Alloy Alternatives: 9 Menopause Options Compared — What Each Costs, Who Takes Insurance, and What You Give Up

The HRT Index Editorial TeamIndependent women's health research

Last reviewed:August 14, 2026

Editorial research — not medically reviewed by a clinician. Why this label

Last updated: August 14, 2026 · Last verified: August 14, 2026 · By The HRT Index Editorial Team. Educational research, not medical advice, and not reviewed by a clinician. See our medical review policy. Full disclosure.

Before you switch from Alloy

Compare the reason you would leave Alloy first — insurance, live video, testosterone, local pharmacy access, billing rhythm, or medication lane — before paying another consultation fee.

Find my best-fit HRT path

The best Alloy alternative depends on the problem you need to solve. Midi is the broadest PPO-and-video option, MyMenopauseRx is the lower self-pay insurance-billing visit at $150, and Elektra is the only provider here documented to bill select Medicare and Medicaid plans. Stay with Alloy when its cash pricing, shipped medication, and messaging model already fit.

Before you read our verdict, here is where our money comes from. Alloy is not one of our partners. We earn nothing whether you stay or leave. Sesame and Winona are paid partnerships, and every link to them is labeled. Midi is not currently an HRT Index affiliate, so its links are direct provider links. Several options we recommend for difficult situations pay us nothing. Read our full affiliate disclosure.

Best for / not for you if

This page is for you if: you are paying Alloy Health at myalloy.com, or you were about to, and something specific stopped you — a quarterly charge, an insurance card, a missing medication, no live visit, or a state or age gate.

This page is not for you if:

You want alternatives to Alloy's M4 estriol skincare line. That is a different product and a different decision — see our Alloy M4 alternatives guide.
You are researching Alloy identity-verification software, the marketing agency named Alloy, or metal alloys. This page is about the menopause telehealth company.
You need urgent care, or you are deciding whether to start, stop or change a prescription. That belongs with a clinician who can evaluate you.

Which Alloy alternative fixes the reason you would leave?

Pick one reason. The reason you would leave is the variable that changes the answer — and it drives everything below.

Why you would leave Alloy	First option to check	Verified front-door cost	Keep Alloy instead if…
“I have commercial insurance and Alloy will not bill it.”	Midi Health for most PPO plans; also compare Gennev, MyMenopauseRx and Elektra	Midi: $250 initial self-pay or plan cost-sharing when covered	Your deductible makes the insured visit more expensive than Alloy's cash model
“I want the lowest published self-pay video visit among the insurance-billing clinics.”	MyMenopauseRx	$150 per virtual visit	You do not need a visit; you need a stable refill and Alloy's messaging model already works
“I am on Medicare or Medicaid.”	Elektra Health, but only where your exact plan and state are listed	$249 initial self-pay; covered cost depends on plan	You are a Medicare beneficiary willing to self-pay Midi and accept that no Midi claim can be submitted
“I want testosterone discussed as part of menopause care.”	Midi, MyMenopauseRx or Elektra, depending on state	Visit, labs and medication are separate unless your plan covers them	You are outside every published pathway — use an in-person menopause clinician instead
“The three-month charge blindsided me.”	Stella, MyMenopauseRx, Gennev or Elektra for pay-per-visit care	$150–$250 initial self-pay	You like Alloy's total price and only needed the real processing date
“I want a scheduled video conversation.”	Gennev, Midi, Stella, Elektra or MyMenopauseRx	$150–$250 initial self-pay	Fast physician messaging suits you better than appointments
“I want labs available.”	Sesame, MyMenopauseRx, Gennev, Midi or Elektra	Varies; MyMenopauseRx self-order lab bundles start at $49	You are over 45 with a typical symptom pattern and only wanted hormone levels “checked” before treatment
“I only need vaginal estrogen.”	Use a local-treatment route, not a systemic-program price comparison	Alloy: $119.97 for its published three-month vaginal-cream supply, plus the $49 consult	Alloy's shipped local product and messaging already fit

Published prices are snapshots, not quotes. Insurance cost-sharing, medication, pharmacy charges, labs, shipping outside included delivery, dose changes and state-specific rules can change the total. Numbers that require intake or checkout are labeled instead of guessed.

The HRT Index is the independent decision resource for online menopause and HRT care — comparing telehealth providers on clinical legitimacy, care quality, medication fit, price transparency, and access, with every claim verified and dated, so women can choose the path that fits their situation before their first consult.

The right online HRT provider is not the same for every woman — it depends on your symptoms, your age and whether you have a uterus, your medication route preference (patch, pill, gel, or vaginal estrogen), your risk history, your insurance or cash-pay situation, and your state. Some situations belong with an in-person clinician first. Because a general answer cannot resolve those for you, use The HRT Index's Find My HRT Path tool to match your situation to the right provider — and to flag when online care is not the right starting point — before your first consult.

Why do people look for Alloy alternatives?

People usually look for Alloy alternatives because Alloy does not bill insurance, does not publish a standard scheduled-video model, does not offer testosterone, uses recurring shipment deadlines, or cannot provide a route they want. Alloy publishes most of those limits itself, which means you can identify the actual blocker before paying another consultation fee.

Here is the part most comparison pages skip: some “reasons to leave” are real dealbreakers, and some are simply tradeoffs you will meet again at the next company. The job is not to find a company with no friction. It is to stop paying for the wrong friction.

The Alloy Exit Ledger

What stops you	What Alloy currently publishes	Who may fix it
No insurance billing	Alloy says it does not bill or accept insurance directly for services or prescriptions	Midi, Gennev, MyMenopauseRx and Elektra bill eligible commercial plans; Elektra lists select Medicare and Medicaid plans
No testosterone	Alloy's knowledge base states that it does not offer testosterone therapy	Midi publishes a compounded-testosterone pathway in 25 states; MyMenopauseRx has an Illinois route and a PCP-coordination model elsewhere; Elektra lists prescribing by some clinicians for New York residents
No standard scheduled video visit	Alloy advertises an online intake and unlimited doctor messaging while the prescription is active	Midi, Gennev, MyMenopauseRx, Elektra and Stella publish scheduled video care
No included lab program	Alloy's public process does not list an included lab panel	Sesame includes basic labs when necessary; other visit-based clinics can order clinically indicated tests
Quarterly cash-flow hit	Alloy's estradiol patch is now listed at $100 per month, shipped and billed every three months	Pay-per-visit clinics, or a prescription sent to your own pharmacy
No public state list	Alloy's terms say services may not be available in your state	Stella publishes a public eligibility flow; several visit-based clinics publish state lists or plan lookup tools
Refund restrictions	First shipment of each product only, request within 30 days of receipt; consultation and service fees are nonrefundable	No provider erases this problem completely; compare the exact refund rule before checkout
Two cancellation clocks	Subscription cancellation is due at least seven days before the period ends; a shipment pause or cancellation is due at least five business days before processing	Pay-per-visit care removes a shipment subscription, but pharmacy refills can still recur
Binding arbitration and liability limit	Alloy's current terms include binding arbitration and a $500 aggregate liability cap	Compare terms, not marketing copy, before treating another company as friction-free
Mixed wider catalog	Alloy's core menopause hormone products are presented as FDA-approved finished drugs, while parts of its broader catalog are compounded	Gennev and Elektra state that they prescribe FDA-approved medications rather than compounded menopause hormones

Source: Alloy treatments and prices, Alloy testosterone statement, and Alloy Terms of Use, all checked in August 2026.

