Elektra Health vs Midi Health: Which Menopause Provider Actually Fits You? (2026)

Introduction

Bottom line on Elektra Health vs Midi Health: for most women with commercial insurance, Midi Health is the better first choice — it works in all 50 states, takes most PPO plans, and costs $250 for a first visit or $150 for a follow-up without insurance. Choose Elektra Health if you have Medicare or Medicaid, want a built-in coach and community, or live in one of its 16 clinical-care states.

One line settles it for a lot of women: Elektra takes Medicare and Medicaid — Midi takes neither.We’ll show you exactly why that matters, what each really costs, and who each one is built for. No fluff. Just the answer.

Best for you, in one line

Not sure yet? Get your personalized action plan with The HRT Index’s Find My HRT Path tool →

Quick answer by your main question

Elektra vs Midi: find your fit in three questions

First, who we are — and why this isn’t one-size-fits-all

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.

Quick definition, since we’ll use it a lot: HRT(hormone replacement therapy, also called menopause hormone therapy) means adding back hormones — usually estrogen, often with progesterone — to ease menopause symptoms like hot flashes, night sweats, poor sleep, brain fog, and vaginal dryness. According to The Menopause Society, hormone therapy is the most effective treatment for hot flashes, night sweats, and vaginal symptoms of menopause.

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, your risk history, your insurance, and your state. Some situations belong with an in-person clinician first. Use Find My HRT Path to match your situation to the right provider →

Elektra Health vs Midi Health: the side-by-side comparison

Elektra Health and Midi Health are both menopause telehealth clinics with menopause-trained clinicians, FDA-approved hormone therapy, and insurance billing. The biggest split isn’t price — it’s coverage and care style. Midi wins on nationwide access and works with most commercial PPO plans; Elektra wins on Medicare and Medicaid, coaching, and community, and it’s strongest in New York.

Last verified: July 2026. Sources: Elektra Health FAQ, Midi Health pricing/menopause pages.

Editorial read: for most insured women who live outside New York, Midi is the more available, broader-scope choice. For women on Medicare or Medicaid, women who want a coach, or New Yorkers, Elektrais the better fit. That’s a conclusion from the data — not medical advice.

This is a lot to weigh. Want us to match your exact situation — state, insurance, symptoms, and whether online care even makes sense? Take Find My HRT Path →

Which provider is right for your situation?

Find yourself here:

Midi Health: best for insurance-covered care in all 50 states

Midi Health is a 50-state menopause telehealth clinic, in-network with most major PPO plans, serving more than 230,000 patients with menopause-trained clinicians. It prescribes FDA-approved hormone therapy in every common form, plus non-hormonal options, and treats the broader midlife picture. Cash-pay is $250 for a first visit; with in-network insurance you’ll typically owe a specialist copay.

Here’s what Midi does well. It’s the biggest name in the space — it reached a $1 billion valuation in early 2026 and has more than 500 clinicians. It’s available in all 50 states, which alone makes it the realistic pick if you live somewhere Elektra doesn’t reach yet. It’s in-network with most PPO plans, and it carries real trust signals: NCQA accreditation and LegitScript certification.

On medications, Midi prescribes FDA-approved hormone therapyin the form that fits you: estradiol patches, pills, gels, and creams, plus vaginal estrogen and progesterone. For hot flashes without hormones, it can prescribe options like fezolinetant (Veozah). One honest note on the clinicians: many are nurse practitioners rather than physicians, and you may not see the same person every visit. For standard menopause care that’s common and fine. If your case is complex, ask about clinician continuity up front.

What patients say: Midi holds about 4.0 out of 5 on Trustpilot from roughly 1,400 reviews — around three-quarters are 5-star — and the theme is consistent: women who’d been dismissed for years finally felt heard. (Individual experience, not a typical result.)

Want to see your real cost? Check whether Midi is in-network for your plan → (Low-commitment — you can confirm the price before your visit.)

