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By The HRT Index Editorial Team · Last verified:

The HRT Index is an independent comparison resource for HRT telehealth providers. This article is editorial research, not medical advice, and it was not reviewed by a clinician. Talk to a licensed provider before starting or stopping any treatment.

How we make money: We are not affiliated with Alloy or Evernow, they don't pay us, and our links to them earn us nothing — we cover them because you're comparing them. When neither one fits and we point you somewhere better, a few of those links may earn us a small commission at no extra cost to you. It never changes our verdict or what we verify.

Alloy vs Evernow: Which Menopause HRT Provider Fits You? (2026)

Alloy vs Evernow really comes down to one question most comparisons skip: are you using insurance, or paying cash?

Bottom line: pick Evernow if you want to use insurance — it works with UnitedHealthcare, Aetna, Anthem, and Blue Cross Blue Shield for video visits, and lets you fill most prescriptions through insurance at a local pharmacy. Pick Alloy if you're paying cash and want clear, upfront prices for FDA-approved hormones shipped to your door, with a one-time $49 doctor fee and no membership. Both are legit and certified. Both treat women across the U.S. Neither prescribes testosterone.

Two catches can cost you money if you miss them. Evernow's membership fee doesn't include your medication, and its clinicians may prescribe either FDA-approved orcompounded hormones — so you'll want to ask which. Alloy won't bill your insurance, and it asks for a recent mammogram before it will keep refilling your hormones. Both are covered below, along with the real first-90-day cost.


Alloy vs Evernow: the quick verdict

Alloy and Evernow are both real, certified, menopause-focused telehealth services. The main difference is how you pay: Evernow runs on a membership or a per-visit fee and can bill your commercial insurance, while Alloy charges a one-time $49 doctor fee plus clear cash prices for FDA-approved medication shipped to your door. Pick by how you want to pay and how much hand-holding you want.

Here's the whole decision in one screen:

If this sounds like you…Start with
I have UnitedHealthcare, Aetna, Anthem, or Blue Cross Blue Shield and want to use itEvernow
I'm paying cash and want to see exact prices before anything shipsAlloy
I want my meds at my own local pharmacy (CVS, Walgreens, etc.)Evernow
I want a one-and-done doctor visit, not a subscriptionAlloy ($49 consult) or Evernow pay-per-visit ($150)
I only want standard, FDA-approved hormones, nothing customAlloy
I have Medicare or Medicaid and need it coveredNeither — see insurance-friendly options
I want testosteroneNeither — see providers that offer it

Want the single-provider deep dives? Read our Alloy review and our Evernow review. This page is the head-to-head.

The one honest catch (read this before you pay)

Alloy will not bill your insurance. Not for the visit, not for the meds. If using your insurance card is the whole point for you, Evernow is the better choice, full stop.

But a lot of women pick Alloy because of that, not in spite of it. Because Alloy skips insurance, there are no claim denials, no prior-authorization waiting games, and no “surprise, that's not covered” letters. You see the exact price — $39.99 a month for estradiol pills, for example — before you ever approve a plan.


What will you really pay in the first 90 days?

For most common plans, the two land within a few dollars of each other when you pay cash. Alloy charges a one-time $49 doctor fee plus published prices (estradiol pills from $39.99/month, the patch from $74.99/month, progesterone from $23/month), billed every 3 months. Evernow charges a membership ($129 for 3 months is the cheapest short plan) plus medication billed separately — and that medication can run through your insurance. The cheapest option depends on your prescription and your insurer.

Why “first 90 days”? Because that's where the surprises hide. A price that looks small per month can land differently once you add the doctor fee, the medication, and the billing cycle. So we did the math, using each company's own current prices.