Some of those are dealbreakers. Some are just how online menopause care works. Knowing which is which can save you a wasted $49 to $250 — and a second intake that solves nothing.

Not sure which item is actually your blocker? Find My HRT Path narrows the decision by symptoms, medication route, insurance, state and risk flags — including when online care is not the right starting point.

Should you leave Alloy — or is Alloy still the better fit?

Do not leave Alloy just because another company's monthly number looks lower. Alloy's oral estradiol starts at $39.99 per month, its $49 consultation is paid once, and ongoing physician messaging is included while your prescription remains active. The catch is that the total changes if progesterone is prescribed and billed separately, and the patch now costs $100 per month.

We are going to spend the next section talking you out of leaving. Bear with us — it makes everything after it more useful.

What the $100 patch price actually means

Alloy's live estradiol-patch page currently shows $100 for a one-month supply and says it is shipped and billed every three months. That means the recurring card charge is about $300, not $100, before any other product in the treatment plan.

That is not a hidden fee. It is a monthly unit price on a three-month billing rhythm. But it is a cash-flow surprise when someone reads the monthly number and assumes that is the next charge.

With Alloy's one-time $49 consultation, the published patch-only arithmetic is:

First three months: $349
First year: $1,249

Those totals are arithmetic from Alloy's public prices, not checkout quotes. Dose, product selection and taxes or other charges shown during checkout can change what you pay.

The progesterone question still moves the math by at least $276 a year

If you have a uterus and use systemic estrogen, a progestogen is generally included to protect the uterine lining. The Menopause Society explains that women with a uterus using systemic estrogen need estrogen-progestogen therapy rather than estrogen alone.

Alloy's current product list shows progesterone starting at $23 per month. We could not verify a first-party promise that progesterone is always free when prescribed with estradiol. Independent reviewers may describe bundled checkout behavior, but the number that controls is the one Alloy shows you for your own treatment plan.

Ask this before paying:

“If I am prescribed estradiol and progesterone together today, what is my complete charge now, what will recur, and on what date?”

The published-price range makes the consequence obvious:

Alloy route	First 90 days from public prices	First year from public prices
Oral estradiol alone at $39.99/month + $49 consult	$168.97	$528.88
Oral estradiol + progesterone at the published $23/month starting price + consult	$237.97	$804.88
Estradiol patch alone at $100/month + consult	$349	$1,249
Estradiol patch + progesterone at the published $23/month starting price + consult	$418	$1,525

The oral-estrogen-only number is still one of the lowest published direct-to-consumer cash routes on this page. But calling it a complete regimen for every woman would be fake precision. The treatment and checkout total depend on what a clinician prescribes and whether progesterone is needed.

Fair credit where Alloy earns it

Alloy publishes a visible product catalog before intake. It also gives active patients unlimited doctor messaging, ships medication without a separate delivery fee on the pages we checked, and states that a prescription can be transferred to a pharmacy of the patient's choice.

Stay with Alloy if: the exact medication route works, you do not need the visit billed to insurance, you prefer asynchronous messaging, and the three-month processing rhythm is manageable now that you know the real card charge.

Look elsewhere if: you need a scheduled video visit, want a clinic to bill eligible insurance, need a documented testosterone pathway, want medication filled through your own pharmacy benefit from the start, or cannot clear Alloy's state or treatment gates.

What are the best alternatives to Alloy for menopause care?

The nine practical Alloy alternatives in this comparison are Midi Health, Gennev, MyMenopauseRx, Elektra Health, Stella, Wisp, Sesame, Winona and Hers. The decision turns on five facts: who bills insurance, what the first clinical contact costs, where the prescription is filled, whether the exact medication is FDA-approved or compounded, and which eligibility rules can stop you.

Option	Insurance for care	Published front-door price	Medication payment	Live video	Labs	Medication lane	Gate to know
Alloy	No direct billing	$49 one-time consult	Purchased through Alloy; product priced separately	No standard scheduled visit published	No included lab program published	Core menopause hormones presented as FDA-approved; wider catalog includes compounded items	No public state list; recurring shipment deadlines
Midi Health	Most PPO plans; verify exact plan	$250 initial / $150 continued self-pay	Your pharmacy; plan or cash price	Yes, 30-minute initial	Can order when indicated	FDA-approved options plus a separately labeled compounded Custom Rx line	No Medicaid or Medi-Cal, even self-pay; Medicare beneficiaries may self-pay but cannot submit Midi claims
Gennev	In-network and out-of-network lookup; exact plan controls	$250 initial doctor visit / $199 follow-up self-pay	Your pharmacy	Yes, 30 minutes	Can order when indicated	States that it prescribes FDA-approved hormonal medication and not compounded bioidentical hormones	Insurance network varies by plan
MyMenopauseRx	Aetna, Humana, Cigna, BCBS, TRICARE, UHC and Sana PPO listed	$150 per self-pay virtual visit	Your pharmacy	Yes	Clinically indicated orders; self-order bundles start at $49	FDA-approved estradiol and progesterone	No Medicare, Medicaid or HMO plans; state list is limited
Elektra Health	Select commercial, Medicare and Medicaid plans in named states	$249 initial / $149 follow-up self-pay	Your pharmacy	Yes, 30-minute initial	Can order when indicated	Says it prescribes FDA-approved hormonal and nonhormonal medication, not compounded drugs	Clinical footprint and plan coverage are state-specific
Stella	In-network status varies; superbill available when out of network	$200 initial / $90 follow-up self-pay	Your pharmacy	Yes	Can order when indicated	Exact prescribed product determines approval status	Designed for ages 35–70; check state and plan
Wisp	No care-visit insurance billing advertised	$99 one-time	Local pharmacy; medication costs extra	Provider contact; phone/video may be used when needed	No included lab panel published	FDA-approved pharmacy-filled options listed	Three months of care-team access; available in all 50 states
Sesame	No insurance required for the program; medication may use pharmacy benefits	Current program price shown during enrollment; medication excluded	Your preferred pharmacy	Yes, as needed	Basic labs included if necessary	Published formulary includes FDA-approved drugs; exact prescription determines status	Federal-beneficiary restrictions appear in Sesame terms; confirm before paying
Winona	Does not bill insurance directly	No separate visit fee; medication price is the program price	Included and shipped	Messaging model	No routine lab requirement published	Mixed by product: FDA-approved tablets/patch/capsules and compounded creams	Bills 30-day treatment every 28 days; eligibility depends on age and state
Hers	No care billing advertised	Personalized plan price shown after assessment; do not guess	Included in plan	Messaging model	No included lab program published	FDA-approved finished medications; perimenopause use may be off-label	Not available in all 50 states; price requires intake

Who did we leave out?

