Cost & Insurance
How Much Does HRT Cost? We Priced All 14 Providers
Medical disclaimer: This article is for general information, not medical advice.
HRT Picks is an independent comparison site, not a medical provider. Nothing here is a substitute for advice from a licensed clinician who knows your personal and family history. Decisions to start, change, or stop hormone therapy should be made with that clinician. If you have an urgent medical concern, contact a healthcare professional directly.
You went looking for one number and found a dozen ranges. Here is the honest answer before the table: hormone replacement therapy through telehealth costs $35 to $200 per month for the platform subscription, plus medication that's sometimes included and sometimes billed separately at your pharmacy. If you have PPO insurance, the right provider brings that down to a $0–$30 copay. We verified every price below directly against each provider's site on July 6, 2026 (or against third-party sources where the provider blocks crawlers — flagged in each case).
The reason no one gives you a straight figure is that four things move the price independently: whether you pay cash or bill insurance, whether the medication is bundled or separate, how deep the clinical model goes, and how honestly the provider publishes its pricing. We'll take those one at a time.
How much does HRT cost with each provider?
This is the table almost no one in this niche will show you: the actual entry price, consult fee, and a realistic first-year total for each women's menopause HRT provider we track. Prices are the lowest verified systemic-estrogen entry SKU per provider — your exact cost depends on the format (pill, patch, gel) and whether you add progesterone.
| Provider | Entry price / mo | Consult fee | Insurance | First-year est. | Transparency |
|---|---|---|---|---|---|
| Alloy | $39.99 (estradiol pill) | $49 one-time | No | ~$530 | A |
| Winona | $54 (estrogen tablets) | $0 | No | ~$648–$1,068 | B |
| Midi Health | $0 w/ insurance | $250 cash / copay | Yes (PPO) | ~$700 cash | C |
| Hone Health | $25 membership + meds | $65 assessment | No | ~$700 floor | C |
| Gennev | $49 membership | Insurance path | Yes | — | C |
| Evernow | $49 ($35 annual anchor) | Gated pre-intake | Hybrid | ~$588 | D |
| Hers Menopause | $79 (12-mo plan, oral) | Gated pre-intake | No | ~$948 | D |
| Joi Women's Wellness | $99 (quiz-gated) | Quiz-gated | No | — | D |
| Inner Balance | $99 (unverified) | Unverified | No | — | D |
| Defy Medical | ~$200–$300 all-in | $250–$350 initial | No | ~$2,700 | C |
The pattern is clear once it's laid out: the two providers with the highest Transparency Grades — Alloy (A) and Winona (B) — are also two of the three cheapest all-in. Honest pricing and low pricing tend to travel together here, because the providers hiding their numbers are usually hiding a bigger one.
What does HRT cost with insurance?
Most menopause telehealth is cash-pay, but two providers we track bill insurance directly. Midi Health is in-network with major PPO plans (Aetna, Cigna, BCBS, United), where the typical copay is $0–$30 per visit — the cheapest route to menopause-trained clinicians, labs, and a real testosterone conversation. Gennev also offers an insurance path with its OB-GYN network.
Two cautions before you assume insurance wins. First, Midi's cash price if your plan doesn't verify is the category's highest: $250 for the first visit and $150 for follow-ups, excluding labs and medication. Second, Midi cannot treat Medicaid or Medi-Cal patients even as self-pay. Insurance is the cheapest path only when your plan actually clears — budget for the cash number as a fallback.
The part the calculators skip
"Insurance-covered" refers to the visit, not always the drug. Your estradiol or progesterone is usually filled at your own pharmacy and priced by your formulary — generic oral estradiol can be under $15/mo with a discount card, while a brand-name patch can run $30–$130. Ask what the visit covers and what you'll pay at the pharmacy counter separately.
What's the real first-year cost of HRT?
Monthly numbers hide the onboarding costs — the consult, the first labs, the setup fees that only hit once. Here's what a realistic first 12 months looks like on the cheapest sensible path for a few common situations, using each provider's own verified pricing.
- Lowest transparent cash path — Alloy: $49 one-time consult + $39.99/mo estradiol pill × 12 ≈ $530/year, medication included. (Note: Alloy bills in 3-month blocks, so each refill is a ~$120 charge.)
- Cheapest all-inclusive — Winona: $0 consult + $54/mo estrogen tablets × 12 = $648/year, with consults, follow-ups, and shipping included. The dual-active cream route is $89/mo, or ~$1,068/year.
- Insurance route — Midi: roughly $0–$120 in copays for the year with an in-network PPO, or ~$700 cash ($250 first visit + three $150 follow-ups) if insurance doesn't clear — plus medication at your pharmacy.
- Clinic-grade — Defy Medical: consults, a ~$279 lab panel, and $75–$100/mo medication land steady-state around $200–$300/mo, or roughly $2,700 in year one with the heavier onboarding labs.
The takeaway: most women shopping cash-pay menopause HRT will spend between $530 and $1,100 in the first year. Anything materially above that is buying you either insurance-grade clinical depth (Midi, Defy) or a brand name you're paying a premium for (Hers).
Why is HRT pricing so confusing?
Because several providers are engineered to look cheaper than they are. This is the single most useful thing to understand before you enter a credit card, and it's why we grade pricing transparency separately from the overall score.
- Annual-billing anchors. Evernow advertises "starting at $35/month" — that's the annual-prepay rate. The actual month-to-month price is $49, and BBB complaints describe a $420 surprise annual charge from people who didn't realize they'd signed up for a year.
- 12-month-plan anchors. Hers' "$79/mo" oral and "$134/mo" patch both require a 12-month commitment; shorter plans cost more and the exact numbers sit behind intake.
- Membership-plus-meds math. Hone Health's advertised "$25/mo" is a membership, not treatment — stack the medication and the real bill is $53–$180+/mo.
- Program-fee framing. For men's TRT, Marek Health leads with a "$299" guided-optimization fee while publishing no medication prices at all — the realistic all-in is $1,000–$3,000/year. It earns the only Transparency F we've issued.
- Pricing buried off the pricing page. Midi's cash rates ($250/$150) are real but live in a Zendesk help article, not on its pricing page.
Our rule
A provider that won't show you a price before you hand over an email address is telling you something. We penalize intake-gated and anchor pricing in the Transparency Grade specifically so the number you see on our table is the number you'll actually pay.
How do I find the cheapest HRT that's actually good?
Cheap is easy; cheap-and-trustworthy is the real target. Match the price to your situation rather than chasing the lowest headline. If you have a PPO plan, start with Midi Health and let insurance do the work. If you're paying cash and want every number published before you commit, Alloy is the transparency benchmark. If you want the lowest all-in with nothing billed separately, Winona at $54/mo is the honest budget pick.
For a sorted, cheapest-first view of every provider, see our cheapest HRT online ranking, or run your own numbers on the HRT cost calculator. Then read the full provider rankings to weigh price against clinical depth and transparency — the three things that should decide this, in that order of your own priorities.