The True First-90-Day Cost Matrix (verified ):

Your planAlloy (cash pay)Evernow (3-month membership + meds)
Estradiol pill only$49 + (3 × $39.99) = $168.97$129 + (3 × $20) = $189
Estradiol patch only$49 + (3 × $74.99) = $273.97$129 + (3 × $55) = $294
Estradiol pill + progesterone$49 + 3 × ($39.99 + $23) = $237.97$129 + 3 × ($20 + $20) = $249
Estradiol patch + progesterone$49 + 3 × ($74.99 + $23) = $342.97$129 + 3 × ($55 + $20) = $354
Vaginal estrogen cream only$49 + $119.97 (3-month supply) = $168.97$129 + $40 (3-month supply) = $169

Alloy rows use Alloy's published cash prices. Evernow rows use the prices Evernow lists for home-delivered medication on its cheapest short membership. These are public examples, not a guaranteed checkout total — your real Evernow medication cost can drop to a copay with commercial insurance at a local pharmacy, or change on a high-deductible plan. If you have a uterus and take estrogen, you'll also need progesterone to protect your uterine lining. Prices verified .

The takeaway:


Which one works with your insurance?

Evernow works with major commercial insurance — UnitedHealthcare, Aetna, Anthem, and Blue Cross Blue Shield — for video visits, and lets you use insurance for most medications filled at a local pharmacy. It does not cover Medicare or Medicaid, and the membership fee itself isn't insurance-covered (though it can be HSA/FSA eligible). Alloy does not bill or accept insurance at all; you can ask your PPO for reimbursement after you pay, or use HSA/FSA funds.

Evernow + insurance

  • Video visits covered by UnitedHealthcare, Aetna, Anthem, and BCBS. Not covered? A visit is $150 self-pay.
  • You can fill most medications at your own local pharmacy and apply your insurance there.
  • Somemedications are cash-only through Evernow's mail-order partner pharmacies (GoGo Meds and Art of Medicine) and can't run through insurance.
  • No Medicare or Medicaid. The membership fee is on you, but HSA/FSA cards work for it.

Alloy + insurance

  • Alloy does not bill insurance for anything — services or prescriptions.
  • Many patients get partial reimbursement from a PPO plan after the fact, and HSA/FSA funds cover eligible Alloy charges.
  • Simple and predictable, but you carry the full price upfront.

If a low copay is the goal, Evernow is built for that. If your coverage isn't great anyway — or you're tired of fighting your insurer — Alloy's flat cash prices may actually be cheaper and far less annoying. Want the bigger picture? See our roundup of online HRT that works with insurance.


Which one has the hormones you want?

Both cover the core of menopause hormone therapy — estrogen to ease symptoms and progesterone to protect your uterine lining — plus vaginal estrogen for dryness. Alloy offers the widest menu of estrogen forms (pill, patch, gel, spray, vaginal cream). Evernow offers patch, pill, vaginal tablet and cream, progesterone, and non-hormonal options like Veozah. What's on the menu is similar; the big difference is whether a product is FDA-approved or compounded.

A quick word on terms. Estrogen is the hormone your ovaries make less of in menopause; replacing it eases hot flashes, night sweats, and vaginal dryness. Progesterone is added if you still have a uterus, to keep the uterine lining healthy. Body-identical (also called bioidentical) just means the hormone matches what your body used to make.

What Alloy prescribes

  • • Estradiol pill — $39.99/mo
  • • Estradiol patch — $74.99/mo
  • • Estradiol gel — $69.99/mo
  • • Evamist estradiol spray — $69.99/mo
  • • Micronized progesterone — $23/mo
  • • Vaginal estradiol cream — $39.99/mo
  • • Low-dose birth control pill (perimenopause option)
  • • Paroxetine — $34.99/mo (non-hormonal hot-flash option)

What Evernow prescribes

  • • Estradiol patch
  • • Estradiol pill
  • • Vaginal estradiol tablets
  • • Vaginal estrogen cream
  • • Progesterone
  • • Norethindrone (alternative uterine protection)
  • • Veozah (fezolinetant) — prescription non-hormonal option for hot flashes
  • • Paroxetine — non-hormonal option

Neither prescribes testosterone.Why? It's a regulatory issue, not a quality one — there is no FDA-approved testosterone product for women, and testosterone is a Schedule III controlled substance requiring a prescription and ongoing monitoring. See the “skip both” section below if that's your main goal.


