Alloy vs Midi Health
Side-by-side HRT telehealth comparison · Verified July 6, 2026
The short answer
Too close to call on score alone — Alloy 8.9 vs Midi Health 8.8, inside our 0.3-point tie margin. The verdict depends on which buyer you are: for cash-pay HRT with every price published before you give an email address, pick Alloy (from $40/mo (~$530 realistic first year)); for insurance-covered HRT with menopause-trained clinicians and real lab work, pick Midi Health ($0-$30 typical copay with in-network insurance; $250 cash first visit, $150 follow-ups [Reported] (~$700 realistic first year)).
| Alloy | Midi Health | |
|---|---|---|
| Score | 8.9/10 | 8.8/10 |
| Transparency grade | A | C |
| Consult fee | $49 one-time [Reported] | $0-$30 typical copay with in-network insurance; $250 cash first visit, $150 follow-ups [Reported] |
| Monthly cost | From $40/mo | $0-$30 typical copay with in-network insurance; $250 cash first visit, $150 follow-ups [Reported] |
| Real first-year cost | ~$530 | ~$700 |
| Bloodwork | Not required — no lab panel mentioned on pages reviewed [Verified July 2026 — absence noted] | Labs can be ordered and billed to insurance [Reported] |
| Formats offered | patch, gel, spray, oral, vaginal, cream | patch, gel, spray, oral, vaginal, cream |
| Insurance | No — cash pay | Yes |
| States | All 50 states + DC; compounded formulas unavailable in AL, AR, CA, NV, LA, MS, DC [Verified July 2026] | All 50 states + DC [Reported — widely cited, not re-verified this pass] |
| Trustpilot | 4.4/5 · ~3,600 reviews | 4.5/5 · ~1,281 reviews |
| Visit Alloy | Visit Midi Health |
Alloy first-year math: $49 consult + estradiol pill at $39.99/mo × 12 ≈ $530. Patch route: $49 + $74.99 × 12 ≈ $949. Progesterone adds $0 when co-prescribed with estradiol [Reported].
Midi Health first-year math: Cash-pay estimate: $250 first visit + 3 follow-ups × $150 ≈ $700, excluding labs and medications. With in-network PPO insurance: typically $0-$120 in copays for the year.
Choose Alloy if
Women without insurance who want to know the exact cost of every option before starting, with menopause-specialist doctors and fast asynchronous onboarding.
From $40/mo · Transparency A
Read full Alloy review →Choose Midi Health if
Women with PPO insurance who want a thorough workup from menopause-trained clinicians, insurance-billed labs, and access to both HRT and non-hormonal options.
$0-$30 typical copay with in-network insurance; $250 cash first visit, $150 follow-ups [Reported] · Transparency C
Read full Midi Health review →Where both fall short
The honest part
Alloy
- 3-month billing blocks front-load the cash outlay (~$225/refill for the patch)
- Subscription-management complaints on Trustpilot [Reported]
Midi Health
- Customer-service complaints disproportionate to the marketing polish [Reported — Trustpilot]
- Medicaid/Medi-Cal patients turned away even as self-pay [Reported]
- $250 cash exposure if insurance verification fails after the visit
Go deeper
This is general information, not medical advice. Hormone therapy is prescription treatment — whether either provider fits your health history is a decision for a licensed clinician. Facts on this page render from our provider data layer, verified July 6, 2026 where sites allow crawling; items marked [Reported] rest on third-party sources.