See also: Full Midi Health review →

Elektra Health: best for Medicare, Medicaid, coaching, and New York

Elektra Health pairs board-certified, Menopause Society–certified clinicians with a Menopause Guide (a trained coach), a private community, and an education library — a support layer most clinics don’t offer. It prescribes only FDA-approved medications and doesn’t sell supplements. It was the first virtual menopause provider to accept Medicare and Medicaid, and it’s in-network for roughly 4 in 5 women in New York.

Elektra’s edge is the wraparound. Every patient gets a clinician anda Guide — Elektra calls them “menopause doulas” — who talks through your symptoms and care plan after your visit, helps you put it into action, and points you to vetted education and a community of thousands of women going through the same thing.

Two things set Elektra apart on trust. First, it prescribes only FDA-approved medications and says plainly it does not prescribe compounded or non-FDA-approved ones. Second, it deliberately doesn’t sell supplements— it may recommend them, but it doesn’t profit from them, which it frames as avoiding a conflict of interest.

In 2024, Elektra became the first virtual menopause care provider to accept Medicare and Medicaid, opening the door for women those plans usually leave stranded. It’s in-network for roughly 4 in 5 women in New York. It also co-built HelloMenowith Oscar Health — the first ACA marketplace plan designed around menopause, offering $0 visits, labs, and hormone therapy in 11 states.

Worth knowing before you commit: Elektra’s direct clinical care runs in 16 states(its coaches reach all 50), it’s a smaller operation than Midi, and portal messages can take 2–3 business days to answer. If you’re outside its 16 states, Midi is the more realistic option.

What patients say: 97% of Elektra patients say they’d recommend it to a friend or family member (Elektra’s own reviews). (Individual experience, not a typical result.)

On Medicare or Medicaid, or want a coach in your corner? Check whether Elektra lists your state and plan →

See also: Full Elektra Health review →

How much does Elektra Health vs Midi Health cost in 2026?

Cash-pay pricing is almost identical: Elektra is $249 for a first visit and $149 for follow-ups; Midi is $250 and $150. The bigger cost difference comes from insurance — whether your plan is in-network, your copay and deductible, plus labs and prescriptions. A compounded Custom Rx product at Midi is cash-pay and not billed to insurance.

So the $1 gap on visits? Ignore it. It won’t decide anything.

What will move your real cost:

• Is your plan in-network? This is the whole ballgame. An in-network visit might cost a $30 copay; an out-of-network one could cost full price. Confirm before you book.
• Prescriptions. FDA-approved hormones are usually covered by your pharmacy benefit. Compounded products — like Midi’s Custom Rx or its testosterone (from about $100 per 90-day supply) — are typically cash-pay and not covered.
• Labs. Coverage varies by plan. Ask whether labs are ordered and where.
• Follow-ups. Elektra says that once you’re on a stable dose, it asks to see you every 6 months. Fewer visits can mean lower ongoing cost.

A quick, important definition: compounded medications are custom-mixed by a pharmacy and are not FDA-approved— the FDA does not review compounded drugs for safety, effectiveness, or quality before they’re sold. That doesn’t make them useless; a clinician may have good reasons to use one. It just means “compounded” and “FDA-approved” are two different categories, and you deserve to know which you’re being prescribed.

The real question isn’t the sticker price — it’s your copay. Check whether Midi is in-network for your plan before you book →

See also: HRT cost in 2026: what to budget →

Insurance, Medicare, and Medicaid: which one takes your plan?

Both clinics bill commercial insurance, but they split sharply on government coverage. Midi does not bill Medicaid or Medicare at all — Medicare beneficiaries can only self-pay. Elektra accepts both Medicare and Medicaid through participating plans, and was the first virtual menopause provider to do so. For PPO members, both can work; confirm your exact plan.

Commercial / PPO plans

Midi is in-network with most PPO plans across the country. Elektra has around 40 payer partners and is especially strong in New York. Either way, your plan has to be in-network — check it first.

Medicare

Midi is not covered by Medicareor Medicare-related plans. Medicare beneficiaries can pay cash, but no claims get filed. Elektra accepts Medicare through participating plans. If you’re on Medicare, that’s a decisive point in Elektra’s favor.