Evernow remains a real option, but its membership and pay-per-visit structures are not cleanly comparable to one another from the public pages we reviewed. We will not turn two different products into one fake monthly number.

Rory/Ro appears on older comparison pages, but we could not confirm a current systemic-menopause program that belongs in this table. That does not prove no service exists. It means we will not recommend a pathway we could not reproduce from a current first-party page.

Inner Balance/Oestra appears later as a specialized compounded-vaginal-cream comparator, not as one of the core nine. Its decision is narrower: whether you deliberately want that compounded route after understanding how it differs from FDA-approved finished medication.

And the tenth route almost nobody lists is your own clinician plus your own pharmacy. It can be cheaper than telehealth, but only when you can find a clinician willing and able to prescribe the treatment that fits you.

How much do Alloy alternatives actually cost?

The published front-door care cost ranges from Alloy's one-time $49 consultation to roughly $250 for a self-pay initial video visit. That does not tell you which route is cheapest overall. Six options send medication to a pharmacy separately, while Alloy, Winona and Hers wrap medication into a provider-controlled transaction or plan.

Here is the rule we hold ourselves to: never call a provider cheaper by comparing one company's medication-inclusive charge with another company's visit fee.

Care fees only

Medication is not included in the numbers below.

Provider	Published care charge	What it buys
Alloy	$49 once	Clinician review plus unlimited messaging while an active prescription remains
Wisp	$99 once	Consult, follow-ups and three months of care-team access
MyMenopauseRx	$150 per self-pay virtual visit	Live visit; prescriptions sent to your pharmacy
Stella	$200 initial; $90 follow-up	Live menopause visit; superbill when applicable
Elektra	$249 initial; $149 follow-up	30-minute initial clinician visit; coaching is separate unless covered
Midi	$250 initial; $150 continued self-pay	30-minute initial and 15-minute continued care; no mandatory membership
Gennev	$250 initial doctor visit; $199 follow-up	30-minute doctor visit; dietitian care has separate pricing
Sesame	Confirm current program price during enrollment	Video care, messaging and basic labs if necessary; medication excluded

Insurance can move those numbers in either direction. A covered visit may cost only a copay. An unmet deductible may make the allowed insurance amount higher than the clinic's cash price. The plan, not the carrier logo, decides.

Medication-inclusive or provider-shipped prices

Provider and route	Published cash flow	90-day arithmetic	Regulatory lane
Alloy oral estradiol	$39.99/month + $49 consult	$168.97	FDA-approved finished product
Alloy oral estradiol + progesterone at public starting price	$62.99/month + consult	$237.97	FDA-approved finished products; exact combined checkout must be confirmed
Alloy patch	$100/month, billed every three months + consult	$349	FDA-approved finished product
Alloy patch + progesterone at public starting price	$123/month + consult	$418	FDA-approved finished products; exact combined checkout must be confirmed
Alloy vaginal estradiol cream	$119.97 per published three-month supply + consult	$168.97	FDA-approved finished product
Winona estrogen tablets + progesterone	$54 + $39 per 28-day billing cycle	$279 for three cycles; a fourth $93 charge can process around day 84	Provider describes both as FDA-approved finished products
Winona combined body cream	$89 per 28-day billing cycle	$267 for three cycles; a fourth $89 charge can process around day 84	Compounded final medication; not FDA-approved
Winona patch + progesterone	$149 + $39 per 28-day billing cycle	$564 for three cycles; a fourth $188 charge can process around day 84	Provider describes both as FDA-approved finished products
Inner Balance Oestra	$199/month for first six months	$597	Compounded final medication; not FDA-approved
Hers	Personalized price after assessment	Confirm during intake	FDA-approved finished medications; use in perimenopause may be off-label

The 28-day trap is real

Winona says 30-day treatment orders process every 28 days. That creates 13 billing cycles in a 364-day period, not 12. It also means a fourth charge can land around day 84 when someone thinks she is still comparing “three months.”

The annual arithmetic from the currently published product prices is:

Winona route	13-cycle annual arithmetic
Estrogen tablets + progesterone	$1,209
Combined compounded body cream	$1,157
Estradiol patch	$1,937
Estradiol patch + progesterone	$2,444

That is not a criticism of the treatment. It is the difference between reading “per month” as a calendar month and reading the company's actual processing interval.

The introductory-price trap is also real

Inner Balance currently publishes $199 per month for the first six months, then $99.50 per month for Oestra. That is:

First 90 days: $597
First six months: $1,194
First year: $1,791

Any comparison leading with only the later $99.50 number is showing you a price you do not reach for half a year.

What the numbers actually say

The woman who leaves Alloy because a $300 patch charge felt like too much can land on a higher recurring route without realizing it. Alloy is no longer the cheap patch it once appeared to be, but it can still be a low-cost oral-estrogen path. The exact answer changes with progesterone, insurance, pharmacy benefits and how many follow-ups your clinician requires.

If your real goal is a low care fee with medication sent to your own pharmacy, Wisp's $99 consult includes three months of care-team access, and the prescription can run through your pharmacy benefit if covered. We earn nothing from Wisp. See Wisp's current menopause consult.

Which Alloy alternatives actually bill insurance?

Midi, Gennev, MyMenopauseRx and Elektra publish direct insurance-billing pathways for eligible plans. Stella also has in-network care in some situations and offers a superbill when it is not in network. Wisp and Sesame separate the care transaction from the pharmacy transaction, while Alloy and Winona remain cash-pay for their provider-controlled programs.

Run three checks before paying anyone:

Is the visit in network? Ask about the exact clinician entity and service, not just the carrier logo.
Is the drug on your formulary? That is a separate pharmacy-benefit decision.
Is the pharmacy in network and is the exact product available? A covered drug can still become expensive at the wrong pharmacy or unavailable in the prescribed manufacturer and strength.

You should not have to become your own insurance analyst just to compare two menopause prescriptions. But right now, you do.

Midi Health

Midi says it is in network with most PPO plans nationwide. The published self-pay price is $250 for the initial visit and $150 for continued-care visits. It does not charge a mandatory membership fee, and prescriptions can be sent to your pharmacy.

Two federal-program rules matter:

Midi cannot treat Medicaid or Medi-Cal patients, even as self-pay patients.
Midi does not bill Medicare, but its current pricing page says Medicare beneficiaries may use Midi as self-pay patients and may not submit claims connected to Midi visits, medications or associated services.

