Alloy vs Gennev: Which Online Menopause Clinic Fits You in 2026?

Introduction

Alloy vs Gennev really comes down to one question: do you want a predictable cash price with your medication shipped to your door, or a live video visit you can try to run through insurance? For most women paying cash, Alloy is the simpler, more predictable choice — about $273.97 for your first 90 dayson the estradiol patch, with progesterone included free if you have a uterus and everything mailed to you. Gennev is built for women who’d rather have a scheduled 30-minute appointment with a doctor and may be able to use insurance for the visit. There’s one detail almost every other page gets wrong — and it changes the math.

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.

Which provider fits you best?

Alloy vs Gennev at a glance

Here’s the short version. Every number under it is sourced and dated further down.

Sources: Alloy (myalloy.com product, consult, and terms pages); Gennev (gennev.com and help.gennev.com pricing, insurance, and policy pages). Verified June 2026. Full notes at the end.

Editorial links — we earn no commission from either.

The right provider isn’t the same for every woman

The right online HRT provider isn’t 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 can’t 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 isn’t the right starting point — before your first consult.

Not sure which model fits your insurance and your symptoms?
→ Take Find My HRT Path — it’s free and takes about a minute.

Is Alloy or Gennev cheaper?

Honestly? It depends on you — and anyone who says one is flatly cheaper is guessing.Alloy’s “$74.99/month” is the price of the patch, billed three months at a time, with progesterone free in the standard combo. Gennev’s visit fee is just that — the visit — and your medication is a separate charge at your own pharmacy, which your insurance may or may not cover. Those are two different ways of paying, so the cheaper one flips depending on your plan and which medication you’re prescribed.

So we stopped guessing and did the math both ways. We pulled the published prices, split the visit cost from the medication cost, and built the first-90-day total for each. That’s below — and it’s the kind of thing a quick AI summary can’t do for yoursituation, because it doesn’t know your plan.

We use 90 days on purpose. Alloy bills in 3-month cycles, so 90 days is exactly one billing event — the real amount that leaves your account first.

What you’d actually pay with Alloy

Alloy publishes its prices, which makes this easy to pin down. The patch is $74.99 a month, sold as a 3-month supply. If you have a uterus, progesterone is typically prescribed alongside estradiol to protect the uterine lining — and Alloy includes it free when it’s paired with an estradiol prescription. (On its own, progesterone is listed separately at $23/month.)

Alloy patch price and $49 consult verified on Alloy’s site, June 2026. Free-progesterone-with-estradiol confirmed across independent 2025–2026 reviews, including firsthand testing. The pill is reported at roughly half the patch price; confirm the exact figure during intake.

A few honest notes. The patch is the example here because its price is clearly published; it isn’t necessarily the most common plan. A pill-based plan costs less. Local vaginal estrogen (for genitourinary symptoms like dryness, irritation, painful sex, and some urinary symptoms) is cheaper still — but it is nota stand-in for whole-body hormone therapy. That’s a clinical decision, not a price decision. And Alloy doesn’t bill insurance, so this is your real out-of-pocket number. One real-world heads-up from testers: Alloy says shipping takes about 5–7 days, but some orders have taken closer to two weeks, so don’t count on overnight relief.

What you’d actually pay with Gennev

Gennev’s cost has two parts, billed by two different places: the visit (billed by Gennev) and the medication (billed by your pharmacy).

Gennev self-pay visit prices verified on Gennev’s site and support center, June 2026(support center lists $199 for a new visit and $149 for an established visit; some Gennev service pages list $250 and $199 — confirm your exact price at booking). Generic medication prices per GoodRx and drug-pricing guides; your cost depends on the drug, dose, pharmacy, and coverage.

Here’s the takeaway most women need. Alloy’s number includes three months of medication. Gennev’s visit fee does not — the medication is separate. So with cheap generic medication, a self-pay Gennev first quarter can land in a similar ballpark to Alloy, but the total is less predictable because the drug price isn’t set until you fill it. And with an in-network plan, Gennev can be much cheaper than Alloy, since you’d pay only copays for the visit and the medication.

