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Top-scored is Alloy (8.9/10), the only provider in the set holding a Transparency Grade A: every SKU priced on its public site before intake, estradiol pills from $39.99/mo and patches from $74.99/mo, and named menopause doctors carrying MD, FACOG and MSCP credentials. It is cash-pay only, and it pays us nothing. Winona (8.4/10) is next, compounded bioidentical HRT on a true $0-consult model from $54/mo with ~6,000 Trustpilot reviews at ~4.7; Winona is an affiliate partner, ranked at its earned score. For FDA-approved (not compounded) generics from named clinicians you can fill on your own insurance, Sesame Care (7.6/10) is the value alternative, though it is a general marketplace rather than a menopause specialist. (Sesame is an affiliate partner, ranked at its earned score, never promoted for it.) Three of the thirteen women's-wing platforms bill insurance directly (Midi Health, Gennev, Elektra Health); the other ten are cash-pay.

Verified August 2026: the cheapest route we can stand behind is Alloy at $39.99/mo for FDA-approved oral estradiol, plus a $49 one-time consult [Reported], about $530 for year one. The thirteen women's-wing platforms run $25-$250/mo depending on product and provider; ten are cash-pay and three (Midi Health, Gennev, Elektra Health) bill commercial insurance per visit instead. Winona is the cheapest compounded route at $54/mo with a $0 consult, on a 28-day billing cycle that puts 13.04 charges in a year rather than 12. Hone Health's labs-first model floors around $53/mo all-in. Watch the framing: Hone's advertised $25/mo is a membership, not a treatment price (real all-in $53-$180+), Hers' $79/mo requires a 12-month plan, Gala advertises $79/mo but bills $237 every 12 weeks, which works out to $85.82 a month, Sesame is a per-visit marketplace where FDA-approved generic estradiol goes to your own pharmacy (the exact drug price we could not verify this pass), Telos RX publishes no HRT price at all, only GLP-1 and peptide prices from $49 to $399/mo, and Wisp's $99 buys the consult alone with the hormones billed separately by your own pharmacy.

Most commercial plans cover FDA-approved HRT medications (generic estradiol, micronized progesterone), often with step-therapy rules; compounded bioidentical HRT is almost never covered. Three of the thirteen women's-wing platforms we track bill commercial insurance directly: Midi Health, Gennev, and Elektra Health. The other ten, including Alloy, Winona, Sesame Care, Hone Health, Hers, Wisp, Gala Health, Inner Balance, and Telos RX, are cash-pay (several are HSA/FSA eligible). The way to use insurance on a cash-pay platform is to fill an FDA-approved prescription at your own pharmacy on your plan's formulary, which is exactly what Sesame's FDA-approved generics and Wisp's local-pharmacy routing are built for.

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 the 17 providers we track: one A (Alloy, the only provider here that prices every SKU on its public site before intake, names its clinicians with credentials, and leaves its review profiles open; it loses the last point because no cancellation policy is published), six B (Winona, full product pricing but no named clinicians; Sesame Care, FDA-approved generics from named clinicians, held to B because its menopause all-in varies by pharmacy; Wisp, every price published pre-intake but no clinicians named and the drug cost left to your pharmacy; Midi Health, both self-pay visit tiers public pre-intake but no carrier list and no lab or medication pricing; Gennev, four visit fees public with durations attached but no medication or lab pricing at all; and Elektra Health, visit price public but labs deflected to insurance and medication left to your pharmacy), six C (Hone Health, PeterMD, Gala Health, MangoRx, Fella Health, whose enclomiphene pricing is public but no clinician is named, and Defy Medical, whose lab pricing is A-tier public while its consult and medication pricing sit behind account approval), and four D (Hers, Inner Balance, Maximus, and Telos RX, which gate or omit pricing or leave clinicians unnamed).

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-$250/mo, above the $25 marketing number (that's a membership fee, not a treatment price). Highest-scored is Defy Medical (7.6/10), a long-established physician-led clinic that prices labs separately and visibly; Hone Health (7.5/10) is the labs-first telehealth alternative; the cheapest flat monthly is MangoRx at $99/mo covering visits, consultations and medication, with labs billed on top at $75 or $100 (a broad men's-health platform, not a TRT specialist); PeterMD bundles more into $139/mo month to month, with a BBB file worth reading first; Maximus specializes in enclomiphene and oral-TRT protocols on a 6-month or 12-month commitment (but carries a BBB F, so we cap its score at 7.0).

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.