Are Alloy and Evernow FDA-approved or compounded?

Alloy's menopause hormone therapy is FDA-approved — standard, body-identical estradiol and progesterone from regular pharmacies. Evernow prescribes those same FDA-approved options too, but its own hormone-therapy page also says clinicians may prescribe compounded bioidentical formulations, which are not FDA-approved. So before you approve an Evernow plan, ask one question: “Is my exact prescription FDA-approved or compounded?”

FDA-approved

The medicine was tested and cleared by the U.S. FDA for safety, quality, and effectiveness. It comes with a standard label and a standard dose.

Compounded

A pharmacy mixes a custom version for one patient. Compounded drugs are notFDA-approved — the FDA does not check their safety, quality, or effectiveness before they're sold. They're made by licensed pharmacies under state oversight and have a real place in care, but they are not the same category as an FDA-approved drug.

Hormone optionAlloyEvernow
FDA-approved estradiol (patch, pill, gel, spray)YesYes (patch, pill)
FDA-approved vaginal estrogenYes (cream)Yes (cream and tablets)
FDA-approved progesterone for uterine protectionYes (micronized progesterone)Yes (progesterone and norethindrone)
Compounded bioidentical hormonesNot in its hormone therapyMay be prescribed

Compounded drugs are not FDA-approved, and the FDA does not verify their safety, quality, or effectiveness before they're sold.

Alloy keeps its hormone therapy to FDA-approvedproducts. If you want standard, well-studied hormones and total clarity about what you're getting, that's the simpler path. Evernow gives clinicians the option to prescribe a compounded bioidenticalformula when they think it fits. That can be a plus if you want a custom dose or form — but it's not FDA-approved, so you should know which one you're being offered. Neither approach is “bad” — they're different. Just don't approve a plan without knowing which bucket your prescription is in.

Want the full breakdown? Read our guide to FDA-approved vs compounded HRT.


How do they actually work day to day?

Alloy is built for low-effort, async care: a 3-minute questionnaire, a menopause-trained doctor who reviews it, a plan, and free shipped medication, with unlimited messaging once you buy. Evernow is built for flexibility: pick a membership (unlimited messaging plus optional video visits) or a single $150 visit, and get meds by mail or at your local pharmacy. Hate phone calls and pharmacies? Alloy feels easier. Want a live video visit or your own pharmacy? Evernow wins.

Alloy, step by step

  1. 1.Fill out a short health assessment (about 3 minutes).
  2. 2.Get matched with a doctor certified by The Menopause Society — Alloy says its consult doctors have held that certification for over 10 years.
  3. 3.Review your plan and prices, and approve what you want.
  4. 4.Meds ship free to your door, billed every 3 months. Buy a prescription and get unlimited messaging with your doctor.

No video visits — it's message-based. For a lot of women, that's the appeal.

Evernow, step by step

  1. 1.Choose your path: membership or a one-time visit.
  2. 2.Answer health questions (membership) or book an insurance-eligible video visit (pay-per-visit).
  3. 3.Get matched with a menopause-trained clinician licensed in your state and approve your plan.
  4. 4.Choose home delivery or your own local pharmacy. Switch anytime.

Often books video visits within 24 hours; messages usually answered within a day.

Bottom line: want video and your own pharmacy? Evernow. Want to never think about it again after you order? Alloy.


The catches people miss before they pay

The biggest Alloy catches: it asks for an updated mammogram before it will keep refilling menopause hormones, it doesn't bill insurance, and its fees are non-refundable. The biggest Evernow catches: the membership fee doesn't include your medication, there's no Medicare or Medicaid, and you should confirm whether your prescription is FDA-approved or compounded. Knowing these upfront saves money and frustration.

We read the fine print so you don't have to.

