Last checked November 2026 against 24 sources · Editorial policy

Winona vs Midi: cash-pay HRT or insurance-based care

Winona vs Midi comes down to insurance. Midi bills most PPO plans for video visits with a menopause clinician; without coverage, visits are $250 and $150, and medicines are billed separately. Winona takes no insurance and charges no visit fee: you pay a monthly price per product, from $54 for estrogen tablets. Midi covers all 50 states; Winona serves only some, and only women aged 35 to 59.

Winona vs Midi side by side: visit fees, insurance and Medicare, HRT prices, compounded products, testosterone, GLP-1s, states and Trustpilot scores.

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Winona vs Midi side by side

Winona vs Midi Health
	Winona	Midi Health
How it works	Online intake reviewed by a doctor licensed in your state; medicines shipped to you.	Video visits: 30 minutes first, 15 minutes for follow-ups.
Visit fee	None; follow-ups free and unlimited.	$250 first visit, $150 follow-up self-pay; usually a specialist copay with insurance.
Insurance	Not accepted; HSA or FSA receipts can be submitted.	In-network with most PPO plans; HSA and FSA accepted.
Medicare and Medicaid	Can't be billed: Winona takes no insurance.	Medicare self-pay only, no claims; Medicaid and Medi-Cal not accepted, even self-pay.
Estrogen tablets	From $54 a month, FDA-approved.	FDA-approved; billed separately, may be covered by insurance.
Estrogen patch	From $149 a month, FDA-approved.	FDA-approved; billed separately, may be covered by insurance.
Compounded products	Estrogen, progesterone and combined body creams, vaginal cream: from $89 a month, not FDA-approved.	Testosterone, GLP-1s and a vaginal estradiol cream ($89 for 30 days), not FDA-approved.
Testosterone	No; prescription DHEA instead, $27 for 3 months.	Compounded, in 25 states, from $100 for 90 days.
GLP-1s	No.	Brand-name to your pharmacy; compounded injections from $165.90 for 4 weeks.
Hormone pellets	No.	No.
Where available	Listed states plus Puerto Rico; not in Alabama, Alaska, Arkansas, Kansas, Louisiana, Mississippi, New Mexico, North Dakota, Rhode Island, South Dakota, Utah, Vermont, West Virginia or D.C.	All 50 states.
Age for HRT	35 to 59.	No age range listed.
Trustpilot, November 2026	4.6 from 8,986 reviews; invites customers to review.	4.1 from 1,795 reviews; hasn't invited customers recently.

How it works
Winona
Online intake reviewed by a doctor licensed in your state; medicines shipped to you.
Midi Health
Video visits: 30 minutes first, 15 minutes for follow-ups.
Visit fee
Winona
None; follow-ups free and unlimited.
Midi Health
$250 first visit, $150 follow-up self-pay; usually a specialist copay with insurance.
Insurance
Winona
Not accepted; HSA or FSA receipts can be submitted.
Midi Health
In-network with most PPO plans; HSA and FSA accepted.
Medicare and Medicaid
Winona
Can't be billed: Winona takes no insurance.
Midi Health
Medicare self-pay only, no claims; Medicaid and Medi-Cal not accepted, even self-pay.
Estrogen tablets
Winona
From $54 a month, FDA-approved.
Midi Health
FDA-approved; billed separately, may be covered by insurance.
Estrogen patch
Winona
From $149 a month, FDA-approved.
Midi Health
FDA-approved; billed separately, may be covered by insurance.
Compounded products
Winona
Estrogen, progesterone and combined body creams, vaginal cream: from $89 a month, not FDA-approved.
Midi Health
Testosterone, GLP-1s and a vaginal estradiol cream ($89 for 30 days), not FDA-approved.
Testosterone
Winona
No; prescription DHEA instead, $27 for 3 months.
Midi Health
Compounded, in 25 states, from $100 for 90 days.
GLP-1s
Winona
No.
Midi Health
Brand-name to your pharmacy; compounded injections from $165.90 for 4 weeks.
Hormone pellets
Winona
No.
Midi Health
No.
Where available
Winona
Listed states plus Puerto Rico; not in Alabama, Alaska, Arkansas, Kansas, Louisiana, Mississippi, New Mexico, North Dakota, Rhode Island, South Dakota, Utah, Vermont, West Virginia or D.C.
Midi Health
All 50 states.
Age for HRT
Winona
35 to 59.
Midi Health
No age range listed.
Trustpilot, November 2026
Winona
4.6 from 8,986 reviews; invites customers to review.
Midi Health
4.1 from 1,795 reviews; hasn't invited customers recently.