Medicaid (and Medi-Cal)

Midi says it cannot treat Medicaid or Medi-Cal patients at this time, even as self-pay.Elektra accepts Medicaid through participating plans. If this is you, Elektra isn’t just the better choice — it may be the only one of the two that can see you.

ACA marketplace shoppers

If you buy your own insurance on the marketplace, look at HelloMeno — the plan Elektra built with Oscar Health. It offers $0 primary care, gynecology, and behavioral health visits, plus no-cost labs, hormone therapy, and bone-density scans, in 11 states: Arizona, Florida, Georgia, Iowa, Missouri, Nebraska, North Carolina, Ohio, Oklahoma, Tennessee, and Texas.Two bits of fine print: in North Carolina the care is delivered by Atrium Health, and in Florida it’s not available on certain AdventHealth HMO plans.

See also: Online HRT providers that accept insurance →

Which one can actually treat you in your state?

Midi has the clear access advantage — it’s available in all 50 states. Elektra provides direct clinical care in 16 states, though its Menopause Guides and community are available in all 50. If you live outside Elektra’s 16 clinical states, Midi is your realistic option; if you’re inside them, the decision moves to insurance, coaching, and medication preference.

Elektra’s 16 clinical-care states: New York, Connecticut, Massachusetts, Florida, Pennsylvania, New Jersey, Illinois, Arizona, Georgia, Iowa, Missouri, Nebraska, Ohio, Oklahoma, Tennessee, and Texas— and it’s still expanding. Its coaches, who provide non-clinical support (education, lifestyle, emotional support), can work with women in every state.

Outside those 16 states and need clinical care? Midi covers all 50. Check Midi’s availability in your state →

See also: Online HRT availability by state →

Do Elektra and Midi prescribe FDA-approved or compounded hormones?

Both prescribe FDA-approved hormone therapy for menopause — estradiol patches, pills, gels, creams, and vaginal estrogen, plus progesterone. Elektra prescribes only FDA-approved medications and no compounded ones. Midi also prescribes FDA-approved HRT, but it runs a separate compounded line (Custom Rx) and offers compounded testosterone, which are cash-pay and not FDA-approved.

• FDA-approved means the medication has been reviewed by the FDA for safety, effectiveness, and quality.
• Compounded means a pharmacy custom-mixes it. Compounded drugs are not FDA-approved, and the FDA does not review them for safety, effectiveness, or quality before they’re sold. The FDA has also said it has no evidence that compounded “bioidentical” hormones are safer or more effective than FDA-approved hormone therapy.

Compounded medicine can be the right call for some patients — for example, when someone can’t tolerate an FDA-approved option. The point isn’t that one is good and one is bad. The point is that they’re different things, and you should always know which one you’re getting.

Elektrakeeps it simple: FDA-approved hormonal and non-hormonal medications only, no compounded prescriptions. Prescriptions go to your preferred pharmacy, and Elektra doesn’t sell them directly.

Midi prescribes FDA-approved HRT for menopause, but it also runs Custom Rx— a separate compounded line. These are cash-pay because they aren’t commercially available from major drug makers and can’t be billed to insurance. If you don’t want anything compounded, ask your Midi clinician to keep you on FDA-approved medications — or start with Elektra.

Want FDA-approved-only care with no supplement upsell? See if Elektra covers your state →

See also: FDA-approved vs compounded HRT: what the difference actually means →

Which is better if testosterone or low libido is part of your question?

Midi is the stronger option for testosterone access— it offers a testosterone program in 25 states using a two-visit, lab-monitored process, from about $100 per 90-day supply. Elektra’s testosterone prescribing is limited, mainly to some New York clinicians. Two facts matter most: testosterone for women is prescribed off-label (there’s no FDA-approved testosterone made for women in the U.S.), Midi’s is compounded and not FDA-approved, and testosterone is a Schedule III controlled substance that requires a prescription and monitoring.