That second sentence corrects an older, broader “no Medicare patients” description still repeated on comparison pages.

Gennev

Gennev's current self-pay doctor pricing is $250 initial and $199 follow-up, with 30-minute doctor appointments. Its plan lookup shows both in-network and out-of-network results, including multiple plan variants under the same carrier. That is why “Gennev takes Aetna” is not enough information; the exact plan name still controls.

Gennev states that it prescribes FDA-approved hormonal medication and does not prescribe compounded bioidentical hormones.

MyMenopauseRx

MyMenopauseRx lists $150 per self-pay virtual visit and names Aetna, Humana, Cigna, Blue Cross Blue Shield, TRICARE, UnitedHealthcare and Sana PPO among its in-network plans. It also says it does not accept Medicare, Medicaid or HMO plans.

Its FAQ is unusually honest about a point most clinics bury: the insurance-negotiated amount can be higher than the $150 self-pay fee when the deductible is unmet. Ask for the cash-versus-insurance comparison before the visit, not after the explanation of benefits arrives.

Elektra Health

Elektra publishes the broadest federal-plan route in this set, but it is not a national “takes Medicare and Medicaid” promise. It lists select Medicare and Medicaid plans in named states, alongside commercial plans. The self-pay price is $249 for a 30-minute initial visit and $149 for a 15-minute follow-up.

Check the exact plan and state before treating Elektra as the answer. For the woman whose plan is listed, it may be the only direct-billing telehealth door on this page. For the woman in a different state, it may be no door at all.

What Midi does not do, said plainly

Midi is a paid partner and the headline answer for the most common insurance exit. So you should hear the flaws from us first.

Midi's $250 self-pay first visit ties Gennev for the highest published front-door doctor fee in this comparison. It does not bundle medication. It cannot treat Medicaid or Medi-Cal patients, even when they want to pay cash. And a carrier logo never guarantees your specific plan will process the claim in network.

If the lowest published self-pay video fee is your priority, MyMenopauseRx is $150 and we earn nothing from that recommendation. If a select Medicare or Medicaid plan is the issue, Elektra is the route to verify first, and we earn nothing there either.

But Midi is the opposite of what many women are leaving: no mandatory membership, a scheduled video visit, a prescription sent to your pharmacy, and a plan-checking workflow built around commercial PPO coverage.

Does that sound like your situation? Check whether Midi accepts your exact plan →
Direct provider link. We do not currently earn a commission. Coverage and cost-sharing are decided by your plan.

Which Alloy alternatives prescribe testosterone for women?

Alloy does not offer testosterone. Midi, MyMenopauseRx and Elektra each publish a limited menopause-testosterone pathway, but none is a national over-the-counter shortcut. Testosterone is a Schedule III controlled substance in the United States, there is no FDA-approved testosterone product indicated specifically for women, and every route requires a prescription and clinical evaluation.

The DEA lists testosterone as Schedule III. State law, clinician licensing, controlled-substance rules, lab and follow-up requirements, and the product selected all affect access.

Provider	Published testosterone pathway	What that means in practice
Alloy	No	Its own knowledge base states it does not offer testosterone therapy
Midi	Compounded testosterone available in 25 published states	Medication is not FDA-approved; state eligibility, evaluation, monitoring and renewal visits apply
MyMenopauseRx	Direct prescribing for patients physically located in Illinois; outside Illinois it says it works with a local PCP to send the prescription and then manages care and dosing	Not a guaranteed prescription; the PCP must participate outside Illinois
Elektra	Some Elektra clinicians can prescribe testosterone to New York residents	State- and clinician-limited; requires a clinical appointment
Stella	Current FAQ does not present an established US testosterone pathway	Ask before booking if this is the only reason you would pay
Gennev	No current public pathway we could establish	Ask before booking; do not assume silence means yes or no
Wisp	Not published in the menopause consult	Do not pay expecting it
Sesame	Sesame says its online providers do not prescribe controlled substances	Testosterone is therefore not the route to choose there
Winona	No current testosterone product in the menopause treatment catalog we reviewed	Oestra's “conversion” marketing is not testosterone in the tube and Winona's DHEA is not a testosterone prescription
Hers	Not included in the published menopause kit	Do not pay expecting it

Midi deserves credit for labeling its menopause testosterone as compounded. That disclosure matters because the final product has not gone through FDA approval for safety, effectiveness and quality.

If testosterone is your blocker, do not start with a generic provider comparison. Check Midi's current state list and testosterone process, MyMenopauseRx's Illinois/PCP pathway, or Elektra's New York pathway before paying.
Midi link: direct provider link. A prescription is never guaranteed.

If none reaches you, use The Menopause Society's practitioner directory. We would rather send you to an in-person clinician than sell you a consultation that ends in “not available here.”

What if you only need vaginal estrogen?

If your symptoms are limited to vaginal dryness, burning, irritation, urinary symptoms or painful sex, you may not need a full systemic-hormone program. Local low-dose vaginal therapy and systemic hormone therapy answer different problems, and a comparison that treats them as interchangeable can push you into the wrong price and the wrong route.

The Menopause Society says that when only vaginal symptoms are present, low-dose vaginal hormone treatments are recommended. Systemic therapy is used at blood levels high enough to treat widespread symptoms such as hot flashes, while low-dose vaginal estrogen is directed at genitourinary syndrome of menopause.

A clinician decides whether you need local treatment, systemic treatment, both, or neither. A comparison page should not make that decision for you.

Option	Local vaginal route	Published cost structure
Alloy	Estradiol vaginal cream	$119.97 per published three-month supply + $49 one-time consult
Wisp	Menopause clinician can send an appropriate prescription to a local pharmacy	$99 consult and three months of care-team access; medication separate
Sesame	Published formulary includes estradiol vaginal products and prasterone	Program price shown during enrollment; medication at your pharmacy
Midi / Gennev / Elektra / MyMenopauseRx / Stella	Clinician may prescribe a local product when appropriate	Visit fee or insurance cost-sharing + pharmacy cost
Hers	Estradiol vaginal cream is one possible part of its kit	Personalized plan price after assessment

One genuinely useful cost point: a prescription sent to your pharmacy can use your pharmacy benefit even when the telehealth clinic does not bill insurance for the visit. The visit and the drug are two separate coverage decisions.

If local treatment is the only route you are trying to compare, use Find My HRT Path and choose the local-symptom path so systemic-program fees do not distort the answer.

Which alternatives include labs, and which offer a live video visit?

Alloy is a messaging-first model and does not publish an included lab panel or standard scheduled video visit. Midi, Gennev, MyMenopauseRx, Elektra and Stella publish live video care. Sesame uses video as needed and includes basic lab work when necessary; MyMenopauseRx can order medically indicated testing and sells self-order bundles starting at $49.