Alloy — what to watch for

  • Mammogram required for ongoing care. An updated mammogram is required to get a recurring menopause hormone prescription. A doctor may approve a one-time fill without it, at their discretion. Responsible screening — but if you're overdue, it adds a task before you can stay on treatment.
  • No insurance billing — as covered above.
  • Billed every 3 months. You buy a quarter at a time, so each charge is bigger than the monthly sticker price.
  • Fees are non-refundable, product refunds are first-shipment-only. The $49 consult and membership fees are non-refundable. Product refunds are limited to your first shipment of each item within 30 days. Cancel at least 7 days before your subscription period ends; skip a shipment at least 5 business days ahead.
  • Switching to your own pharmacy is limited. Non-weight prescriptions can transfer only after you've had an active subscription with at least one order — and if you transfer, you must cancel your Alloy subscription.
  • No testosterone, and not for emergencies.

Evernow — what to watch for

  • Membership ≠ medication. Your membership buys the care relationship. The drug is billed separately. Always add both when you compare.
  • No Medicare or Medicaid.
  • FDA-approved or compounded? Confirm which your prescription is before you approve it.
  • Watch the plan length at checkout.Some reviewers were charged for a full year when they thought they'd picked a smaller plan, and others were billed after they meant to cancel. Read the term before you confirm and screenshot the offer.
  • No testosterone.

A fair note on billing complaints: every subscription service collects some, and Alloy gets them too. The fix is the same for both — know your billing cycle, and cancel before the next charge if it's not working.


Who should choose Alloy

Choose Alloy if you're paying cash, want to see exact prices before you commit, like a one-time $49 doctor fee, prefer simple message-based care with free home delivery, and want only standard FDA-approved hormones. It's the cleaner, more predictable option for self-pay shoppers who don't need insurance billing or a live video visit.
Don't make Alloy your first stop if you need insurance billed, you want a live video visit, you want your own pharmacy from day one, or you need testosterone or Medicare/Medicaid coverage.

A trust note: Alloy's Chief Medical Advisor is Dr. Sharon Malone, MD, FACOG, MSCP — a board-certified OB/GYN and certified menopause specialist. Its co-founders and co-CEOs, Anne Fulenwider and Monica Molenaar, built it after their own frustrating menopause experiences. Alloy is LegitScript-certified and follows guidelines from The Menopause Society and ACOG.


Who should choose Evernow

Choose Evernow if you have commercial insurance and want to use it, you'd like the option of a live video visit, you want to fill prescriptions at your own pharmacy, or you prefer flexible membership or pay-per-visit care. It's the better fit for insured women and anyone who wants more clinician contact than a message thread.
Don't make Evernow your first stop if you want one flat all-in price that includes medication, you need Medicare/Medicaid, or you dislike membership and annual-prepay billing.

A trust note:Evernow's care comes from a network of board-certified, Menopause Society–certified clinicians and medical advisors. It was founded by Dr. Alicia Jackson, a PhD scientist from MIT and former DARPA deputy director, and built on its 2021 Menopause Study of more than 40,000 women. Evernow is LegitScript-certified and follows ACOG and The Menopause Society guidelines.


Who should skip both Alloy and Evernow

Skip both — for now — if you need testosterone, you have Medicare or Medicaid, or you have a medical history that needs in-person evaluation. These aren't knocks on either company; they're simply outside what a lightweight menopause telehealth service should be your first choice for.

You want testosterone.

Neither Alloy nor Evernow prescribes it. There is no FDA-approved testosterone product made for women, and testosterone is a Schedule III controlled substance in the U.S. — which means a prescription is required and ongoing monitoring is part of responsible care. See our guide to providers that offer testosterone for women →

You have Medicare or Medicaid.

Evernow doesn't cover them and Alloy doesn't bill insurance, so you'll likely pay full price either way. See HRT options that work with insurance →

Your health history needs a closer look.

If you have unexplained vaginal bleeding, a history of breast or other estrogen-sensitive cancer, a past blood clot, stroke, or heart attack, active liver disease, or another high-risk factor, hormone therapy may not be safe for you, or it may need in-person care and labs first. Please talk to a doctor who can examine you.

Still weighing more than these two? Our Midi vs Alloy vs Winona vs Evernow comparison covers the wider field.


What do real reviews say?