Midi frames its testosterone program around libido, mood, energy, and strength. But here’s the key fact: there is no FDA-approved testosterone product specifically made for women in the U.S. So when a clinic prescribes it for a woman, it’s off-label and, in Midi’s case, compounded — and Midi discloses plainly that its compounded testosterone is not FDA-approved. Testosterone is also a Schedule III controlled substance under federal law.

Midi’s process: it runs its testosterone program in 25 states (AZ, CA, CO, DC, DE, FL, IA, IL, IN, KS, MA, MD, ME, NC, NJ, NM, NV, NY, OH, OR, PA, TX, UT, VA, WA), and it requires a first menopause visit, lab work, and a second visitbefore any prescription. It checks bloodwork at the start, again at 4–6 weeks, then every 6–12 months. It doesn’t do pellets. The testosterone runs from about $100 per 90-day supply through Custom Rx and isn’t covered by insurance.

Elektra can prescribe testosterone through some clinicians, for New York patients, discussed during a clinical visit. So if testosterone is a top priority and you’re outside New York, Midi is likely your path.

Want to ask about testosterone? See if Midi’s program covers your state — then ask about labs, monitoring, and total cost → (Testosterone is prescription-only and requires clinician oversight.)

See also: Testosterone for menopause: online options, costs, and what to know →

Are Elektra Health and Midi Health legit?

Yes — both are real, established menopause telehealth companies with credentialed, menopause-trained clinicians. Midi carries NCQA accreditation and LegitScript certification and has served 230,000+ patients; Elektra’s clinicians are all certified by The Menopause Society, and it partners with major health plans across the country.

Credentials

Elektra’s clinicians are board-certified and Menopause Society–certified. Midi’s clinicians are menopause-trained, and the company holds NCQA accreditation and LegitScript certification — two independent seals that vet quality and legitimacy.

Reviews, read honestly

Midi’s ratings split by platform. On Trustpilot it holds about 4.0 out of 5 from roughly 1,400 reviews — around three-quarters are 5-star, with happy patients saying they finally felt heard. But roughly one in six reviews is 1-star, and on the Better Business Bureau Midi’s customer rating is around 1.2 out of 5, with about 140 complaints logged over three years (as of July 2026), billing being the most common. Midi still holds a “B” BBB rating, is BBB-accredited, and responds to most negative reviews. Elektra publishes fewer third-party reviews, but reports that 97% of its patients would recommend it, and its reviews lean heavily on feeling heard and supported.

One marketing note

In February 2026, BBB National Programs’ National Advertising Division (NAD) challenged a Midi Instagram post about how quickly most patients get relief, and Midi permanently discontinued the challenged claims. It doesn’t mean Midi’s care doesn’t work; it’s a reminder that no provider can promise the same result for every patient, and to weigh any “most patients feel better fast” marketing with a grain of salt.

How we verified this comparison

We built this using The HRT Index Verification Standard: read every published price, separate FDA-approved from compounded, confirm insurance and state availability against primary sources, and re-check on a fixed schedule. We evaluate every provider on five things, in this order: clinical legitimacy, care quality, medication fit, price transparency, and access.We don’t hand out star scores, and we don’t guess. This page is editorial research, not medical advice, and it isn’t reviewed by a clinician.

Two things we couldn’t fully pin down and that you should confirm at booking: each clinic’s exact in-network plans for yourspecific plan, and Midi’s current written cancellation policy.

See: The HRT Index methodology →

Who should NOT start with either online clinic?

Online menopause care is a great starting point for many women — but not for every situation. If you have unexplained vaginal bleeding, possible pregnancy, certain cancer histories, a history of blood clots, stroke, or heart attack, liver disease, or symptoms that may not be menopause at all, see an in-person clinician first.

Route yourself to in-person care first if any of these apply:

• Unexplained vaginal bleeding
• You might be pregnant
• A history of certain cancers, or you’re in active cancer treatment
• Prior blood clot, stroke, or heart attack
• Liver disease
• A new breast lump or an overdue screening (mammogram, Pap)
• Symptoms that could be something other than menopause
• Anything urgent or severe

Both clinics work virtually and will order labs when needed, and both coordinate with your in-person care — Midi’s clinicians work with you on things like Pap tests and mammograms, and Elektra says openly that it complements (but doesn’t replace) your local gynecologist or primary care and may refer you out when symptoms aren’t from menopause. That’s the honest boundary of telehealth, and a good clinic respects it.

