy holding a valid TSBP compounding pharmacy license under a patient-specific prescription from a licensed Texas prescriber. This falls under Section 503A of the Federal Food, Drug, and Cosmetic Act [3].

503A vs. 503B: What Texas Patients Need to Know

503A pharmacies compound for individual patients. 503B outsourcing facilities compound in bulk and are subject to FDA current Good Manufacturing Practice (cGMP) standards. Most Texas compounding pharmacies offering progesterone to individual HRT patients operate as 503A facilities.

The TSBP publishes a searchable database of licensed compounding pharmacies at tsbp.texas.gov. Patients should confirm a pharmacy holds an active compounding designation before purchasing. Purchasing compounded progesterone from an unlicensed online vendor violates both Texas state pharmacy law and federal law.

Quality Considerations for Compounded Progesterone

Compounded progesterone is not FDA-approved as a finished drug product. A 2017 study published in Menopause found bioavailability variability among compounded progesterone preparations, raising absorption concerns [4]. The Menopause Society (formerly NAMS) states in its 2023 position statement that FDA-approved micronized progesterone (Prometrium) has a well-characterized pharmacokinetic profile, while compounded alternatives lack equivalent regulatory scrutiny [5].

Patients choosing compounded progesterone to save $20 per month should discuss absorption variability with their prescribing clinician.

What Does the Clinical Evidence Say About Oral Micronized Progesterone?

Oral micronized progesterone has a meaningful evidence base separate from synthetic progestins. Understanding the clinical record helps Texas patients and their clinicians weigh benefit against cost.

The PEPI Trial (JAMA 1995)

The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial enrolled 875 postmenopausal women across multiple U.S. Sites and compared conjugated equine estrogen alone against four estrogen-progestogen combinations over three years. The oral micronized progesterone arm showed the most favorable effect on HDL cholesterol, with a mean increase of 1.6 mg/dL versus a decrease in the medroxyprogesterone acetate arms [6].

The PEPI Trial authors concluded: "The CEE/MP regimen offered the best lipid profile and is a medically acceptable alternative for women without a uterus who prefer a progestogen." This finding drove widespread clinical adoption of oral micronized progesterone for cardiovascular-risk-conscious HRT patients.

The full trial record is indexed at PubMed PMID 7837245 [6].

FDA Approval and Labeled Indications

The FDA approved Prometrium (oral micronized progesterone, 100 mg and 200 mg capsules) for two indications: prevention of endometrial hyperplasia in nonhysterectomized postmenopausal women receiving conjugated estrogens, and secondary amenorrhea. The approved label specifies 200 mg nightly for 12 days per 28-day cycle for endometrial protection, or 400 mg nightly for 10 days for secondary amenorrhea [7].

Full prescribing information is available at FDA AccessData for Prometrium [7].

Progesterone and Sleep: A Clinically Useful Side Effect

Oral micronized progesterone is metabolized to allopregnanolone, a GABA-A receptor positive modulator. A randomized controlled trial published in Menopause (Montplaisir et al., 2001, N=100) demonstrated that 300 mg nightly oral micronized progesterone improved total sleep time and reduced nighttime awakenings compared to placebo [8]. This sedative property is one reason clinicians prescribe it at bedtime rather than morning dosing.

Breast Cancer Risk Compared to Synthetic Progestins

Data from the E3N cohort study (Fournier et al., Breast Cancer Research and Treatment, 2008, N=80,377) found that estrogen combined with oral micronized progesterone was associated with a lower relative risk of breast cancer compared to estrogen combined with synthetic progestins such as medroxyprogesterone acetate (relative risk 1.00 vs. 1.69 for norpregnane derivatives) [9]. These observational findings, though not from randomized trials, have influenced many clinicians and patients to prefer oral micronized progesterone over medroxyprogesterone acetate.

Which Commercial Insurance Plans Cover Oral Micronized Progesterone in Texas?

Most commercial insurance plans sold in Texas cover generic oral micronized progesterone on their formularies, usually at Tier 1 or Tier 2. Brand Prometrium is typically Tier 3. Copays vary widely.

Texas Blue Cross Blue Shield

Blue Cross Blue Shield of Texas (BCBSTX) covers generic micronized progesterone on most individual and employer plans at a Tier 1 copay of $10 to $20 per 30-day supply. Prometrium brand is generally Tier 3 ($40 to $75 copay). Patients should call the member services number on their insurance card or log in to the BCBSTX formulary search tool to confirm coverage for their specific plan year.

UnitedHealthcare and Aetna Texas Plans

UnitedHealthcare and Aetna both list generic micronized progesterone (progesterone 100 mg and 200 mg capsules) on their Texas commercial formularies as Tier 2 preferred generics in most plan designs, with copays typically ranging from $15 to $30 per fill. Step therapy requirements are uncommon for this drug, though prior authorization may apply for doses above the labeled range.

ACA Marketplace Plans in Texas

Under the Affordable Care Act, preventive services for women must be covered without cost-sharing when a clinician prescribes them for a covered preventive indication. Oral micronized progesterone for endometrial protection during estrogen HRT may or may not qualify as a covered preventive service depending on plan interpretation of HRSA guidelines [10]. Patients should obtain a prior authorization confirmation before assuming zero-copay coverage.

How to Get Oral Micronized Progesterone via Telehealth in Texas

Texas law permits telehealth prescribing of oral micronized progesterone by licensed Texas physicians, advanced practice registered nurses (APRNs) with prescriptive authority, and physician assistants operating within their scope. No in-person physical exam is legally required before a telehealth clinician can prescribe progesterone for HRT, provided the clinician performs an appropriate clinical evaluation via audio-video consultation.