Not sure which model fits your insurance and your symptoms? → Take Find My HRT Path — it’s free and takes about a minute.

Can you actually use insurance with Alloy or Gennev?

Alloy does not bill or accept insurance for visits or prescriptions, though you can usually pay with HSA/FSA funds and some PPO plans may reimburse you afterward. Gennev can bill in-network insurance for the visit, and because it sends prescriptions to your own pharmacy, your separate drug benefit may cover the medication too. Those are two different coverage questions, and mixing them up is the most common mistake women make here.

Let’s make it simple.

With Alloy, insurance is out of the picture.You pay Alloy directly. The upside is the price is low and you know it up front. The downside is you can’t run it through your plan. You can usually use HSA/FSA dollars, and some PPO members submit the receipt for partial reimbursement — but that isn’t guaranteed, so don’t bank on it.

With Gennev, there are two coverage checks:

1. The visit. If your plan is in-network, Gennev bills your insurance and you pay your copay, coinsurance, or deductible. Gennev runs an eligibility check, collects the estimated amount before your visit, then bills the rest to your insurer. One honest caution: that pre-visit amount is an estimate. After your insurer processes the claim, you may get a statement for a remaining balance.
2. The medication.Gennev sends your prescription to your local pharmacy, so the drug is covered — or not — by your pharmacy benefit, just like any prescription from any doctor.

So the real Gennev edge is this: with the right in-network plan, bothyour visit and your medication can run through insurance. The catch is which plans count. Gennev’s support center currently says it’s in-network for commercial Aetna plans and is working to add more, and other Gennev pages reference additional carriers. Because that list is changing, don’t trust a third-party article (including older versions of this one) — check Gennev’s live insurance lookup for your exact plan.

“Insurance accepted” is not the same as “this will only cost my copay.” Check the visit benefit and the pharmacy benefit before you book.

One honest limitation — and what to do about it. Gennev only helps your wallet if your plan is one it’s actually in-network with, and that list is short and changing. If your plan is on it, that’s a real edge. If it isn’t, Gennev’s self-pay visits plus separate medication costs can add up, and Alloy’s flat ~$74.99/month patch may serve you better. But if using insurance for both your visit and your medication matters most to you, there’s a third option worth comparing: Midi Health, a menopause-specialist telehealth practice that accepts many major commercial plans and sends FDA-approved prescriptions to your pharmacy.

Disclosure: Midi is a provider The HRT Index has an affiliate relationship with, so we may earn a commission if you start care there. We earn nothing from Alloy or Gennev — those are plain editorial links. We mention Midi here only because it answers the exact gap this section describes.

Need more detail on getting HRT covered? See our HRT benefits and risks guide and the non-hormonal options overview.

Are Alloy and Gennev legit?

Both are legitimate, clinician-led menopause services with real credentials — neither is a supplement shop in disguise.Alloy is a LegitScript-certified telehealth platform whose prescribers are physicians with menopause certification from The Menopause Society. Gennev is a virtual menopause clinic and part of Unified Women’s Healthcare, a large national women’s-health network. The difference is style, not legitimacy.

One thing to ask either provider directly: continuity. If seeing or messaging the sameclinician every time matters to you, confirm how each handles that before you start — neither markets itself as a one-doctor concierge practice.

What can Alloy and Gennev actually prescribe?

Both prescribe FDA-approved hormone therapy, so there’s no compounded-versus-FDA-approved gap to navigate on the hormone side.Alloy publicly lists FDA-approved estradiol in several forms — patch, pill, gel, spray, and vaginal — plus micronized progesterone, but it does not prescribe testosterone. Gennev prescribes FDA-approved hormonal and non-hormonal options, filled at your pharmacy.

A quick but important label. Neither Alloy nor Gennev is itself “FDA-approved” — companies don’t get FDA approval, medications do. Both prescribe specific drugs that are FDA-approved. This matters because some telehealth brands use compounded hormones, which are mixed by a pharmacy and are notFDA-approved; the FDA doesn’t review compounded drugs for safety, effectiveness, or quality before they’re sold, and they shouldn’t be described as equivalent to, safer than, or more natural than approved products. On the menopause hormone side, both Alloy and Gennev lean on FDA-approved drugs.