On Trustpilot, Alloy (myalloy.com) holds a 4.3 out of 5 from about 3,669 reviews, with 77% five-star and roughly 9% one-star. Evernow's Trustpilot page is small and skews negative — about 2.0 from a dozen reviews — while its app store rating sits near 4.0 from about 28 ratings. Treat reviews as a clue about the experience — billing, shipping, responsiveness — not as proof a treatment will work for you.

Alloy reviewer patterns

Most often praise how easy sign-up is and how fast doctors reply. The complaints cluster around the subscription — auto-renewals, an occasional unexpected charge, and a shipping mix-up — plus a few skin reactions to the cosmetic creams. Alloy replies to 100% of its negative reviews, usually within two days.

Evernow reviewer patterns

Positive reviewers talk about feeling heard and finally having a doctor they can reach. Critical reviews echo the billing catch above — most often the annual-charge surpriseand trouble stopping the membership. Evernow's public third-party footprint is thinner, which is exactly why we don't lean on a tiny star average to judge it.

Testimonials describe individual experiences. They are not evidence that hormone therapy is safe or effective for any specific person, and results vary.


Is one safer than the other?

Neither company is “safer” in a blanket sense, because hormone therapy safety depends on you — your age, how long since menopause, your health history, and the hormone, dose, and form you use — not on which website you order from. Both use licensed, menopause-trained clinicians and follow ACOG and The Menopause Society guidelines.

What the medical consensus says: The Menopause Society and ACOG agree that hormone therapy is the most effective treatment for hot flashes and night sweats and for the genitourinary symptoms of menopause (vaginal dryness, irritation, and related urinary issues). For many healthy women under 60, or within 10 years of menopause, the benefits outweigh the risks. But it's not for everyone.

One difference worth repeating: Alloy's hormone therapy is FDA-approved, while Evernow may prescribe FDA-approved orcompounded formulas. Compounded drugs aren't FDA-reviewed for safety, quality, or effectiveness, so if you're offered one, that's a good moment to ask your clinician why it's the right fit for you.

Hormone therapy may not be appropriate if you have unexplained vaginal bleeding, a history of breast or other estrogen-sensitive cancer, a prior blood clot, stroke, or heart attack, active liver disease, or a high risk of blood clots. If any of those apply, that's a conversation for a doctor who can evaluate you directly.

Don't choose based on a “safety score.” Choose the model that fits your life, then let a qualified clinician confirm the specific plan is right for you.


How we verified this comparison

We built this page from each company's own pricing pages, help centers, terms, and FAQs, then checked the medical claims against the FDA and The Menopause Society. We separated hard facts (prices, policies) from our opinions (who fits whom) so you can see exactly what's sourced.

✅ What we actually verified ():

  • Prices:Alloy's $49 consult fee and current medication prices; Evernow's $49/$129/$420 membership tiers, $150 self-pay visit, and listed medication prices — all from the companies' own pages.
  • States:Evernow's FAQ states it serves all 50 states plus D.C. Alloy's terms say its services may not be available in every state, so it confirms your state during intake.
  • Insurance:Evernow lists UnitedHealthcare, Aetna, Anthem, and Blue Cross Blue Shield for video visits, with no Medicare/Medicaid; Alloy's help center confirms it does not bill insurance.
  • Mammogram & cancellation:Both confirmed in Alloy's help center and terms — updated mammogram for recurring hormone scripts; cancel at least 7 days before renewal; non-refundable service fees.
  • Medications:Alloy's menopause hormone therapy is FDA-approved. Evernow lists FDA-approved options and says clinicians may prescribe compounded bioidentical formulations. The FDA says compounded drugs are not FDA-approved.
  • Reviews: Pulled live from Trustpilot and the App Store.

What we did not do: We didn't test the medications or audit the pharmacies. Final prices, coverage, and eligibility depend on your prescription, plan, and state. Prices and policies change, so we re-check this page every month.

We're The HRT Index — an independent comparison resource for HRT telehealth providers. We're not paid by Alloy or Evernow. When a different provider fits you better, we'll say so, even though we earn nothing on these two.