Winona vs Midi: expectation vs reality

What people often expect

“Winona and Midi are the same kind of online HRT service, so the cheaper monthly price wins”

What the evidence shows

They're built differently. Midi is a clinic: you see a clinician by video, it bills your insurance, and your prescriptions are billed separately. Winona is a subscription: a doctor reviews your online answers, and you pay one monthly price per product with no insurance. Which costs less depends almost entirely on whether Midi is in-network with your plan.

Winona vs Midi: the differences that matter

Winona vs Midi cost: insurance decides

With an in-network PPO plan, Midi visits usually cost your specialist copay, and generic HRT may be covered at your pharmacy. Without insurance, Midi's first visit is $250 and each follow-up $150, before medicines. Winona never charges a visit fee, but everything is out of pocket: from $54 a month for estrogen tablets plus $39 for progesterone capsules, or $149 for the patch alone.

Learn more →

Winona vs Midi on Medicare

Neither works with Medicare. Midi lets Medicare members book only as self-pay patients, and they can't submit claims for visits, medicines or related services; Medicaid and Medi-Cal patients can't be seen at all. Winona takes no insurance of any kind and prescribes HRT only up to age 59. On Medicare, your own doctor or a certified menopause practitioner who accepts Medicare is the cheaper route.

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Compounded hormones at Winona and Midi

Both sell compounded products, which aren't FDA-approved. At Winona, that's its estrogen and progesterone creams, made in its own pharmacies. At Midi, it's testosterone, GLP-1 injections and a vaginal estradiol cream, while its systemic HRT is FDA-approved. The National Academies found no rigorous evidence that compounded bioidentical hormones are safe or effective, so asking for the FDA-approved version is the safer default at either.

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Testosterone and GLP-1s: Midi offers them, Winona doesn't

Midi prescribes compounded testosterone in 25 states and GLP-1s, both brand-name and compounded. Winona offers neither and prescribes DHEA for low libido instead. The evidence supports testosterone for women only for low sexual desire after menopause, and in October 2026 a study presented by The Menopause Society linked it to higher cardiovascular risk, so it isn't a reason on its own to pick a service.

Learn more →

Winona vs Midi reviews

On Trustpilot in November 2026, Winona scored 4.6 from 8,986 reviews and Midi 4.1 from 1,795. The scores aren't collected the same way: Winona invites its customers to review, while Trustpilot notes Midi hasn't invited customers recently, so its reviews may not be representative. Trustpilot doesn't fact-check reviews, and 16% of Midi's reviews were one-star. Winona replied to 100% of negative reviews and Midi to 92%.

Winona and Midi by the numbers

$0 vs $250

first visit at Winona vs Midi without insurance

$149

a month for Winona's estrogen patch; Midi bills patches separately, often through insurance

4.6 vs 4.1

Trustpilot score of Winona vs Midi, November 2026

50 states

where Midi is available; Winona serves only some states, plus Puerto Rico

Prices were checked on both websites on November 1, 2026. With insurance, what you pay at Midi depends on your plan.