Worth noting for accuracy: Alloy’s broadercatalog does include some compounded non-hormone products, like certain weight-care items — so “Alloy is FDA-approved only” would be wrong at the company level. The menopause hormones it prescribes are FDA-approved. Gennev’s support center has previously said it doesn’t prescribe compounded hormones, but that note is a few years old — reconfirm it at your visit if it matters to you.

A word on risk. Hormone therapy isn’t right for everyone. Depending on the type, it can carry risks including blood clots, stroke, and certain cancers, and a personal or family history of those conditions changes the picture. That’s exactly what the intake and a clinician’s review are for — and it’s one reason some women should start with an in-person clinician rather than any online service. See our full HRT benefits and risks guide.

Alloy’s wider menu also covers a non-hormonal hot-flash prescription, prescription skincare, hair-thinning treatment, sexual-health options, and a separate weight-care program. The one gap to flag: no testosterone.If you’re asking specifically about testosterone, know that it’s a Schedule III controlled substance, no testosterone product is FDA-approved for women in the U.S., and professional guidance limits its evidence-based use to properly evaluated postmenopausal women with hypoactive sexual desire disorder — not general libido, energy, mood, or “brain fog.” That’s a conversation for a qualified clinician.

Gennev’s medication details are less public.Gennev clearly prescribes FDA-approved hormonal and non-hormonal medication when appropriate, but it doesn’t publish a route-by-route price list the way Alloy does — because your medication comes from your own pharmacy. That’s not a knock on quality; it just means you confirm the exact drug and price during your visit and at the pharmacy.

Looking for the best online estradiol patch providers? We break those down separately, or use our non-hormonal options guide if you’re exploring alternatives to hormone therapy.

How do you get care — and your medication?

With Alloy, you complete an online intake, a doctor reviews it (Alloy advertises under 12 hours; plan on 1–2 business days), and approved medication ships to your door from a partner pharmacy in a 3-month supply. With Gennev, you book a 30-minute video visit (usually within a week), and any prescription is sent to your local pharmacy to pick up. One is built around delivery and messaging; the other around a live visit and your own pharmacy.

Labs and screening

Alloy says it does notrequire bloodwork to start or continue treatment, and it doesn’t order labs — which removes a common hurdle. But “no labs” isn’t “no requirements”: consistent with standard hormone-therapy guidance, Alloy asks for an up-to-date mammogram to keep you on hormone therapy longer-term (a one-time fill may be possible at the prescriber’s discretion), so have that handy or confirm the current rule at intake. Gennev’s specific lab and screening policy isn’t published clearly, so confirm that at your visit. Don’t assume one provider’s policy matches the other’s, or what someone said in a forum.

Are Alloy and Gennev available in my state?

Gennev says video visits are available in all 50 states and every ZIP code. Alloy says it’s licensed to prescribe in all 50 states plus DC.In practice, both are effectively nationwide for menopause care — but availability and, for Gennev, insurance coverage still depend on your state and plan, so confirm yours at signup.

A quick note: Gennev being available in your state is a separate question from whether your insuranceis in-network there. And some unrelated Alloy programs (like weight care) have their own state limits that don’t apply to its hormone-therapy service. Check your state in the signup flow rather than assuming.

How do Alloy and Gennev cancellation rules differ?

Their cancellation “gotchas” are very different: Alloy bills in 3-month cycles, so you cancel before your next cycle processes, while Gennev charges a $100 fee if you cancel or reschedule a visit within 24 hours. Knowing each one before you pay saves money and frustration.

So who should choose Alloy, and who should choose Gennev?

Choose Alloy if you’re paying cash and want a predictable price with medication delivered. Choose Gennev if you want a live visit and your plan is one it’s in-network with. If your plan isn’t, compare Midi. And if you’re not sure online care is even the right starting point, use the matching quiz first.The right answer follows your situation, not anyone’s payout.