Not sure whether online care is right for your situation? Find My HRT Path flags when you should see someone in person first →

If neither one feels right

Sometimes the honest answer is “neither.” If you want a flat monthly membership with hormones shipped to your door and no insurance paperwork, a direct-pay provider may suit you better than either Elektra or Midi. Our guide to the best online HRT providers lays those out — or let the quiz sort it for you.

Want a different kind of provider? Get matched to the model that fits you with Find My HRT Path →

Elektra Health vs Midi Health: which should you choose?

Your best choice comes down to four things: your state, your insurance, your medication preference, and whether testosterone or coaching matters. Decide on those — not on which brand is louder.

What to verify before you book either provider

Before you pay, confirm your state, your in-network status, your real visit cost, whether labs and prescriptions are covered, your medication route, the follow-up plan, and whether anything prescribed is FDA-approved or compounded. This prevents the most common surprise: a clinic that looks right online but doesn’t match your plan or your situation.

1. What state am I in, and does this clinic offer clinical care there?
2. Commercial insurance, Medicare, Medicaid, or self-pay?
3. Is my specific plan in-network? (Get it in writing.)
4. What’s my telehealth specialist copay? Have I met my deductible?
5. Are labs covered? Are prescriptions covered by my pharmacy benefit?
6. Do I want a patch, pill, gel, cream, or vaginal estrogen?
7. Do I have a uterus, and do I understand why progesterone matters if so?
8. Am I asking about testosterone? (Expect two visits, labs, and monitoring.)
9. Is anything being prescribed compounded or FDA-approved?
10. How often are follow-ups? What’s the cancellation policy?
11. What happens if I need an in-person exam?

Elektra Health vs Midi Health: frequently asked questions

Short version: Midi usually wins on nationwide access and commercial-insurance convenience, while Elektra wins for women on Medicare or Medicaid, women who want coaching, and those in its 16 clinical states. Below are the specific answers women ask most.

Is Elektra Health or Midi Health better?

Neither is better for everyone. Midi is better for broad, all-50-state access and commercial PPO insurance. Elektra is better if you have Medicare or Medicaid, want a coach and community, live in one of its 16 clinical states, or prefer FDA-approved-only care.

Is Midi Health available in all 50 states?

Yes — Midi is available in all 50 states. Insurance coverage and specific programs (like testosterone) still vary by state, so verify before booking.

Is Elektra Health available in all 50 states?

No. Elektra provides direct clinical care in 16 states (New York, Connecticut, Massachusetts, Florida, Pennsylvania, New Jersey, Illinois, Arizona, Georgia, Iowa, Missouri, Nebraska, Ohio, Oklahoma, Tennessee, and Texas); its coaching and community are available in all 50.

How much does Midi Health cost without insurance?

$250 for the first visit and $150 for follow-ups.

How much does Elektra Health cost without insurance?

$249 for the first visit and $149 for follow-ups. Coaching is $0 if your plan covers it, otherwise $99 per session.

Does Midi Health take Medicare?

No. Midi is not covered by Medicare or Medicare-related plans; Medicare beneficiaries can only self-pay, with no claims filed.

Does Midi Health take Medicaid or Medi-Cal?

No. Midi says it cannot treat Medicaid or Medi-Cal patients, even as self-pay.

Does Elektra Health take Medicare or Medicaid?

Yes, through participating plans. Elektra was the first virtual menopause provider to accept both Medicare and Medicaid, in 2024. Confirm your specific plan and state.

Does Elektra prescribe compounded hormones?

No. Elektra says it prescribes only FDA-approved medications and does not prescribe compounded or non-FDA-approved ones.

Does Midi prescribe compounded hormones?