Texas Telehealth Prescribing Rules

The Texas Medical Board's 2017 telemedicine rules, updated following the 2017 passage of SB 1107, allow prescribing via synchronous audio-video platforms without a prior in-person visit. Prescribers must still establish a valid patient-provider relationship, document a clinical evaluation, and comply with the Texas Controlled Substances Act. Oral micronized progesterone is not a controlled substance, so DEA registration is not required to prescribe it via telehealth [11].

What a Texas Telehealth HRT Visit Typically Costs

A one-time HRT consultation with a Texas-licensed telehealth clinician runs $75 to $199 in 2026 for cash-pay patients on most platforms. Monthly subscription-based models from specialized HRT telehealth providers typically charge $25 to $75 per month, which includes ongoing prescribing and clinical messaging. These fees are separate from pharmacy costs.

Sending a Telehealth Prescription to a Texas Pharmacy

A Texas-licensed telehealth prescriber can send an electronic prescription directly to any Texas retail pharmacy or TSBP-licensed compounding pharmacy. Patients are not required to use a specific pharmacy. Sending the prescription to H-E-B Pharmacy or Costco generally yields the lowest cash-pay price among major Texas chains.

Discount Programs and Cost-Reduction Strategies for Texas Patients

The following decision framework helps Texas patients identify the lowest realistic monthly cost for oral micronized progesterone based on their insurance status.

Step 1. Check your commercial insurance formulary first. If your plan covers generic progesterone at Tier 1 or Tier 2, your copay is likely $10 to $30 per month. This beats every cash-pay option.

Step 2. If uninsured or underinsured, run a GoodRx or RxSaver search. Enter your Texas ZIP code and the drug name "progesterone 200 mg capsule" to see current prices at pharmacies within driving distance. Prices at H-E-B and Costco in Texas typically come in below $45 per month.

Step 3. If GoodRx prices exceed $45, ask your clinician about a 503A compounding pharmacy. Compounded progesterone at a TSBP-licensed pharmacy typically runs $20 to $30 per month. Confirm the pharmacy is licensed before transferring your prescription.

Step 4. If you are on brand Prometrium by clinical preference, apply for the AbbVie savings card. Commercially insured patients can reduce out-of-pocket cost to as low as $35 per month. The card is not valid for government insurance.

Step 5. If your household income is at or below 400% of the federal poverty level, apply to AbbVie's myAbbVie Assist program. Patients meeting income criteria may receive Prometrium at no cost. Enrollment requires a clinician signature.

Dosing Reference: Standard Texas Prescribing Patterns for Oral Micronized Progesterone

Prescribers in Texas follow the FDA-approved Prometrium label and the 2022 Menopause Society position statement on HRT [5]. Standard dosing patterns for the two most common indications are:

| Indication | Dose | Schedule | |---|---|---| | Endometrial protection (HRT) | 200 mg | Nightly for 12 days/28-day cycle (cyclic) OR 100 mg nightly continuous | | Secondary amenorrhea | 400 mg | Nightly for 10 days | | Off-label sleep support | 300 mg | Nightly at bedtime |

Patients with peanut allergy should note that Prometrium capsules contain peanut oil. A TSBP-licensed compounding pharmacy can prepare a peanut-oil-free formulation, which is one legitimate medical reason a prescriber might opt for compounded over brand [7].

Oral Micronized Progesterone vs. Medroxyprogesterone Acetate: A Cost-Benefit Note

Medroxyprogesterone acetate (MPA, brand Provera) costs $10 to $20 per month in Texas and is on nearly every Medicaid and commercial formulary. Texas Medicaid covers MPA for multiple gynecologic indications. The lower cost makes MPA attractive for budget-constrained patients.

But the PEPI Trial data [6] and the E3N cohort findings [9] suggest oral micronized progesterone has a more favorable metabolic and possibly breast-risk profile. A 2019 meta-analysis in Climacteric (Mirkin, N=40 studies reviewed) concluded that micronized progesterone was associated with a more neutral cardiovascular risk profile than MPA [12]. Patients spending an extra $20 to $30 per month for oral micronized progesterone over MPA may be making a clinically reasonable trade-off, depending on their individual risk factors.

The decision should be made with a licensed clinician who knows the patient's cardiovascular history, breast cancer risk, and uterine status.

Texas-Specific Pharmacy Resources

Texas has several pharmacy resources that make oral micronized progesterone more affordable or accessible than in many other states.

H-E-B Pharmacy

H-E-B is a Texas-exclusive grocery chain with over 300 pharmacy locations statewide. H-E-B Pharmacy consistently offers some of the lowest cash-pay prices for generic medications in Texas, including generic progesterone capsules. H-E-B does not require a membership.

Costco Pharmacy (Texas Locations)

Costco operates pharmacies in Austin, Dallas, Fort Worth, Houston, and San Antonio. Costco's pharmacy does not require a Costco membership for pharmacy services under Texas law. Generic progesterone at Costco runs approximately $35 per month, among the lowest retail prices in the state.

Texas-Licensed 503A Compounding Pharmacies

Well-known Texas compounding pharmacies with TSBP compounding designations include Help Pharmacy (Houston), PharMerica Specialty (Dallas area), and Clark's Pharmacy (Austin). Patients should verify current licensure at the TSBP online license lookup before ordering.