Last checked September 2026 against 16 sources · Editorial policy
Online HRT providers compared
Online HRT means getting menopause care and prescriptions through a telehealth service instead of an in-person visit. Some services bill insurance: Midi is in-network with most major plans, and Evernow covers video visits with several national insurers. Others are cash-pay: Alloy charges a $49 one-time consult fee, with an estradiol pill from $39.99 a month. Check whether you'll get FDA-approved or compounded hormones.
Telehealth menopause clinics compared by price, insurance, prescriptions offered and wait times. What to check before you book.
Online HRT: expectation vs reality
What people often expect
“Online HRT clinics are all the same, and they're always cheaper than a regular doctor”
What the evidence shows
They differ a lot in insurance, price and what they prescribe. Midi and Evernow bill insurance for visits; Alloy and Winona don't. Monthly prices for the same estradiol patch ranged from $100 at Alloy to $149 at Winona in September 2026, while a generic weekly patch carton cost $36.05 at a low-cost online pharmacy with a prescription. Winona's creams are compounded and not FDA-approved.
How online HRT works
How online HRT works
You fill in a health questionnaire, then either have a video visit or a clinician reviews your answers and messages you. If HRT is appropriate, the prescription goes to your local pharmacy or the service ships it to you. Alloy says a doctor connects within 12 hours; Midi's first visit is 30 minutes and follow-ups 15. You usually don't need blood tests if you're over 45 with typical symptoms.
Learn more →Online HRT with insurance
Midi is in-network with most major insurance plans, including most PPOs, but Medicare is out of network and it doesn't accept Medicaid. Evernow covers video visits with UnitedHealthcare, Aetna, Anthem and Blue Cross Blue Shield, but not Medicare or Medicaid, and it can send prescriptions to your own pharmacy so insurance covers the medicine. Deductibles and copays still apply.
Learn more →Cash-pay online HRT
Alloy and Winona don't take insurance, though HSA and FSA cards can usually be used. Alloy charges a one-time $49 consult fee, then about $39.99 a month for estradiol pills, $100 a month for patches and $39.99 a month for vaginal cream. Winona lists estrogen patches at $149 a month, estrogen tablets at $54 and progesterone capsules at $39 a month.
FDA-approved vs compounded hormones online
Ask what you'll be prescribed. Alloy lists FDA-approved estradiol pills, patches, gel and vaginal cream. Winona's tablets, capsules and patches are FDA-approved, but its estrogen and progesterone body creams are made in its own compounding pharmacies and aren't FDA-approved. The National Academies found no rigorous evidence of safety or effectiveness for compounded hormones.
Learn more →Online HRT vs your own doctor
Your own doctor or gynecologist can prescribe the same FDA-approved HRT, usually covered by insurance, and generic prescriptions can be cheap: 30 estradiol 1 mg tablets cost $6.76 and 30 progesterone 100 mg capsules $9.45 at one low-cost online pharmacy. Telehealth menopause services add convenience and clinicians focused on menopause, which helps if your doctor isn't comfortable prescribing HRT.
Learn more →Is online HRT safe and legitimate?
Reputable services use licensed clinicians who follow the same guidelines as in-person care: Alloy, for example, says its doctors are board-certified and follow The Menopause Society and ACOG protocols. The main safety steps are the same anywhere: a full medical history, blood pressure, a progestogen if you have a uterus, and a review after 3 months.
What to prepare before an online HRT visit
Note your symptoms, when they started and how they affect sleep, work and mood; your period pattern; any medicines and supplements; your blood pressure if you can check it; and your personal and family history of breast cancer, clots, stroke and liver disease. The NHS suggests asking how HRT will help, the benefits and risks, alternatives, and how long you'll take it.
Learn more →Who should see a doctor in person
Online care is less suitable if you've had breast, ovarian or uterine cancer, a blood clot, a stroke or liver disease, or have unexplained bleeding: these need a careful individual assessment and sometimes tests or an exam. Bleeding after menopause needs an in-person evaluation, usually with an ultrasound. A menopause specialist can manage complex cases, in person or by telehealth.
Learn more →Online HRT prices by the numbers
$250 / $150
$49
$35/month
$6.76
Prices were checked on each company's website in September 2026 and change often. Insurance coverage depends on your specific plan.
