Last checked November 2026 against 24 sources · Editorial policy
Alloy review: menopause HRT prices without insurance
Alloy is a cash-pay online menopause service in all 50 states and D.C. You pay a $49 one-time consult fee, a doctor reviews your intake within 12 hours, and medicines ship to you: estradiol pills from $39.99 a month, gel or spray $69.99, patches $100 and progesterone from $23. Its HRT is FDA-approved. Alloy doesn't take insurance; on Trustpilot it scores 4.3 from 4,146 reviews.
Alloy charges a $49 one-time consult fee, then from $39.99 a month for estradiol. Full price list, what is compounded, insurance, Trustpilot score and who it suits.
Alloy menopause: expectation vs reality
What people often expect
“Alloy's $49 fee is the whole cost of menopause treatment”
What the evidence shows
The $49 is a one-time consult fee that includes unlimited messaging with your doctor. Every medicine is billed on top at Alloy's cash price: the estradiol patch, for example, is $100 a month, shipped and billed every 3 months. Alloy doesn't bill insurance, though you can submit itemized receipts to a PPO plan, HSA or FSA, and medicines can't be returned.
Alloy review: prices, what it prescribes and insurance
Alloy menopause prices
Alloy lists the estradiol pill from $39.99 a month, Evamist spray and estradiol gel at $69.99, the estradiol patch at $100 and progesterone from $23. A low-dose birth control pill for perimenopause is $39.99, paroxetine for hot flashes $34.99, and estradiol vaginal cream $119.97 for a 3-month tube. For comparison, 30 generic estradiol 1 mg tablets cost $6.76 at one low-cost online pharmacy with a prescription.
Learn more →Alloy and insurance
Alloy doesn't accept insurance and says its prices are generally comparable to co-pays. HSA and FSA cards should work, and many women get Alloy prescriptions reimbursed by their PPO insurer, FSA or HSA by submitting the itemized receipt. Medicare and Medicaid can't be billed. If your plan covers generic estradiol at a low copay, a prescription from your own doctor or an in-network service will usually cost less.
Learn more →What Alloy prescribes: FDA-approved HRT
Alloy's hormone therapy list is FDA-approved: estradiol pill, Evamist spray, estradiol gel, estradiol patch, progesterone and estradiol vaginal cream, plus a low-dose birth control pill for women still having periods. Its doctors are board-certified, trained in perimenopause and menopause, and follow The Menopause Society and ACOG protocols. Alloy doesn't list testosterone, hormone pellets or Veozah; its non-hormonal hot flash option is paroxetine.
Learn more →Alloy's GLP-1 program and compounded semaglutide
Alloy Weight Care costs $99 a month for the program plus medicine: compounded semaglutide from $70 a month, or FDA-approved GLP-1s from $149 a month, with Zepbound from $299. Compounded versions aren't FDA-approved or reviewed for safety, effectiveness or quality, and Alloy doesn't offer them in Alabama, Arkansas, California, Nevada, Louisiana, Mississippi or D.C. The FDA says compounded drugs should only be used when an approved drug can't meet your needs.
Learn more →Alloy's estriol skincare and sexual health products
Much of Alloy's range is beyond HRT. Its M4 face cream with estriol is $150 for 3 months, an eye cream $90 and a body treatment $195; O-mazing, a custom-blended prescription arousal cream, is $89.97 for 3 months. These are optional add-ons. Estrogen applied to the face isn't a treatment for hot flashes, night sweats or bone loss, which need systemic HRT.
Learn more →Alloy reviews on Trustpilot
As of November 1, 2026, Alloy Health scored 4.3 on Trustpilot from 4,146 reviews. Trustpilot shows that Alloy invites its customers to review, positive or negative, and replied to 100% of negative reviews. Trustpilot's own AI summary says reviewers often praise the products and easy online access, including the skincare. Trustpilot doesn't fact-check reviews.
Is Alloy worth it?
Alloy is the simplest cash route to FDA-approved HRT in any state: one $49 fee, a doctor within 12 hours and clear monthly prices. It's good value for the estradiol pill at $39.99, less so for the patch at $100, which generic patches with insurance usually beat. If you have in-network PPO insurance, Midi or your own doctor is usually cheaper; if you want Veozah, Evernow lists it.
Learn more →Alloy by the numbers
$49
$39.99
$100
4.3
Prices were checked on Alloy's website on November 1, 2026; the patch price is unchanged from September 2026.
Alloy vs other online menopause clinics
Midi Health
Learn more →Good for
In-network with most PPO plans, so visits often cost a copay and generic HRT can go through insurance.Watch
Self-pay first visit $250; no Medicare or Medicaid.Evernow
Learn more →Good for
Insurance for video visits with four national insurers; lists Veozah and paroxetine.Watch
Membership $35 to $49 a month isn't covered by insurance.Winona
Learn more →Good for
No consult fee and free unlimited follow-ups; progesterone capsules from $39 a month.Watch
Patch $149 a month; compounded creams; not in every state; HRT only at ages 35 to 59.Your own doctor
Learn more →Good for
Usually covered by insurance, including Medicare, and can send generic prescriptions to a low-cost pharmacy.Watch
Some doctors have limited menopause training.