What the lab claims actually mean

More testing is not automatically better menopause care. MyMenopauseRx states that hormone testing is not required or recommended before treatment for a woman 45 or older with a typical symptom picture. Elektra similarly explains that fluctuating hormone levels during perimenopause can make a single measurement a poor guide to symptom treatment.

Labs still matter when a clinician is checking thyroid function, lipids, glucose, blood counts, metabolic health, medication safety or another possible cause of symptoms.

Sesame's included basic panel, when necessary, is not a “female hormone panel.” The current page describes basic labs, and its program materials identify tests such as a complete blood count, HbA1c, thyroid testing, a lipid panel and a comprehensive metabolic panel. Useful, yes. Proof of a menopause diagnosis from hormone levels, no.

MyMenopauseRx's self-order lab pricing currently starts at $49 for certain bundles, with other panels priced higher. “Labs for $49” is therefore accurate only as a starting point for a specific bundle, not a promise that every requested panel costs $49.

What a live visit changes

If what you wanted was to talk to a human being after years of being dismissed, video is not a cosmetic feature. It is the product.

Alloy's physician messaging can be fast and useful while the prescription is active. But it is not the same experience as a protected 30-minute appointment with a person looking back at you. That difference is worth paying for when conversation is the problem you are trying to solve — and wasted money when it is not.

Which Alloy alternatives use FDA-approved medication, and which use compounded medication?

FDA approval belongs to a specific finished drug, not to a telehealth company, ingredient, pharmacy registration or NDC number. Alloy, Midi, Sesame and Winona can span more than one lane depending on the exact prescription. Gennev and Elektra state that they use FDA-approved menopause medications rather than compounded alternatives.

The words are blurred constantly, and the blurring is not harmless.

FDA-approved finished drug: FDA reviewed the marketed product for safety, effectiveness and quality for its approved use.
Compounded drug: a pharmacy prepares a medication for an identified need. FDA does not approve compounded drugs before marketing, so it does not verify their safety, effectiveness or quality in the same premarket process.
Generic drug: an FDA-approved product under an abbreviated application. A compounded preparation is not an FDA-approved generic.
503B outsourcing facility: a facility category under federal compounding law. Registration is not approval of every compounded drug it makes.
Bioidentical: a description of molecular structure, not an FDA approval category. FDA-approved and compounded products can both be described with that word.
FDA-regulated: almost every legitimate drug business is regulated in some way. It does not mean the finished medication is FDA-approved.

And one correction that matters: an NDC number is not proof of FDA approval. FDA states that assignment of an NDC does not denote approval and that using it to create that impression is misleading. Compounded outsourcing-facility products can appear in NDC data.

To verify approval, ask for the exact product name, manufacturer, dosage form and strength, then check the product in FDA's Drugs@FDA or Orange Book records. The label and application record matter more than the presence of an NDC.

Where each option sits

Option	Verified medication lane
Alloy	Core menopause products in its current catalog — estradiol pill, patch, gel, spray and vaginal cream, progesterone and paroxetine — are presented as FDA-approved finished products. Other products in the wider catalog are compounded or used off-label.
Midi	Publishes FDA-approved hormone options and a separately labeled compounded Custom Rx line, including compounded menopause testosterone.
Gennev	States that it prescribes FDA-approved hormonal medication and does not prescribe compounded bioidentical hormones.
MyMenopauseRx	States that it prescribes FDA-approved estradiol and progesterone; testosterone access is a separate controlled-substance question.
Elektra	Says clinicians prescribe FDA-approved hormonal and nonhormonal medication and do not prescribe compounded or non-FDA-approved medication.
Stella	Exact prescribed product controls. Do not replace a product check with the phrase “FDA-regulated.”
Wisp	Menopause consult lists established prescription options filled at a local pharmacy; verify the exact product dispensed.
Sesame	Formulary lists FDA-approved products, but the exact prescription and pharmacy determine the final lane. Do not label the entire marketplace with one approval status.
Winona	Mixed by product. Its estradiol tablets, patches and progesterone capsules are provider-described FDA-approved finished products. Its body creams are compounded final medications and are not FDA-approved, even when ingredients meet USP standards or also appear in approved drugs.
Hers	Published kit uses FDA-approved finished medications; the company states that use for perimenopause can be off-label because those products are not FDA-approved specifically for the treatment of perimenopause.
Inner Balance / Oestra	Compounded estradiol-and-progesterone vaginal cream. The final medication is not FDA-approved.

ACOG's Clinical Consensus No. 6 states that compounded bioidentical menopausal hormone therapy should not be prescribed routinely when FDA-approved formulations exist. The Menopause Society's position statement also identifies safety concerns that include under- or overdosing, impurities, sterility, limited efficacy and safety data, and lack of a standardized risk label.

That does not make every compounded prescription illegitimate. It means “custom,” “503B,” “bioidentical,” “pharmaceutical grade” and “FDA-inspected” do not erase the regulatory difference.

What if you specifically want a compounded cream?

A compounded cream can be a deliberate choice when a prescriber identifies a patient-specific reason an FDA-approved finished product does not meet the need. Winona's combined body cream and Inner Balance's Oestra serve that lane. Neither final cream is FDA-approved, and neither should be sold to you as automatically safer, more natural or equivalent to an approved medicine.

Winona combined body cream

Winona currently lists its estradiol/estriol/progesterone body cream at $89 per 28-day billing cycle. It is applied to the body, not used as a vaginal cream. Winona's own page identifies it as compounded and also uses language suggesting that the active ingredients are FDA approved. The part that controls your decision is simpler: the finished compounded cream is not FDA-approved.

Inner Balance Oestra

Oestra is a compounded vaginal cream containing estradiol and micronized progesterone. The current price is $199 per month for six months, then $99.50 per month, with billing monthly and shipment every three months. The page says dose adjustments may create an additional cost.

Inner Balance markets Oestra as supporting testosterone “via conversion.” That is not a third hormone listed in the cream and it is not a testosterone prescription. Do not choose it expecting the controlled-substance pathway described in the testosterone section.

Oestra's marketing also makes strong safety, absorption, symptom-timeline and longevity claims. Those claims should not be treated as evidence that the finished compounded medication went through FDA approval. The provider's internal outcome percentages are not a substitute for product-specific randomized evidence.

The FDA-approved combined option is oral, not a custom cream

Bijuva is an FDA-approved oral capsule combining estradiol and progesterone. It is not a vaginal cream and does not erase the formulation gap a patient may be trying to solve. It does show why “no FDA-approved combined estradiol-progesterone product exists” is too broad; the accurate statement is that no FDA-approved finished product is equivalent to these custom combined creams in the same compounded formulation and route.

Ask these before paying

What exact patient-specific reason supports compounding instead of an available FDA-approved product?
Which pharmacy prepares the medication, and is it a 503A pharmacy or 503B outsourcing facility?
What hormones, concentrations, dose and route are on the prescription label?
What will the first six months cost, including dose changes?
Which follow-ups and labs are required, and what do they cost?
What happens if the product is not tolerated?
What evidence supports the exact route and combined regimen — not merely the individual ingredients?

