The cleanest read on the
HRT telehealth market.

It depends on whether you have insurance. Top-scored overall is Alloy (8.9/10) — the only provider with a Transparency Grade A: every product priced before intake, estradiol pills from $39.99/mo, named menopause-specialist doctors. If you have PPO insurance, Midi Health (8.8/10) is the stronger pick — the only pure insurance-billed menopause specialist we track, typical copay $0-$30. For compounded bioidentical HRT, Winona (8.4/10) has a true $0-consult model from $54/mo.

Verified July 2026: cash-pay runs $23-$250/mo depending on product and provider. Cheapest verified systemic estrogen is Alloy's estradiol pill at $39.99/mo (+$49 one-time consult); cheapest all-inclusive route is Winona at $54/mo with nothing else to pay. With PPO insurance, Midi Health drops to a $0-$30 copay per visit. Watch the anchors: Evernow's advertised $35/mo requires annual billing (actual monthly: $49), and Hers' $79/mo requires a 12-month plan.

Most commercial plans cover FDA-approved HRT medications, often with step-therapy rules; compounded bioidentical HRT is almost never covered. Among telehealth providers, Midi Health is the only pure insurance-billed specialist (in-network with major PPO plans; it cannot treat Medicaid/Medi-Cal patients even as self-pay). Gennev accepts insurance for some services, Evernow for video visits only. Every other provider we track is cash-pay.

Our A-F grade for what a provider discloses BEFORE you hand over an email address — separate from the 0-10 quality score. Five criteria: pricing disclosed pre-intake, named clinicians with credentials, published cancellation policy, corporate disclosure, and third-party review accessibility. Current spread across 14 providers: one A (Alloy), two B (Winona, Fountain TRT), five C, five D, and one F (Marek Health, which publishes no medication pricing at all).

In November 2025 the FDA began removing black-box warnings (for cardiovascular disease, breast cancer, and dementia) from menopausal hormone therapy products, with labeling changes approved in February 2026, and demand surged. Estrogen-patch prescriptions are up 184% since 2018 (Truveta). Multiple estradiol patch products from Amneal, Zydus, Sandoz, Noven and Viatris are now on the ASHP shortage list (including Amneal's Dotti) — though the FDA has not added estradiol patches to its own shortage database. Gel, spray, and pill alternatives are not in shortage; our live tracker shows which providers can switch you.

Yes — a clearly-labeled second wing at /trt covers 6 TRT providers under the same methodology and transparency grading. The short version: real all-in TRT cost is $53-$300/mo, not the $25 marketing number (that's a membership fee, not a treatment price). Highest-scored is Hone Health (7.5/10); the only homepage-verified all-inclusive price is Fountain TRT at $199/mo; the budget pick is PeterMD from $99/mo — with a BBB file worth reading first.

A 0-10 score on fixed weights — cost 25%, formulary 20%, clinical depth 20%, patient experience 20%, transparency 15% — plus a separate A-F Transparency Grade. Two hard rules: affiliate status is excluded from score computation, and any provider with an unanswered BBB F rating is capped at 7.0 no matter how good the rest looks (currently applied to Maximus). Every price carries a Verified or Reported status label with the verification date.

We earn commissions when readers sign up with some of the platforms listed — disclosed on every page. Our score is methodology-driven, never adjusted for affiliate status: if a higher-scored platform pays less than a lower-scored one, the higher-scored one ranks higher anyway. Where we have no independent review data we say 'Not surfaced' instead of inventing ratings. Full firewall details in our editorial policy.