Winona, Midi or something else: who each one suits

Midi if you have PPO insurance
Strong evidence
If Midi is in-network with your plan, you pay your specialist copay for video visits with a menopause clinician and can often fill generic HRT through insurance. It covers all 50 states. Skip it on Medicare or Medicaid, and be wary of compounded add-ons you didn't come for.
Related guide →
Winona if you pay cash and want no visits
Strong evidence
If you're 35 to 59, live in a state Winona serves and don't want to use insurance, Winona's FDA-approved tablets, capsules or patch with free follow-ups are a simple monthly subscription. Choose those over its compounded creams, and remember refunds are possible only in the first 24 hours of an order.
Related guide →
Neither Winona nor Midi if you're on Medicare
Some evidence
Neither can bill Medicare. A certified menopause practitioner who accepts Medicare, or your own doctor, can prescribe the same FDA-approved generics, and 30 estradiol 1 mg tablets cost $6.76 at one low-cost online pharmacy even without coverage. Insurance generally covers generic FDA-approved estradiol and progesterone.
Related guide →

When neither Winona nor Midi is 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 →
Urgent: Leg pain or swelling, or chest pain with breathlessness, on HRT
Leg symptoms: call a doctor now. Chest pain or breathlessness: call 911.

Winona vs Midi: questions women ask

Is Winona or Midi cheaper?

With in-network PPO insurance, Midi is usually cheaper: you pay a copay per visit and insurance may cover generic HRT. Without insurance, Winona is cheaper to start, because it has no visit fee, while Midi charges $250 for a first visit before any medicine.

Does Winona or Midi take insurance?

Midi does: it's in-network with most PPO plans, though not Medicare or Medicaid. Winona doesn't work with any insurance; you can only submit HSA or FSA receipts for reimbursement. Midi bills you for whatever your plan doesn't pay, such as a specialist copay or deductible, and prescriptions and labs are billed separately from the visit.

Are Winona and Midi hormones bioidentical?

Yes, both prescribe bioidentical estradiol and progesterone. The difference is whether a product is FDA-approved: Winona's tablets, capsules and patch are, its creams aren't. Midi's systemic HRT is FDA-approved, while its testosterone, GLP-1s and vaginal cream from its store are compounded.

Which is better for perimenopause, Winona or Midi?

Both treat women who still have periods. Winona prescribes HRT from age 35 and doesn't require blood or saliva hormone tests. Midi offers a 30-minute first video visit with a menopause clinician and covers all 50 states. Your insurance and your state usually decide more than the service does.

Can I switch from Winona to Midi?

Yes. Cancel Winona's subscription in your account settings, then book a Midi visit and bring your current prescriptions. FDA-approved tablets, capsules and patches have direct equivalents your insurance may cover; a compounded cream will need a new prescription for an approved product.

Winona vs Midi vs Alloy: how does Alloy compare?

Alloy sits between them: cash-pay like Winona, but with a $49 one-time consult fee, estradiol pills from $39.99 a month and patches at $100, and it serves all 50 states and D.C. like Midi. It doesn't take insurance.

Sources

See our editorial policy.

Winona vs Midi: cash-pay HRT or insurance-based care

Winona vs Midi side by side

How it works

Visit fee

Insurance

Medicare and Medicaid

Estrogen tablets

Estrogen patch

Compounded products

Testosterone

GLP-1s

Hormone pellets

Where available

Age for HRT

Trustpilot, November 2026

Winona vs Midi: expectation vs reality

Winona vs Midi: the differences that matter

Winona vs Midi cost: insurance decides

Winona vs Midi on Medicare

Compounded hormones at Winona and Midi

Testosterone and GLP-1s: Midi offers them, Winona doesn't

Winona vs Midi reviews

Winona and Midi by the numbers

Winona, Midi or something else: who each one suits

Midi if you have PPO insurance

Winona if you pay cash and want no visits

Neither Winona nor Midi if you're on Medicare

When neither Winona nor Midi is the right route

Winona vs Midi: questions women ask

Is Winona or Midi cheaper?

Does Winona or Midi take insurance?

Are Winona and Midi hormones bioidentical?

Which is better for perimenopause, Winona or Midi?

Can I switch from Winona to Midi?

Winona vs Midi vs Alloy: how does Alloy compare?

Sources

Related guides

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