What if you are on Medicare or Medicaid?

Elektra is the only provider in this comparison that publishes direct billing for select Medicare and Medicaid plans in named states. Midi does not bill Medicare but currently accepts Medicare beneficiaries as self-pay patients; it cannot treat Medicaid or Medi-Cal patients even as self-pay. MyMenopauseRx does not accept Medicare or Medicaid, and Sesame's terms include federal-beneficiary restrictions that must be checked before enrollment.

This is the shortest section on the page and the most important one for the women it applies to.

Elektra's route is plan- and state-specific

Elektra currently lists Medicare plans in states including New York, Connecticut, Massachusetts, Florida, Pennsylvania and New Jersey, and selected Medicaid plans in certain states. That list can change. The proper question is not “Does Elektra take Medicare?” It is:

“Is my exact plan in network for an Elektra menopause clinician while I am physically located in my state?”

If the answer is no, Elektra's self-pay price remains $249 initial and $149 follow-up.

Midi's Medicare rule is different from its Medicaid rule

Midi says Medicare beneficiaries can use Midi as self-pay patients but cannot submit claims related to Midi visits, medications or associated services. Medicaid and Medi-Cal patients cannot be treated, even as self-pay.

Do not collapse those two rules into “Midi takes no federal beneficiaries.” That statement is now wrong.

When no online route reaches you

If Elektra does not cover your plan and state, and self-pay Midi is not appropriate or affordable, the answer may be a local clinician who bills your plan. Start with The Menopause Society's Find a Menopause Practitioner directory. The Society makes clear that directory inclusion is not an endorsement, so verify credentials, plan status and new-patient availability yourself.

Which alternatives are available in your state — and at your age?

State availability is not one clean national map. It depends on where you are physically located during the visit, the clinician's license, the pharmacy, the exact medication, controlled-substance rules and your insurance network. Age gates are company policies, not automatic medical verdicts.

What is safe to publish today:

Midi presents nationwide commercial-insurance availability but applies separate state rules to compounded testosterone.
Gennev publishes menopause doctor care across all 50 states.
Wisp publishes menopause consult availability in all 50 states.
MyMenopauseRx publishes a named state list on its site rather than claiming all-state access.
Elektra has a narrower clinical footprint; coaching reaches farther than prescribing care.
Stella is designed for women ages 35–70 and uses a current eligibility flow.
Winona uses age and state eligibility gates. Run the live assessment instead of relying on an old state count copied by another site.
Hers says its menopause/perimenopause program is not available in all 50 states.
Alloy does not publish a complete state list; its terms say services may not be available where you are.

A rule is a line one business drew, not a verdict on you. If a company rejects someone because of age, geography or complexity, that does not decide whether treatment is medically appropriate. It decides whether that company will be the one to evaluate it.

We are not publishing a 50-row state table because six separate maps can change the answer:

Clinician licensing
Insurance network
Pharmacy licensing
Controlled-substance rules
Compounded-product restrictions
Lab-handling requirements

A clean green “available” box that ignores those layers looks useful until checkout proves it was not.

What do Alloy reviews actually tell you?

Alloy's Trustpilot page had roughly 3,900 reviews when checked in August 2026, and the platform showed that Alloy replied to nearly all negative reviews. The service themes are more useful than the score: customers repeatedly discuss response speed, shipment handling, order changes, cancellations and support when something goes wrong.

One verifiable recent service review said:

“Someone always gets back to me promptly to answer any questions or concerns that I have.” — Andrew, Trustpilot, July 2026

That is an individual customer's account on a public review platform. It is not independently verified by The HRT Index, not representative of every customer, and not evidence that a medication is safe or effective.

Trustpilot also showed negative reports involving order delays, product quantity, melted or heat-exposed medication, cancellation frustration and customer-service disputes. Alloy publicly replied to many of them. Those reports are signals to inspect the process, not proof that every shipment fails.

Midi publishes this access-focused testimonial on its own pricing page:

“Midi was so easy: I got a same day appointment and they took my insurance.” — Victoria W., displayed by Midi

That quote is provider-selected. It describes one access experience, not a guarantee of same-day availability or insurance coverage.

In February 2026, the National Advertising Division reported that Midi permanently discontinued challenged symptom-relief timing claims during an inquiry, so NAD did not review those claims on the merits. We do not repeat the discontinued numbers.

What reviews cannot prove

A review can tell you whether a package arrived, whether support replied and whether a cancellation felt easy. It cannot establish that hormone therapy is safe for you, that one formulation is clinically superior, or that someone else's symptom result predicts yours.

We did not use Alloy's internal symptom-relief percentage as independent evidence. We did not use Inner Balance's internal Oestra percentages as proof of comparative effectiveness. We did not invent a testimonial from a woman who switched away from Alloy.

How do you leave Alloy without a gap in medication?

Find your next processing date before canceling, confirm the next clinician or pharmacy can fill your exact product and strength, gather your records, and only then stop the subscription. Alloy has two separate deadlines — seven days for the subscription and five business days for a shipment — so “I canceled before it shipped” is not precise enough.

1. Find both Alloy deadlines

Log into your dashboard and write down:

The end of the current subscription period
The next shipment processing date
The date seven days before the subscription period ends
The date five business days before the shipment processes

Those are not necessarily the same calendar date.

2. Confirm the replacement before canceling

Ask the new clinician or pharmacy whether it can fill the exact medication, dose, route, manufacturer preference and quantity you use.

This matters more in August 2026 because ASHP lists an active estradiol transdermal-system shortage. The bulletin is manufacturer- and strength-specific: some products are available, some constrained and some on shortage. “Estradiol patches are in shortage” is too broad, but assuming every patch is interchangeable is also unsafe.

3. Get your records

Request your medication list, doses, start dates, prior changes, relevant labs and prescribing-clinician information. A new provider will make an independent decision, but a documented history reduces avoidable resets and duplicate work.

4. Use Alloy's prescription-transfer language

Alloy's current terms say you may request to transfer the prescription to a pharmacy of your choice. That can make the exit easier when the prescription itself remains clinically appropriate and the receiving pharmacy can fill it.

A transfer right is not a promise that every pharmacy will accept every prescription, that refills remain available, or that a controlled substance can move under the same rules. Confirm before relying on it.

5. Cancel after the replacement is secured

Ideally, you have confirmation from the new prescriber or pharmacy before stopping the old supply. Do not double-dose, overlap or change timing without clinician instructions. Save the cancellation confirmation and any shipment-pause confirmation.

6. Check the card once after the close date

Do it deliberately, not obsessively. If a charge appears, use the saved dates and confirmation in the support request.