How we compared Alloy and Gennev

This is a documentation review, done under The HRT Index Verification Standard: read every published price, separate FDA-approved from compounded, verify state availability and insurance language, and re-check on a fixed schedule (top providers monthly, the full roster quarterly). We evaluate every provider on five things, always in this order — clinical legitimacy, care quality, medication fit, price transparency, and access — and we never invent numeric scores. We did not sign up, complete an intake, or test cancellation ourselves; where that kind of firsthand detail comes from testers, we say so.

• Clinical legitimacy: Licensed prescribers, prescription required, named clinical leadership. Alloy: LegitScript-certified, physician care, MSCP-credentialed clinicians, CMO Dr. Sharon Malone. Gennev: menopause-trained OB-GYNs, part of Unified Women’s Healthcare, CMO Dr. Rebecca Dunsmoor-Su.
• Care quality: Alloy: secure messaging, free while your prescription is active. Gennev: live 30-minute visits, plus dietitians, health coaches, and mental-health referrals.
• Medication fit: Both lean FDA-approved for hormones. Alloy publishes its menu (no testosterone); Gennev prescribes via your pharmacy.
• Price transparency: Alloy publishes flat medication prices. Gennev publishes visit prices (though its own pages differ — $199 to $250 self-pay initial), and medication prices come from your pharmacy.
• Access: States, speed, delivery vs. local pharmacy, insurance, cancellation — covered above.

What we actually verified

Verified from current public sources (June 2026):

• Alloy’s $49 consult and $74.99/month patch, billed as a 3-month supply
• Alloy includes progesterone free when paired with an estradiol prescription ($23/month on its own)
• Alloy does not accept insurance and does not prescribe testosterone
• Alloy is licensed in all 50 states + DC and is LegitScript-certified
• Gennev’s self-pay visit prices ($199–$250 initial, $149–$199 follow-up across its pages) and 30-minute visit length
• Gennev’s support center lists commercial Aetna as in-network and says more carriers are coming; prescriptions go to your pharmacy
• Gennev’s $100 cancel/reschedule-within-24-hours fee and nationwide availability

Calculated by The HRT Index:

• Alloy’s ~$273.97 first-90-day total for the patch-plus-progesterone plan
• Gennev’s self-pay vs. insured cost scenarios
• The visit-cost vs. medication-cost breakdown

Not verified, or true only for your situation:

• The exact medication you’ll be prescribed
• Your final insurance responsibility and any balance after the claim
• Your local pharmacy’s price for a given drug
• Gennev’s full, current in-network carrier list and route-by-route formulary
• Gennev’s current lab/screening policy and its current compounded-medication policy
• Whether Gennev’s initial self-pay visit is $199 or $250 on your booking page today

We re-check Alloy’s pricing monthly and Gennev’s quarterly, and update the “Last verified” date when we do. If you spot something out of date, see our transparency policy.

What women say about Alloy and Gennev

Patient reviews can tell you whether women felt heard, understood the billing, and liked the visit and pharmacy experience — they can’t tell you a medication is effective or safe, so we keep those separate.

“Heard and seen.” — One Gennev patient, in a review published on Gennev’s website, described feeling heard and seen by a provider she found knowledgeable and compassionate.

Alloy vs Gennev: frequently asked questions

Is Alloy or Gennev cheaper?

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There’s no universal winner. Alloy’s patch-plus-progesterone plan is about $273.97 for the first 90 days, medication included and shipped. Gennev’s self-pay first visit is $199–$250 (its pages differ) before medication, which you fill separately — but with an in-network plan, you may pay only copays, which can beat Alloy.

Does Alloy take insurance?

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No. Alloy doesn’t bill or accept insurance for visits or prescriptions. You can usually pay with HSA/FSA funds, and some PPO members seek partial reimbursement, but that isn’t guaranteed.

Does Gennev take insurance?

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Gennev is in-network with a limited, growing list of plans (its support center currently lists commercial Aetna) for the visit. Your medication is filled at your own pharmacy, where your separate drug benefit may also cover it. Check Gennev’s live insurance lookup for your exact plan.

How much does Alloy cost per month?

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About $74.99 a month for the estradiol patch, billed as a 3-month supply, after a one-time $49 consult. Progesterone is included free when paired with estradiol. A pill-based plan costs less.

