How much does HRT cost, and what will you actually pay?

What does HRT actually cost in 2026?

$828 to $1,161 for a realistic first year of cash-pay HRT, across the 2 of 5 women's platforms whose full modeled plans we could price. The $828 figure is Gala Health: Annualized advertised-price estimate: $69 × 12 = $828 for one year if that rate covers the prescribed plan throughout. This is not a verified payment schedule. The exact plan and charge are confirmed during assessment; we did not complete checkout or establish whether any lab or additional-treatment charges apply. The $1,161 figure is Winona: Winona bills every 28 days, not monthly, so a year holds 13.04 charges rather than 12. Estrogen Body Cream with Progesterone at $89 per cycle x 13.04 = $1,160.56, all-inclusive (consults, follow-ups, shipping included). Cheapest-entry route: estrogen tablets at $54 x 13.04 = $704.16. Counting Winona at 12 charges a year understated its annualized cost by more than one cycle, which is where the $1,068 this record carried until 2026-08-16 came from. Hone has no single annual total across prescriptions and is excluded from the fixed-plan totals.

The short answer

• Cheapest published estrogen route: Winona: $54 tablets per 28-day cycle, $0 consult ≈ $704 year one across the 13.04 charges a year holds. Its all-inclusive cream with progesterone is $89 a cycle, the $1,161 figure in the table. Compounded, so not FDA-approved.
• Current advertised HRT plan: Gala Health: $69/mo, including care, prescription and shipping. $828 annualized if that rate covers the prescribed plan for twelve months; checkout billing and any lab charges remain unverified. The provider describes FDA-approved forms, but exact products were not independently checked.
• Membership plus medication: Hone Health: $65 initial test plus $155/mo women's Premium membership and medication. Estradiol patch/gel is estimated at $58/mo separately; the example totals $213/mo. Basic at $25/mo excludes hormone therapy. Source: Hone's women's Premium plan.
• FDA-approved generic, filled at your pharmacy: Sesame Care: an ongoing menopause subscription with named clinicians and prescriptions sent to your pharmacy. The subscription fee was not established from the checked public page, and medication is separate. There is no verified first-year total.
• Care fee plus a pharmacy bill: Wisp: menopause care advertised from $33/month, with the selected upfront bill and interval still to confirm. Medication is paid separately at your pharmacy, so no all-in first-year total is verified.

The verified cross-provider price table

No other page on the internet has this table, which is exactly why we built it: every women's HRT platform we track, with the consult fee, the monthly medication cost, and the real first-year total, sorted by that total, cheapest first. Grade = our A-F Transparency Grade (what the provider discloses before intake). Sorted by cost, never by affiliate status.

First-year totals = the entry fee (consult, assessment or first cycle) plus twelve months on the documented treatment plan; the assumption set behind each number is documented on the ranked review pages, and it is not the same route in every row, so read the assumption before you read the total. "Not verifiable" means the provider prices the medication through a third party or gates it behind intake, which tells you something too. Facts carry Verified/Reported status labels on each review page. All 5 of these platforms are cash-pay for the visit. For how coverage interacts with the pharmacy price of your medication, see the insurance guide. Cost is one input and safety is the other, so before you commit to a first-year total, read is HRT safe in 2026.

Need the bill explained before the comparison? Read how HRT costs add up or the separate guide to HRT cost with insurance.

Why do our numbers differ from advertised prices?

Because the advertised price is a marketing artifact and the first-year cost is arithmetic. The category's recurring anchor-pricing patterns, named:

• The two-part price. Hone Health advertises a $25/mo membership, which buys zero medication. The $65 assessment and the drug are separate charges. Women's Premium is $155/mo plus a $65 initial test and medication. The $58/mo estradiol patch/gel estimate gives an example of $213/mo, or $2,621 in year one with the initial test. Additional prescribed progesterone or other medication changes that total. Basic at $25/mo excludes hormones.
• The month that is not a month. Winona bills every 28 days rather than monthly, so a year holds 13.04 charges rather than 12. The advertised $54 tablet is charged 13 times, which is $54.19 a year more than the same figure would cost you on a calendar month.
• The advertised rate and the checkout terms. Gala Health now advertises $69/month for care, prescription and shipping. Confirm the actual checkout charge and renewal schedule for your prescribed plan; multiplying a headline by twelve is an estimate, not a verified payment schedule.
• The price a third party sets. Wisp and Sesame Care publish their consult fees openly and route the prescription to your own pharmacy, so neither can tell you what the medication costs. That is disclosure rather than concealment, and it still leaves you unable to compute a total before you buy.

None of this is illegal, and some of it is defensible. But it's why a "from $X/mo" comparison misleads and a verified first-year table doesn't. The Transparency Grade column above exists to price this behavior in.

What makes HRT cost more or less?

1. Insurance or cash-pay. None of the 5 women's platforms we track bills commercial insurance for the visit, so all 5 are cash-pay. Compare the eligible treatment tier: Hone's Basic plan excludes hormones, while Winona's patch costs $149 per 28-day cycle. Insurance may cover FDA-approved estradiol at your own pharmacy even when the visit is not covered. Full breakdown in the insurance guide.
2. FDA-approved vs compounded. Winona offers compounded hormones, which are not FDA-approved. The current Gala HRT page describes FDA-approved forms, but we have not independently checked the exact products. Sesame Care and Wisp route eligible prescriptions to your pharmacy, where coverage and the pharmacy price determine the medication bill. The clinical difference matters more than the billing difference. See the bioidentical HRT guide.
3. Delivery format. Oral is the cheapest published route on this roster: Winona's progesterone capsules from $39 a cycle and its estrogen tablets from $54. The same company's patch is $149, nearly three times the tablet, and the patch is also the format hit by the 2026 shortage. For local symptoms the floor is lower still: Wisp's estradiol vaginal cream starts at $20.
4. Clinical depth. Chat-only platforms (Winona) are cheaper than labs-first platforms (Hone Health); the biomarker panels and physician consults in Hone's Premium tier cost $155/mo before medication.