Online HRT providers compared
Midi Health
Good for
In-network with most major insurance plans and most PPOs; available in all 50 states; no referral needed. Self-pay first visit $250, returning visit $150.Watch
Medicare out of network and no Medicaid. Also sells supplements and its own face cream, which aren't needed for HRT.Evernow
Good for
Insurance for video visits with UnitedHealthcare, Aetna, Anthem and Blue Cross Blue Shield; can send prescriptions to your pharmacy. Membership from $35 a month; self-pay visit $150.Watch
No Medicare or Medicaid. Membership fees aren't covered by insurance, and some medicines are cash-only through partner pharmacies.Alloy
Good for
Simple cash pricing: $49 one-time consult, estradiol pill from $39.99 a month, FDA-approved options, all 50 states and D.C. Doctors follow Menopause Society and ACOG protocols.Watch
No insurance. Patches at $100 a month cost more than generic patches bought with insurance or at low-cost pharmacies.Winona
Good for
FDA-approved tablets ($54 a month), patches ($149 a month) and progesterone capsules ($39 a month) are available.Watch
No insurance. Its estrogen and progesterone body creams are compounded in its own pharmacies and aren't FDA-approved. Not available in every state.Your own doctor or gynecologist
Learn more →Good for
Usually covered by insurance, can do a physical exam, and can send generic prescriptions anywhere, including low-cost pharmacies.Watch
Some doctors have limited menopause training or waits can be long; ask directly whether they prescribe HRT.Menopause Society certified practitioner
Learn more →Good for
Clinicians who passed The Menopause Society's competency exam (MSCP); many offer telehealth. Best for complex histories.Watch
Availability and insurance vary; check whether they accept your plan or Medicare.
How to choose an online HRT provider
- Check insurance first: whether the service is in-network for visits, and whether prescriptions can go to your own pharmacy.
- Add up the real monthly cost: visit or membership fees plus medicine, and compare with generic prices at your pharmacy.
- Ask whether the hormones are FDA-approved or compounded.
- Make sure you'll get a progestogen if you have a uterus, and a follow-up after about 3 months.
- Check clinician credentials, such as the MSCP menopause certification.
- Be wary of services that push supplements, frequent hormone testing or pellets.
When online HRT 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.
Online HRT: questions women ask
Can I get HRT online?
Yes. Several US telehealth services prescribe HRT after an online questionnaire and a video visit or messaging with a licensed clinician. Some bill insurance, such as Midi and Evernow; others, such as Alloy and Winona, are cash-pay.
Is online HRT covered by insurance?
Sometimes. Midi is in-network with most major plans, and Evernow covers video visits with several national insurers. Neither covers Medicare. Alloy and Winona don't accept insurance, but HSA and FSA cards usually work.
Related →What is the best online HRT for menopause?
It depends on your insurance and needs. With good insurance, an in-network service like Midi or Evernow often costs least. Without insurance, compare total cash prices, and prefer FDA-approved hormones. For complex histories, a Menopause Society certified practitioner is a better fit.
How much does online HRT cost?
In September 2026, self-pay visits were $150 to $250, Alloy charged a $49 one-time fee plus medicine from $39.99 a month, and patches cost $100 to $149 a month at cash-pay services. With insurance, you may pay only a copay.
Related →How do I start HRT?
Book a visit with your doctor, a gynecologist, a menopause specialist or a telehealth service. Over 45, HRT can usually be started based on symptoms without blood tests. You'll start on a low dose and be reviewed after 3 months.
Related →Is Midi good for menopause?
Midi is a large insurance-based telehealth clinic for menopause, available in all 50 states, with first visits of 30 minutes. Its main advantage is insurance coverage. Check your plan's network, and note it doesn't accept Medicare or Medicaid.
Can I get estrogen online without seeing a doctor?
No legitimate service prescribes estrogen without a licensed clinician reviewing your history. Some services use messaging instead of a video visit. Estrogen needs a prescription in the US; products sold without one are supplements, not estrogen.
Related →Where can I get HRT if my doctor won't prescribe it?
Ask for a referral to a gynecologist or menopause specialist, search The Menopause Society's practitioner directory, or use a telehealth menopause service. Bring notes on your symptoms and history.
Related →Sources
- Midi Health. Pricing and insurance (checked September 2026).
- Evernow. FAQ and how it works (checked September 2026).
- Alloy. FAQ and product pricing (checked September 2026).
- Winona. Treatments, pricing and FAQ (checked September 2026).
- Mark Cuban Cost Plus Drug Company. Hormone therapy medication prices (checked September 2026).
- NICE. Menopause: identification and management (NG23). Updated 2024.
- US Food and Drug Administration. NASEM study on the clinical utility of treating patients with compounded "bioidentical" hormone therapy.
- NHS. About hormone replacement therapy (HRT).
- Women's Health Concern / British Menopause Society. Fact sheet: HRT types, doses and regimens.
- The Menopause Society. How to find a certified menopause practitioner.
- 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. Postmenopausal bleeding.
- NHS. Oestrogen tablets, patches, gel and spray: side effects.
- National 911 Program. 911.gov.
- Jiang X, Bossert A, Parthasarathy KN, et al. Safety assessment of compounded non-FDA-approved hormonal therapy versus FDA-approved hormonal therapy in treating postmenopausal women. Menopause. 2021;28(8):867-874.
- US Food and Drug Administration. Dietary supplements.
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