Online HRT platforms, honestly compared

We signed up for all of them. Here's who each one is right for, who it's not, and what you'll actually pay.

8 minute read

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Here's the plain-English version. Telehealth for perimenopause care went from barely existing in 2020 to being the easiest way for most women to get HRT. The big-name platforms all prescribe the same bioidentical hormones. They are not compounding pharmacies selling something exotic. They are licensed clinicians writing real prescriptions filled at real pharmacies.

The differences between them come down to four things: price, whether they require lab work, which states they operate in, and how much one-on-one time you actually get with a clinician.

What to look for in any platform

• FDA-approved hormones (not compounded as the default)
• A real clinician visit — not just a questionnaire
• Clear monthly cost, including the meds
• Licensed in your state
• Lab work available if you want it

Who each platform is for

Winona — best if you want the lowest monthly cost and you already know what you need. Questionnaire-based intake, FDA-approved bioidentical hormones, fast shipping. Lean on it if your symptoms are clearly hormonal and you don't need a lot of hand-holding. Skip it if you want a real clinician you can actually talk to on video.

Alloy — best if you want a quick path to treatment with menopause-specialist clinicians. Written visits (not video) with doctors who only treat menopause, flat monthly pricing that includes the meds. Skip it if you want a real-time video visit or if you want labs included by default.

Midi Health — best if you want a proper video visit with a menopause-trained clinician and you have insurance. Midi is in-network with a lot of major insurers, orders labs, and handles the full picture. Skip it if you're uninsured — it's the most expensive out-of-pocket option of the three.

What it actually costs

Expect somewhere between $40 and $100 a month, all in, for the lower-cost platforms. That usually includes the clinician visit, the prescription, and shipping. Lab work is sometimes extra.

Insurance can cover some of this, but most telehealth HRT platforms operate cash-pay and hand you a receipt you can submit for reimbursement. If you want insurance to run directly, you're usually looking at a traditional office or an in-network telehealth option.

When telehealth isn't the right fit

If you have a personal or family history that needs a careful risk conversation — certain cancers, blood clots, liver disease — start with an in-person menopause specialist. Telehealth is excellent for straightforward cases and terrible as a substitute for a nuanced medical history conversation.