Before you order from Alloy
- Compare Alloy's monthly price with your insurance copay for the same generic before you order.
- If you have a uterus, make sure progesterone is in your plan along with estradiol.
- Keep itemized receipts to claim from a PPO plan, HSA or FSA.
- Patches ship and bill every 3 months, so the first charge covers 3 months.
- Treat skincare and GLP-1 add-ons as separate decisions from HRT; compounded GLP-1s aren't FDA-approved.
When Alloy isn't the right route
Urgent: Any bleeding after menopause
See a doctor in person. It needs an exam and usually an ultrasound.
More →A history of breast cancer, blood clots, stroke or liver disease
See a menopause specialist who can review your records before any HRT decision.
More →Menopause symptoms before 45
See a doctor. Early menopause needs diagnosis and may need blood tests.
More →Urgent: Leg pain or swelling, or chest pain with breathlessness, on HRT
Leg symptoms: call a doctor now. Chest pain or breathlessness: call 911.
Alloy menopause reviews: questions women ask
Is Alloy legit?
Yes. Alloy is a US telehealth service whose board-certified doctors follow The Menopause Society and ACOG protocols and prescribe FDA-approved HRT in all 50 states and D.C. It scored 4.3 on Trustpilot from 4,146 reviews in November 2026.
How much does Alloy cost?
A $49 one-time consult fee, then the medicine: estradiol pill from $39.99 a month, gel or spray $69.99, patch $100, progesterone from $23 and vaginal cream $119.97 for 3 months. There's no membership for HRT; the GLP-1 program adds $99 a month.
Related →Does Alloy take insurance?
No. Alloy doesn't bill insurance, including for its GLP-1 program. HSA and FSA cards should work, and many women claim Alloy prescriptions back from a PPO plan, FSA or HSA with the itemized receipt.
Does Alloy prescribe testosterone or Veozah?
Neither is on Alloy's product list. For hot flashes without hormones, Alloy offers paroxetine at $34.99 a month. Evernow lists Veozah. Testosterone is supported by evidence only for diagnosed low sexual desire after menopause.
Related →Is Alloy's HRT bioidentical?
Yes. Alloy's estradiol pill and patch are FDA-approved, bioidentical and plant-based, and its gel and spray are FDA-approved estradiol too. Bioidentical doesn't require compounding: FDA-approved estradiol and progesterone have the same structure as your own hormones.
Related →How fast does Alloy work?
Alloy says a menopause-trained doctor reviews your intake and gives you a plan in less than 12 hours, with unlimited messaging included in the $49 fee. Medicines are then shipped to your door; patches ship and bill every 3 months.
Related →Alloy vs Midi: which is better?
Alloy is better if you pay cash: one $49 fee instead of Midi's $250 first visit. Midi is better if it's in-network with your PPO plan, since visits then cost a copay and generic HRT can go through insurance. Neither bills Medicare.
Related →Sources
- Alloy. Menopause solutions and prices. Accessed November 1, 2026.
- Alloy. Estradiol patch (price, consult fee, timing). Accessed November 1, 2026.
- Alloy. FAQ: insurance, availability, doctors. Accessed November 1, 2026.
- Trustpilot. Alloy Health reviews (myalloy.com): TrustScore and review count. Accessed November 1, 2026.
- Mark Cuban Cost Plus Drug Company. Hormone therapy medication prices (checked September 2026).
- Midi Health. Pricing & insurance (visit prices, insurance, Medicare and Medicaid, FAQ). Accessed November 1, 2026.
- Alloy. Compounded semaglutide and Alloy Weight Care. Accessed November 1, 2026.
- FDA. FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss.
- Evernow. Non-hormonal menopause treatment. Accessed November 1, 2026.
- NHS. Postmenopausal bleeding.
- American College of Obstetricians and Gynecologists. Committee Opinion No. 734: The role of transvaginal ultrasonography in evaluating the endometrium of women with postmenopausal bleeding. Obstet Gynecol. 2018;131(5):e124-e129.
- NHS. About hormone replacement therapy (HRT).
- NICE. Menopause: identification and management (NG23). Updated 2024.
- NHS. Oestrogen tablets, patches, gel and spray: side effects.
- National 911 Program. 911.gov.
- Midi Health. Insurance-covered hormone replacement therapy. Accessed November 1, 2026.
- Evernow. FAQ: membership prices, insurance, states, medications. Accessed November 1, 2026.
- Winona. Home page: online HRT for perimenopause and menopause, FAQ. Accessed November 1, 2026.
- Winona. All products and prices. Accessed November 1, 2026.
- Winona. Frequently asked questions: states, treatments, compounding, insurance, billing and refunds. Accessed November 1, 2026.
- The Menopause Society. How to find a certified menopause practitioner.
- NHS. Types of hormone replacement therapy (HRT).
- Davis SR, Baber R, Panay N, et al. Global Consensus Position Statement on the Use of Testosterone Therapy for Women. J Clin Endocrinol Metab. 2019;104(10):4660-4666.
- US Food and Drug Administration. NASEM study on the clinical utility of treating patients with compounded "bioidentical" hormone therapy.
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