Midi prescribes FDA-approved HRT and also runs a separate compounded Custom Rx line (cash-pay), plus compounded testosterone. Ask which category any prescription falls into.

Does Midi prescribe testosterone for women?

Yes, in 25 states, using a two-visit, lab-monitored process, from about $100 per 90-day supply. The testosterone is compounded and not FDA-approved, and testosterone is a Schedule III controlled substance requiring clinician oversight.

Does Elektra prescribe testosterone?

In a limited way — some clinicians can prescribe it for New York patients, discussed during a clinical visit.

Do I need labs before starting HRT?

It depends on your symptoms, history, and treatment. Midi’s testosterone program requires labs before prescribing and ongoing monitoring; for other treatments, both clinics order labs when appropriate. Confirm each clinic’s lab process during booking.

Can either clinic replace my gynecologist?

No. Elektra says it complements but doesn’t replace local gynecology or primary care, especially for exams and anything needing a physical evaluation. Midi coordinates in-person care like Paps and mammograms. Keep your in-person care.

What if I’m not sure whether I need systemic HRT or vaginal estrogen?

Use Find My HRT Path first. The right route depends on your symptoms, whether you have a uterus, your risk history, and your preferences — and the tool flags when you should see someone in person.

Sources

Last verified: July 2026. We re-check top providers monthly and the full roster quarterly.

1. Midi Health — Pricing & Insurance (joinmidi.com/pricing-insurance): $250/$150 self-pay; in-network with most PPO plans; not enrolled with Medicaid/Medi-Cal; not covered by Medicare (self-pay only, no claims); HSA/FSA accepted.
2. Midi Health — Menopause (joinmidi.com/menopause): available in all 50 states; FDA-approved HRT and forms; labs generally via Labcorp; coordinates Paps/mammograms.
3. Midi Health — Testosterone for women (joinmidi.com/testosterone): offered in 25 states; two-visit, lab-monitored process; compounded and not FDA-approved (Midi’s own disclosure); NCQA-accredited, LegitScript-certified.
4. Midi Health — Custom Rx / Store (joinmidi.com/store): compounded medications cash-pay; testosterone starting at ~$100 per 90-day supply.
5. Elektra Health — FAQ (elektrahealth.com/frequently-asked-questions): 16 clinical-care states; coaches in all 50; cash-pay $249/$149; coaching $0 if covered, else $99; follow-up every 6 months once stable; FDA-approved only, no compounded; recommends but doesn’t sell supplements; testosterone limited to NY; HSA/FSA accepted.
6. (Same as 1)
7. Elektra Health — For Health Plans (elektrahealth.com/for-health-plans): first virtual menopause provider to accept Medicare and Medicaid (2024); ~40 payer partners; in-network for roughly 4 in 5 women in New York.
8. Elektra Health — Reviews (elektrahealth.com/reviews): 97% of patients would recommend.
9. Oscar Health / Elektra Health — HelloMeno (hioscar.com/hellomeno; PRNewswire, Oct 2025): $0 menopause care in 11 states (AZ, FL, GA, IA, MO, NE, NC, OH, OK, TN, TX).
10. Trustpilot — Midi Health: ~4.0/5 from ~1,400 reviews; ~75% 5-star, ~16% 1-star (as of 2026).
11. Better Business Bureau — Midi profile: “B” rating; BBB-accredited; customer-review average ~1.2/5; about 140 complaints filed over three years (as of July 2026); complaints predominantly about billing.
12. U.S. FDA — Human Drug Compounding: compounded drugs are not FDA-approved; no evidence compounded bioidentical hormones are safer or more effective than FDA-approved hormone therapy.
13. The Menopause Society — 2022 Hormone Therapy Position Statement.
14. BBB National Programs / National Advertising Division (bbbprograms.org, Feb 25, 2026): Midi permanently discontinued challenged menopause-care advertising claims.
15. 21 CFR §1308.13 — testosterone is a Schedule III controlled substance.
16. Fierce Healthcare / public reporting (2026): Midi Health $1 billion valuation; 230,000+ patients; 500+ clinicians; NCQA accreditation.

Related reading