How much does Gennev cost?

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Self-pay doctor visits are listed at $199–$250 for the first visit and $149–$199 for follow-ups, depending on which Gennev page you check — confirm at booking. Medication is billed separately at your pharmacy. With an in-network plan, you pay your copay or coinsurance instead.

Does Alloy require bloodwork?

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No. Alloy says lab testing isn’t required to start or continue treatment and it doesn’t order labs. It does ask for an up-to-date mammogram to continue hormone therapy longer-term, so confirm that at intake.

Does Alloy prescribe testosterone?

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No. Alloy does not offer testosterone as part of its hormone therapy. Note that no testosterone product is FDA-approved for women in the U.S., and it’s a controlled substance that requires a clinician’s evaluation.

Does Gennev prescribe HRT?

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Yes. Gennev’s menopause-trained doctors prescribe FDA-approved hormonal therapy when appropriate, along with non-hormonal options, filled at your pharmacy.

Which one has live video visits?

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Gennev. It offers scheduled 30-minute video appointments with a doctor. Alloy is messaging-based — there’s no scheduled video visit, but you get unlimited messaging while your prescription is active.

Where does each fill my prescription?

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Alloy ships medication to your door from a partner pharmacy and can’t send a brand-new prescription to your local pharmacy. Gennev sends prescriptions to the local pharmacy you choose.

Which is faster to start?

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Alloy may start faster for some women — it advertises connecting you with a doctor in under 12 hours, though planning on 1–2 business days is safer. Gennev advertises a video visit within about a week.

Are Alloy and Gennev available nationwide?

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Effectively, yes. Gennev says it covers all 50 states and every ZIP code. Alloy says it’s licensed in all 50 states plus DC. Confirm your state at signup.

How do their cancellation rules differ?

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Alloy bills in 3-month cycles, so cancel before your next cycle processes; the consult fee isn’t refundable and products generally can’t be returned. Gennev charges a $100 fee to cancel or reschedule a visit within 24 hours.

Which is better if I have insurance?

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Gennev, if your plan is one it’s in-network with — but that list is short and changing, so verify yours. If it isn’t, Midi accepts many major plans and is worth comparing.

What if neither one clearly fits me?

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Use Find My HRT Path. It compares care models for your situation and flags when online care may not be the right first step — without diagnosing you or deciding your treatment.

Still not sure which HRT program is right for you? Take our free 60-second matching quiz →

Sources

Commercial facts verified from current public provider pages. Medical and regulatory facts taken from primary sources. Verified June 2026.

Last verified: June 2026. Alloy pricing re-checked monthly; Gennev quarterly. Dates updated when re-verified.

• Alloy: myalloy.com/solutions/estradiol-patch, /drconsult, terms of use, help center — $74.99/month patch, $49 consult, free progesterone with estradiol, no insurance, no testosterone, all 50 states + DC, LegitScript-certified, partner pharmacies (Curexa, Blend, Gogo).
• Gennev: gennev.com (how-gennev-works, patient-resources, insurance-pricing) and help.gennev.com — $199–$250 self-pay initial visit, $149–$199 follow-up, commercial Aetna in-network, prescriptions to your pharmacy, $100 cancel/reschedule-within-24-hours fee, 48-hour intake, nationwide availability. gennev.com
• Generic medication pricing: GoodRx and Drugs.com — generic estradiol tablets often under ~$30/month with a discount card; patches vary.
• HRT indications and risk: The Menopause Society; FDA estradiol labeling (DailyMed).
• Testosterone: Schedule III; none FDA-approved for women; HSDD-limited evidence — The Menopause Society.
• Compounded drugs not FDA-approved: FDA, human drug compounding Q&A.
• Midi (affiliate) accepts many major commercial plans: MenoHello (2026), Flow Space (2026).

The HRT Index is the independent menopause–HRT decision layer for women. This page is editorial research (documentation review), not medical advice, and was not medically reviewed by a clinician. FDA-approved and compounded medications are always labeled distinctly. Prices and policies change — we verify on a fixed schedule and date every page. Always confirm current details with the provider before you pay.