Alloy vs Evernow FAQ

Is Alloy or Evernow cheaper?
For cash payers, they’re close. Alloy’s estradiol-pill path runs about $168.97 for the first 90 days ($49 consult plus three months at $39.99). Evernow’s cheapest short plan is $129 for 3 months plus medication, about $189 total for the pill at its listed price. Evernow can be cheaper overall if you use commercial insurance, since visits and most local-pharmacy medications can run through your plan, which Alloy cannot do.
Does Alloy take insurance?
No. Alloy does not bill or accept insurance for services or prescriptions. Many patients get partial PPO reimbursement after paying, or use HSA/FSA funds. You pay the full price upfront.
Does Evernow take insurance?
Yes, for video visits, with major commercial plans: UnitedHealthcare, Aetna, Anthem, and Blue Cross Blue Shield. You can also use insurance for most medications filled at a local pharmacy, though some are cash-only through Evernow’s partner pharmacies. Evernow does not cover Medicare or Medicaid, and the membership fee is not insurance-covered, but it is HSA/FSA eligible.
Are Alloy and Evernow available in my state?
Evernow says it serves all 50 states plus Washington, D.C. Alloy’s terms note its services may not be available in every state, so it confirms your state during its quick intake. Check eligibility there before you start.
Are Alloy and Evernow FDA-approved or compounded?
Alloy’s menopause hormone therapy is FDA-approved, using standard estrogen and progesterone from regular pharmacies. Evernow prescribes those FDA-approved options too, but its hormone-therapy page also says clinicians may prescribe compounded bioidentical formulations, which are not FDA-approved. The FDA does not verify the safety, effectiveness, or quality of compounded drugs before they are sold, so ask whether your exact prescription is FDA-approved or compounded before approving the plan.
Does Alloy require a mammogram?
Yes. Alloy’s help center says an updated mammogram is required for a recurring menopause hormone prescription. A doctor may approve a one-time fill without one, at their discretion.
Does Evernow require lab work?
Only for select medications. Evernow says it requires labs case by case and can arrange them if needed. Common menopause hormone therapy is usually based on symptoms and history.
Can I get my prescription at my local pharmacy?
With Evernow, yes — you can choose your local pharmacy and apply insurance there, or get home delivery. With Alloy, home delivery is the default; transferring to a local pharmacy is limited, requires an active subscription with at least one order, and means canceling your Alloy plan and giving up perks like unlimited doctor messaging.
Does Alloy or Evernow prescribe testosterone?
No. Neither prescribes testosterone. There is no FDA-approved testosterone product for women, and testosterone is a Schedule III controlled substance that requires a prescription and ongoing monitoring. If you want it, look for a provider set up to prescribe and monitor it.
Can I cancel Alloy or Evernow anytime?
Both let you cancel, but the rules differ. Alloy bills and ships every 3 months; to stop a renewal, cancel at least 7 days before your subscription period ends (by email or in your dashboard), and to skip a shipment, ask at least 5 business days ahead. Alloy’s consult and membership fees are non-refundable, and product refunds are limited to your first shipment within 30 days. Evernow is a membership managed in your account, and prepaid plans are paid through that term. With either, cancel before the next charge and screenshot the confirmation.
Which is better for perimenopause?
Both treat perimenopause — the years of changing hormones before periods fully stop. Alloy also offers a low-dose birth control pill some perimenopausal women use; Evernow offers non-hormonal options and insurance-eligible visits. Match by your symptoms and how you want to pay.

Still deciding?

Both Alloy and Evernow are legitimate, women-built, menopause-specialized services with real clinical leadership. You're not choosing between “good” and “bad” — you're choosing between cash-simple, FDA-approved-only (Alloy) and insurance-flexible, more options (Evernow). Pick the one that matches how you want to pay and how much contact you want, then let the clinician confirm your plan.

Related reading: Full Alloy review · Full Evernow review · Midi vs Alloy vs Winona vs Evernow · HRT providers that take insurance · Testosterone for women: providers that offer it


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