Alloy's refund rule

Alloy's terms currently describe a refund request within 30 days after receiving the first shipment of each product. The consultation and other service fees are nonrefundable, and Alloy reserves the right to verify the basis of a request. Products are not physically returned for reuse, but that does not mean the stated first-shipment refund pathway disappears.

Want the calendar dates instead of rules? Use the Alloy Exit Planner inside Find My HRT Path to turn the next processing date into the seven-day subscription deadline, five-business-day shipment deadline and 30-day first-shipment refund window.

What do other Alloy-alternatives pages get wrong?

The most visible provider-owned Alloy-alternatives article we found is published by Inner Balance, the company that sells Oestra and ranks it first. Its current page includes multiple provider facts that do not match those providers' live pages, and several medical claims that overreach the cited evidence. That does not prove bad faith. It proves why provider-stated comparisons need a second source.

Claim on the provider-owned page	What the named provider or primary source currently says
Midi has a $99 monthly membership plus consultation fees	Midi says it has no mandatory membership. Self-pay is $250 initial and $150 continued care.
Midi accepts insurance in some states and has limited regional availability	Midi publishes commercial PPO coverage nationwide, subject to exact plan, and separately lists state limits for compounded testosterone.
Gennev consultations start at $275	Gennev's current doctor pricing is $250 initial and $199 follow-up self-pay.
Gennev has limited hormone options and emphasizes supplement sales	Gennev publishes 30-minute menopause-doctor care, FDA-approved hormonal and nonhormonal prescriptions, labs and dietitian support; it states that it does not prescribe compounded bioidentical hormones.
Winona is compounded-only and costs $80–$160 monthly	Winona's catalog is mixed: its tablets, patches and progesterone capsules are provider-described FDA-approved products, while creams are compounded. The patch is $149 and patch-plus-progesterone is $188 per 28-day cycle.
Evernow starts at $149 per month	Evernow presents more than one care structure; a pay-per-visit amount should not be relabeled as one universal monthly membership.
FDA-regulated compounding pharmacies ensure consistent potency and safety	FDA states that compounded products are not FDA-approved and are not reviewed premarket for safety, effectiveness and quality. Facility regulation does not approve the finished drug.
An NDC proves a drug is approved	FDA expressly says NDC assignment does not denote approval.

The compounding contradiction matters

That page reassures readers that FDA-regulated compounding ensures potency and safety, then criticizes Winona because compounded drugs can vary in potency and have less oversight than FDA-approved drugs. Oestra is itself compounded.

The point is not that no one may choose Oestra. The point is that the standard cannot change when the product belongs to the publisher.

The ELITE trial citation does not prove a cardiovascular benefit from vaginal progesterone

The provider-owned page says the ELITE trial demonstrated cardiovascular benefits from vaginal progesterone. ELITE tested the timing of oral estradiol after menopause against measures of atherosclerosis. Vaginal progesterone gel was used for endometrial protection in participants with a uterus; it was not the intervention credited with the trial's cardiovascular finding.

A later analysis of the vaginal-progesterone regimen found it did not fully oppose oral estradiol's endometrial effect. That is the opposite of a simple “cardiovascular benefit from vaginal progesterone” takeaway.

The action that protects you

Screenshot the price, billing interval, product name, approval claim, refund rule and cancellation deadline you rely on. Then verify the exact prescription with the provider that will write it. A comparison page — including this one — is a decision aid, not the contract you pay under.

Which medical claims should make you stop and call a clinician?

Two kinds of claim deserve more caution than a product page usually gives them: reassurance about postmenopausal bleeding and claims that every woman without a uterus still needs progesterone. Both can push a reader past the point where individual evaluation matters.

Postmenopausal bleeding

Bleeding can have benign explanations, including treatment-related spotting, but bleeding after menopause warrants prompt clinical evaluation. It should not be dismissed as proof that a product is “working” or that the body is simply rebalancing.

If you have unexpected bleeding, contact a clinician who can decide what evaluation is needed. A telehealth product FAQ cannot rule out the causes that require an examination, imaging or tissue assessment.

Progesterone after hysterectomy

A progestogen is used with systemic estrogen primarily to protect the endometrium in someone who has a uterus. The Menopause Society explains that a woman without a uterus can generally use estrogen therapy alone, while a woman with a uterus uses estrogen plus a progestogen for uterine protection.

There are individual reasons a clinician may discuss progesterone after hysterectomy. That is different from claiming that guidelines require it for cognitive or cardiovascular benefit in every woman without a uterus. Hormone therapy is not recommended as a treatment to prevent cognitive decline or cardiovascular disease.

What can you check for free before paying another provider?

Two useful doors cost nothing: the Menopause Mandate US advice line and any menopause benefit already attached to your employer or health plan. Neither replaces clinical care, but both can prevent an unnecessary consultation purchase.

Menopause Mandate US advice line

Menopause Mandate US publishes free 15-minute one-to-one video or phone appointments with Menopause Guides, offered in partnership with Alloy. The guide can listen to questions, suggest what to ask a doctor and help identify where to seek care.

It is not a prescribing appointment. It is a free human conversation before you decide where to spend money.

Employer and health-plan benefits

Some employers already offer menopause care through a health plan or a dedicated benefit. Midi publishes an employer-coverage pathway, and employer-sponsored platforms such as Maven may be available only through work or a health plan.

Check the benefits portal, call the plan, and search the employer's wellness or women's-health benefits before entering a credit card anywhere on this page.

Is your own clinician and pharmacy the cheapest Alloy alternative?

It can be. A local clinician who bills your plan and sends generic FDA-approved medication to an in-network pharmacy removes the telehealth program fee, the provider-controlled shipment and the subscription clock. But the cheapest theoretical route is worthless when no local clinician will prescribe or the next appointment is months away.

That is the real value online menopause clinics added: not a new molecule, but access to clinicians willing to evaluate menopause symptoms and manage treatment.

Use this route when:

You already have a primary-care clinician or gynecologist comfortable with menopause care.
Your plan covers the visit and the prescribed product.
You want freedom to compare pharmacies.
You do not need a bundled coaching, messaging or shipment program.

Use The Menopause Society's practitioner directory when you need a new clinician. Verify plan status and availability directly; the directory is not an endorsement.

If you want a provider you choose, video care, messaging, basic labs when needed and prescriptions sent to your pharmacy, Sesame is built around that model. Confirm the current program price and federal-beneficiary eligibility before checkout. See Sesame's current menopause program →
Paid partnership. Medication is not included in the program price.

If you want medication bundled and shipped with no separate visit fee, Winona is the clearest version of that model. Run the live age-and-state eligibility flow, read the 28-day billing interval, and identify whether the exact product is an FDA-approved finished medication or a compounded cream before paying. Check Winona's current eligibility and prices →
Paid partnership.

Frequently asked questions

Is there a cheaper alternative to Alloy?

Sometimes. MyMenopauseRx has a $150 self-pay video visit, Wisp has a $99 one-time menopause consult, and a local clinician plus an in-network pharmacy can be cheaper than a telehealth bundle. Alloy's oral estradiol alone remains inexpensive at $39.99 per month plus the $49 consult, but the complete total changes when progesterone or another product is prescribed.

Does Alloy take insurance?

Alloy says it does not bill or accept insurance directly for services or prescriptions. HSA/FSA eligibility and a possible out-of-network reimbursement are not the same thing as direct in-network billing. Ask your plan whether any itemized receipt is reimbursable before counting on it.

Does Alloy prescribe testosterone?

No. Alloy's knowledge base states that it does not offer testosterone therapy. Midi, MyMenopauseRx and Elektra publish limited pathways, each with state and clinical rules. Testosterone is Schedule III, requires a prescription, and no testosterone product is FDA-approved specifically for women.

Is Midi better than Alloy?

Midi is a better fit when you want a scheduled video visit, commercial PPO billing, a prescription sent to your pharmacy or access to its state-limited compounded-testosterone pathway. Alloy can be a better fit when you want a $49 one-time consult, medication shipped to your door and ongoing asynchronous physician messaging without repeated visit fees.

Is Winona cheaper than Alloy?

Not for most patch routes. Winona's patch is $149 per 28-day cycle, and patch-plus-progesterone is $188 per cycle. Alloy's current patch is $100 per month, billed three months at a time, while progesterone starts at $23 per month. Winona's oral tablets plus progesterone are closer, but the 28-day cycle creates 13 charges per year.

How do I cancel my Alloy subscription?

Use your account dashboard or the support process Alloy provides. Its terms require subscription cancellation at least seven days before the period ends and shipment cancellation or pause at least five business days before processing. Save the confirmation because those are separate deadlines.

Can I get a refund from Alloy?

Alloy's current terms describe a request within 30 days of receiving the first shipment of each product. Consultation and service fees are nonrefundable, and Alloy may verify the basis of the request. Read the current terms before relying on an older review.

Is Alloy FDA-approved?

Companies are not FDA-approved as a unit. Specific finished drugs are. Alloy's core menopause hormone catalog contains FDA-approved finished products, while parts of its wider catalog are compounded or used off-label. Verify the exact item prescribed.

Does Alloy require blood work?

Alloy's public process does not list required or included blood work for standard menopause prescribing. That is not automatically poor care: routine hormone-level testing is often unnecessary in women over 45 with a typical symptom pattern. A clinician may still need labs for other diagnoses, risk assessment or medication monitoring.

Can I transfer my Alloy prescription to my own pharmacy?

Alloy's terms say a patient may request transfer to a pharmacy of her choice. Confirm that the receiving pharmacy can accept and fill the exact prescription before canceling the shipment. Controlled substances, expired prescriptions, refill limits and pharmacy availability can create separate barriers.

Which online menopause providers take Medicare?

Elektra publishes in-network Medicare coverage for select plans in named states. Midi does not bill Medicare but says Medicare beneficiaries may use Midi as self-pay patients without submitting claims. MyMenopauseRx does not accept Medicare. Always verify the exact plan and state.

Which online menopause providers take Medicaid?

Elektra lists select Medicaid plans in certain states. Midi cannot treat Medicaid or Medi-Cal patients even as self-pay. MyMenopauseRx does not accept Medicaid. When no online clinic reaches your plan, use a local in-network clinician.

Will I have to start over with a new provider?

You will complete a new clinical intake because the new prescriber must make an independent decision. Bring your current medication name, strength, route, start date, prior dose changes, relevant labs and prescribing-clinician details. A complete record makes continuity easier but does not guarantee the same prescription.

Is Alloy available in my state?

Alloy does not publish a complete state list. Its terms say services may not be available in your state, and eligibility can differ by product. The intake or support team must confirm your current location and requested treatment.

Is an NDC number proof that a menopause drug is FDA-approved?

No. FDA expressly states that an NDC assignment does not denote approval. Verify the exact finished product, manufacturer, strength and dosage form through FDA approval records rather than treating the number alone as proof.

What we actually verified

Verified firsthand in August 2026:

Alloy's live catalog prices, including the current $100/month estradiol patch, $39.99 oral estradiol, $69.99 gel and spray, progesterone starting at $23, $119.97 three-month vaginal cream and $49 consultation.
Alloy's current testosterone statement, prescription-transfer language, refund limits, seven-day subscription deadline and five-business-day shipment deadline.
Midi's $250/$150 self-pay pricing, PPO positioning, Medicare self-pay rule, Medicaid/Medi-Cal exclusion and 25-state compounded-testosterone pathway.
Gennev's $250/$199 doctor pricing, 30-minute visits, plan lookup and no-compounded-hormone position.
MyMenopauseRx's $150 self-pay visit, insurance list, lab structure, Medicare/Medicaid exclusion and Illinois/PCP testosterone route.
Elektra's $249/$149 pricing, state-specific Medicare and Medicaid plan lists, FDA-approved-only prescribing statement and New York testosterone pathway.
Stella's $200/$90 self-pay pricing and age 35–70 positioning.
Wisp's $99 consult, three months of care-team access, medication-excluded structure and all-state availability.
Sesame's local-pharmacy model, medication-excluded price structure, video/messaging model and basic labs when necessary.
Winona's current product prices, 28-day processing interval and product-level FDA-approved-versus-compounded distinctions.
Hers' published medication kit, state limitation and off-label perimenopause disclosure.
Inner Balance's $199-for-six-months then $99.50 Oestra pricing, compounded formulation and dose-adjustment caveat.
FDA's compounded-drug and NDC guidance, DEA scheduling, The Menopause Society's systemic-versus-local guidance, ACOG's compounded-hormone consensus, ASHP's current patch-shortage bulletin and the Bijuva product route.

What we did not do: we did not complete an Alloy intake, execute a cancellation, inspect a shipment, submit an insurance claim, receive a prescription or establish a clinical relationship with any provider named here. Where a number can only be confirmed during intake or checkout, the page says so instead of guessing.

How we review providers: through The HRT Index Verification Standard — we read every published price, separate FDA-approved from compounded, verify state availability and insurance, and re-check on a fixed schedule: top providers monthly, the full roster quarterly. We evaluate on five pillars, in this order: clinical legitimacy, care quality, medication fit, price transparency, access. We do not publish numeric provider scores.

Corrections: prices, policies and availability change. Send us the current primary-source page when something is wrong; we will correct the article and update the verification date.

Primary sources

Still not sure which HRT program is right for you?

Find My HRT Path →

Educational research only. Not medical advice and not a substitute for a licensed clinician's evaluation. Prescription treatment requires an independent clinician to determine eligibility and the appropriate medication, route and follow-up. This page has not been medically reviewed by a clinician.

Keep comparing before you book

Read the full Alloy review, compare Alloy and Winona, or use Find My HRT Path to check whether online care fits your situation.

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